Functional Assessment of Heart Failure Patients

Heart failure (HF) is the condition characterized by the inability of the heart to pump sufficient blood to meet the demands of the body. It has been well established that both the prevalence and incidence of HF is increasing.1 There are 2 primary types of HF, categorized by ejection fraction: Reduced ejection fraction and preserved ejection fraction.2 Additionally, HF is commonly classified into stages from mild to severe using a symptom-based scale related to functional limitations. One of the hallmark features of HF is exercise intolerance, which is accompanied by symptoms of fatigue and shortness of breath.3 As the disease progresses, patients experience a downward spiral as these symptoms typically result in reduced physical activity, which leads to progressively worsening exercise intolerance. Typically, patients with HF are faced with what can be termed a functional disability. Often, their reduced functional abilities restrict or may even prevent them from performing occupational tasks, which may result in loss of work. Additionally, it is well known that patients with HF experience impairment in the ability to carry out activities of daily living and suffer from reduced quality of life. The objective of this paper was to provide an overview of assessments of functional ability of patients with HF. Two categories of assessment are reviewed: Cardiovascular function and muscular function. The review includes procedural guidance on how to administer the assessments and information related to the advantages and disadvantages of each method. Because both HF types (reduced ejection fraction and preserved ejection fraction) are characterized by exercise intolerance, the procedures can be used effectively with either type of HF

An analysis of the relationship of selected eye-hand factors to success in eye-hand skill

Thesis (Ed.D.)--Boston University

The Relationship between Reading Fluency, Writing Fluency, and Reading Comprehension in Suburban Third-Grade Students

The topic of reading fluency is of great importance in education today. Research has shown a significant positive relationship between reading fluency and reading comprehension. However, little is known about writing fluency and its connection with reading comprehension. The purpose of this study was to examine the relationships between reading fluency, writing fluency, and reading comprehension. First, using the principles of assessing reading fluency, I designed a writing assessment and measured the writing fluency of 54 3rd graders. I examined the writing assessments as they related to the students\u27 reading fluency and reading comprehension scores. Secondly, I performed a quasi-experimental scientific study with 3rd grade students. The control group (n=36) were taught the board-adopted language arts curriculum, while the experimental group (n=18) had systematic direct instruction in reading and writing fluency in addition to the regular language arts curriculum. The research questions were: What is the relationship between students\u27 reading comprehension and reading fluency among a group of third graders? What is the relationship between their reading comprehension and writing fluency? What is the relationship between their reading fluency and writing fluency? Will the experimental group of students with direct instruction in reading and writing fluency outperform the control group in reading comprehension? What other factors are involved in increasing reading comprehension? Pearson\u27s correlation statistic, paired t-tests, independent samples t-tests, and multiple linear regression analysis were used to analyze the data. All statistical analyses were performed using PASW (formerly SPSS) for Windows. Consistent with reading research, the results showed there was a strongly positive correlation between reading comprehension and reading fluency. This study also found a correlation between reading comprehension and writing as well as a correlation between reading comprehension and writing fluency. However, the link between reading comprehension and writing fluency was not found in pretest measurement, or the posttest-pretest measurement. The ANOVA results showed that reading and writing fluency explained a statistically significant 50% of the total variance in reading comprehension scores. This study also showed a strong positive correlation between reading fluency and writing fluency in the posttest measurement. In the quasi-experimental study, the experimental group did not outperform the experimental group: both groups made significant progress. The major implication of this study is that writing could help increase reading comprehension, which results in another tool for teachers to use in teaching reading comprehension. This could result in an additional emphasis in teaching writing skills in the classroom

Variability of Objectively Measured Sedentary Behavior

The primary purpose of this study was to evaluate variability of sedentary behavior (SB) throughout a 7-d measurement period and to determine if G7 d of SB measurement would be comparable with the typical 7-d measurement period. Methods: Retrospective data from Ball State University_s Clinical Exercise Physiology Laboratory on 293 participants (99 men, 55 T 14 yr, body mass index = 29 T 5 kgImj2; 194 women, 51 T 12 yr, body mass index = 27 T 7 kgImj2) with seven consecutive days of data collected with ActiGraph accelerometers were analyzed (ActiGraph, Fort Walton Beach, FL). Time spent in SB (either G100 counts per minute or G150 counts per minute) and breaks in SB were compared between days and by sex using a two-way repeated-measures ANOVA. Stepwise regression was performed to determine if G7 d of SB measurement were comparable with the 7-d method, using an adjusted R2 of Q0.9 as a criterion for equivalence. Results: There were no differences in daily time spent in SB between the 7 d for all participants. However, there was a significant interaction between sex and days, with women spending less time in SB on both Saturdays and Sundays than men when using the 100 counts per minute cut-point. Stepwise regression showed using any 4 d would be comparable with a 7-d measurement (R2 9 0.90). Conclusions: When assessed over a 7-d measurement period, SB appears to be very stable from day to day, although there may be some small differences in time spent in SB and breaks in SB between men and women, particularly on weekend days. The stepwise regression analysis suggests that a measurement period as short as 4 d could provide comparable data (91% of variance) with a 1-wk assessment. Shorter assessment periods would reduce both researcher and subject burden in data collection

Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry

Peak Ventilation Reference Standards from Exercise Testing: From the FRIEND Registry. Med. Sci. Sports Exerc., Vol. 50, No. 12, pp. 2603–2608, 2018. Purpose: Cardiopulmonary exercise testing (CPX) provides valuable clinical information, including peak ventilation (V˙ Epeak), which has been shown to have diagnostic and prognostic value in the assessment of patients with underlying pulmonary disease. This report provides reference standards for V˙ Epeak derived from CPX on treadmills in apparently healthy individuals. Methods: Nine laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the Fitness Registry and the Importance of Exercise National Database from 2014 to 2017. Data from 5232 maximal exercise tests from men and women without cardiovascular or pulmonary disease were used to create percentiles ofV˙ Epeak for both men and women by decade between 20 and 79 yr. Additionally, prediction equations were developed for V˙ Epeak using descriptive information. Results: V˙ Epeak was found to be significantly different between men and women and across age groups (P G 0.05). The rate of decline in V˙ Epeak was 8.0% per decade for both men and women. A stepwise regression model of 70% of the sample revealed that sex, age, and height were significant predictors ofV˙ Epeak. The equation was cross-validated with data from the remaining 30% of the sample with a final equation developed from the full sample (r = 0.73). Additionally, a linear regression model revealed forced expiratory volume in 1 s significantly predicted V˙ Epeak (r = 0.73). Conclusions: Reference standards were developed for V˙ Epeak for the United States population. Cardiopulmonary exercise testing laboratories will be able to provide interpretation of V˙ Epeak from these age and sex-specific percentile reference values or alternatively can use these nonexercise prediction equations incorporating sex, age, and height or with a single predictor of forced expiratory volume in 1 s

Risk Adjustment and Reinsurance: A Work Plan for State Officials

Outlines the decisions and actions states need to take to implement the risk adjustment and reinsurance provisions of the 2010 health reform law, including risk adjustment model, reinsurance parameters, stakeholder engagement, and program administration

Estimation of juvenile striped bass relative abundance in the Virginia portion of Chesapeake Bay, January 2012-December 2012 : annual progress report

The 2012 Striped Bass juvenile abundance index is 2.68 and is significantly lower than the historic average of 6.96. Recruitment failure, as defined by Addendum II to Amendment 6 of the FMP, occurred during 2012. All individual watershed JAI values were below their historic mean. The Rappahannock, Pamunkey and Chickahominy River JAI values were significantly lower than their respective historic averages. Although lower JAI values were reported for the James and Mattaponi rivers, annual JAI confidence intervals overlapped with historic confidence intervals suggesting juvenile abundance in these two rivers was not significantly different from the longterm average abundance. Based on our sampling of auxiliary stations juvenile Striped Bass generally did not occupy sites outside of the core nursery zone during 2012. Pilot sampling prior to the 2012 field season revealed that juvenile Striped Bass and White Perch of the size commonly encountered in early July were available to the seine in early June. Therefore, seine survey sampling commenced one week earlier than the traditional start period to ensure sampling of similar sized individuals. The historic average is now properly reported as the geometric mean of annual juvenile abundance estimates in this report and that for 2011. Previous to 2011, the historic average was calculated as the mean abundance across all stations sampled over all years; this method effectively weighted the mean by the number of stations sampled in any given year, and because the survey sampled fewer stations prior to 1988, positively biased the historic mean towards recent abundance estimates. A JAI has been provided for Atlantic Croaker for 2012. Also new to the 2012 report is the use of the revised naming convention for common names of fishes recently adopted by the American Fisheries Society and the American Society of Ichthyologists and Herpetologists

Estimation of juvenile striped bass relative abundance in the Virginia portion of Chesapeake Bay, January 2011-December 2011 : annual progress report

The 2011 striped bass juvenile abundance index is 27.09 and is significantly higher than the historic average of 7.92. Unlike previous years, the 2011 York River index was the highest among Virginia watersheds with high recruitment in both the Pamunkey and Mattaponi rivers. All individual river JAI values were significantly higher than their respective historic averages except for the Chickahominy River which was not significantly different from its historic average. This suggests a strong year class was produced in the Virginia portion of Chesapeake Bay in 2011. Sampling of auxiliary stations provides greater spatial coverage of the nursery grounds and suggests that juvenile striped bass occupied upstream sites in higher abundances during 2011 compared with these sites historic averages. Several important changes were incorporated into the 2011 annual report. Samples collected within the currently established sampling season (early-July through mid-September) were used to estimate annual recruitment indices for 1967 – 1973; we omitted samples taken outside the established sampling time frame to improve our ability to compare contemporary indices with those from the late 1960s to early 1970s. In addition, the historic average is now properly calculated as the geometric mean of annual juvenile abundance estimates. Previously, the historic average was simply the mean over all stations sampled over time; the previous method therefore weighted the mean by the number of stations sampled in any given year and because the survey sampled fewer stations prior to 1988, the previous (incorrect) historic average was biased by recent abundance estimates. A juvenile white perch recruitment index has been developed for each major Virginia tributary to Chesapeake Bay

Cardiorespiratory Fitness Is Inversely Associated With Clustering of Metabolic Syndrome Risk Factors: The Ball State Adult Fitness Program Longitudinal Lifestyle Study

Objective: The focus of this study was the association between the metabolic syndrome (MetSyn) and cardiorespiratory fitness (CRF) defined as maximal oxygen uptake (VO2max). Although previous research has shown a relationship between MetSyn and CRF, most studies are based on less objective measures of CRF and different cardiometabolic risk factor thresholds from earlier guidelines