Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test

BackgroundAlthough the Six-Minute Walk Test (6MWT), as recommended by the American Thoracic Society, is widely used as a measure of functional endurance, it may not be applicable in some settings and populations. We sought to examine, therefore, performance over the first 2 minutes and the full 6 minutes of the 6MWT. Specifically, we investigated completion rates, distances walked, test-retest reliability, and the relationship between distances walked over the first 2 and the full 6 minutes of the 6MWT.MethodsCommunity-dwelling children and adults age 3-85 years (n = 337) were asked to walk back and forth on a 15.24 meter (50 ft) course as far as possible without running over a 6 minute period. Test completion and the distance covered by the participants at 2 and 6 minutes were documented. The reliability of distances covered at 2 and 6 minutes was determined by retesting a subsample of 54 participants 6 to 10 days later. The relationship between distances covered at 2 and 6 minutes was determined for the 330 participants completing the 6MWT.ResultsAll 337 participants completed at least 2 minutes of walking, but 7 children less than 5 years of age ceased walking before 6 minutes had elapsed. For the remaining 330 participants the mean distance walked was 186 meters at 2 minutes and 543 meters at 6 minutes. The distances covered at 2 and 6 minutes were reliable between sessions (intraclass correlation coefficients = 0.888 and 0.917, respectively). The distances covered over 2 and 6 minutes were highly correlated (r = 0.968).ConclusionsThe completion rate, values obtained, test-retest reliability, and relationship of the distances walked in 2 and 6 minutes support documentation of 2 minute distance during the 6MWT. The findings also provide support for use of a Two-Minute Walk Test as the endurance component in the Motor Battery of the NIH Toolbox

Health literacy and public health: A systematic review and integration of definitions and models

<p>Abstract</p> <p>Background</p> <p>Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy.</p> <p>Methods</p> <p>A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model.</p> <p>Results</p> <p>The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively.</p> <p>Conclusions</p> <p>Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.</p

Influence of undergraduate experience on alumni loyalty to their alma mater in the Tanzania’s higher education context

This study examined the influence of undergraduate experience on alumni loyalty to their alma mater in Tanzania’s higher education context. Specifically, the study sought to examine the extent to which alumni are satisfied with their undergraduate academic and social experiences and the influence thereof on their loyalty towards their former universities or colleges. The study involved a questionnaire survey to collect primary data from a conveniently selected sample of 188 Tanzanians who had bachelor's degrees from various Tanzania universities and colleges. Descriptive statistics using mean values were used to measure the satisfaction level. To estimate the influence of alumni satisfaction with their undergraduate experience on loyalty to their alma mater, Binary Logistic Regression Model was used. Overall, the findings indicate that alumni were satisfied with their undergraduate experience and their time as students. Further, Binary Logistic Regression results indicate that satisfaction with undergraduate experience positively and significantly influences alumni loyalty to their alma mater. It is reasonable to conclude from this evidence, that alumni loyalty can be created, reinforced and retained through favorable students’ experiences. Thus, Tanzania’s Higher Education Institutions (HEIs) should improve their level of students’ experience so as to increase their level of satisfaction and consequently enforce their loyalty. The study adds value in the context of Tanzanian HEIs since it provides a base on how to determine strategies to create, reinforce and maintain alumni loyalty through a favorable student experience

Influence of undergraduate experience on alumni loyalty to their alma mater in the Tanzania’s higher education context

This study examined the influence of undergraduate experience on alumni loyalty to their alma mater in Tanzania’s higher education context. Specifically, the study sought to examine the extent to which alumni are satisfied with their undergraduate academic and social experiences and the influence thereof on their loyalty towards their former universities or colleges. The study involved a questionnaire survey to collect primary data from a conveniently selected sample of 188 Tanzanians who had bachelor's degrees from various Tanzania universities and colleges. Descriptive statistics using mean values were used to measure the satisfaction level. To estimate the influence of alumni satisfaction with their undergraduate experience on loyalty to their alma mater, Binary Logistic Regression Model was used. Overall, the findings indicate that alumni were satisfied with their undergraduate experience and their time as students. Further, Binary Logistic Regression results indicate that satisfaction with undergraduate experience positively and significantly influences alumni loyalty to their alma mater. It is reasonable to conclude from this evidence, that alumni loyalty can be created, reinforced and retained through favorable students’ experiences. Thus, Tanzania’s Higher Education Institutions (HEIs) should improve their level of students’ experience so as to increase their level of satisfaction and consequently enforce their loyalty. The study adds value in the context of Tanzanian HEIs since it provides a base on how to determine strategies to create, reinforce and maintain alumni loyalty through a favorable student experience

Identification of Dynapenia in Older Adults Through the Use of Grip Strength t- Scores

OBJECTIVE: To generate reference values and t-scores (1.0 to 2.5 standard deviations below average) for grip strength for healthy young adults and to examine the utility of t-scores from this group for the identification of dynapenia in older adults. DESIGN: Secondary analysis of cross-sectional grip strength data from the NIH Toolbox norming sample. SETTING: Population-based general community sample. PARTICIPANTS: Community dwelling adults, between the ages 20 and 40 years (n=558); and 60 to 85 years (n=390) MAIN OUTCOMES MEASURES: Grip strength measured with a Jamar plus dynamometer. RESULTS: Maximum grip strengths were consistent over the 20–40 year age span. For men they were 108.0 lbs (S.D. 22.6). For women, they were 65.8 lbs (S.D. 14.6) Comparison of older participant grip strengths to those of the younger reference group revealed (depending on age strata) that 46.2–87.1% of older men and 50.0–82.4% of older women could be designated as dynapenic on the basis of t-scores. CONCLUSION: The use of reference value t-scores from younger adults is a promising method for determining dynapenia in older adults

Relative Reliability of Three Objective Tests of Limb Muscle Strength

If measures of muscle strength are to be broadly applied, they should be objective, portable, quick, and reliable. Through this component of the NIH Toolbox study we sought to compare the test-retest reliability of 3 tests of muscle strength that are objective, portable, and quick: the five-repetition sit-to-stand test (FRSTST), hand-grip dynamometry (HGD), and belt-stabilized hand-held dynamometry (BSHHD) of knee extension. Three sets of each test were performed- 1 warm-up and 2 maximal. Measures from the maximal tests obtained 4 to 10 days apart were compared. Reliability was described using descriptive statistics, intraclass correlation coefficients (ICCs) and 4 measures of response stability: standard error of measurement (SEM), method error (ME), coefficient of variation of SEM (SEM(CV)), and coefficient of variation of variation of ME (ME(CV)). The ICCs of all tests were good (≥ 0.853). Measures of response stability showed less variability between test and retest for FRSTST and HGD than for BSHHD. In conclusions all 3 tests demonstrated good test-retest reliability. However, greater differences would need to be observed between tests sessions to conclude that a real change had occurred in measures obtained by BSHHD

Preparedness and Mutuality Affect Quality of Life for Patients With Mechanical Circulatory Support and Their Caregivers

BACKGROUND: Clinical and US regulatory guidelines for patients with mechanical circulatory support (MCS) require the identification of a caregiver to assist with MCS care. There is limited understanding of the impact of MCS caregiving on patients and caregivers. The purpose of this study was to examine how living with MCS affects the quality of life (QoL) of patients and their caregivers through the lens of preparedness and mutuality. METHODS AND RESULTS: The sample included 30 MCS patients and their caregivers. Semistructured qualitative interviews about factors contributing to QoL were conducted with patients and caregivers and analyzed using a 2-phase thematic process. Caregiving impacts QoL of MCS patients and their caregivers long term. When there was limited time to engage in decision-making about MCS implantation, people entered MCS caregiving relationships naive to its full demands. Although most people adjusted to the task demands, MCS caregiving had a significant impact, both positive and negative, on interpersonal relationships. We applied the concepts of preparedness and mutuality to help frame the understanding of the emergent themes of forced choice, adjustment, gratitude, relationship change, strain, and burden (both caregiver and patient perceived). Availability of networks of support was identified as a crucial resource. CONCLUSIONS: MCS caregiving affects QoL for both patients and caregivers. Specifically, preparedness, mutuality, and availability of supportive networks influence QoL of MCS patients and their caregivers. Caregiving relationships change over time. Long-term support by the MCS clinical team can help ensure that physical and emotional needs of MCS patients and caregivers are identified and addressed