Do the architectural barriers affect the daily personal help received by the dependent person in displacements?

[Resumen] Introducción. Diversos estudios demostraron una asociación significativa entre las barreras arquitectónicas y el desempeño de las actividades diarias con ayuda personal, en sujetos mayores o con discapacidad física. No se localizaron investigaciones similares en individuos dependientes. Objetivo. El objetivo principal de este estudio fue determinar la relación entre las barreras arquitectónicas y la ayuda recibida en los desplazamientos dentro del hogar del sujeto dependiente. Como objetivo secundario se planteó identificar diversos factores relacionados con el apoyo en la actividad reseñada. Material y métodos. Se revisaron los Baremos de Valoración de la Dependencia aplicados por el investigador, como técnico valorador, durante 16 semanas consecutivas, en 7 Ayuntamientos de A Coruña, en los que se reconoció dependencia a solicitantes mayores de edad. Se estudió la relación entre el apoyo personal recibido en los desplazamientos y la edad, género, condiciones de salud, comorbilidad, hospitalización y diversas barreras arquitectónicas. Se construyó un modelo de remisión logística para identificar los factores predictores de la ayuda en la actividad, incluyendo las variables significativas del análisis bivariante. Resultados. Se analizaron 208 baremos (68,3% mujeres; mediana 84 años). En el modelo, 3 condiciones de salud (deterioro cognitivo y/o demencia, accidente cerebrovascular y enfermedad pulmonar obstructiva crónica), la hospitalización y 2 barreras (peldaño y puerta estrecha) se asociaron significativamente con la ayuda personal recibida en los desplazamientos. Conclusión. La dependencia en los desplazamientos se explica por varias condiciones de salud, la hospitalización y diversas barreras. Se confirma la influencia del entorno físico sobre el desempeño diario, por lo que es necesario promover el asesoramiento en adaptaciones del hogar.[Abstract] Introduction. Several studies have shown a significant association between architectural barriers and performance of daily activities with personal assistance in elderly subjects or those with physical disabilities. No similar investigations were found regarding dependent persons. Objective. Principal objective: To determine the relationship between the presence of architectural barriers and personal assistance received in displacements within the home of dependent subject. Secondary objective: To identify various factors related to the support in the mentioned activity. Material and methods. We reviewed the Dependency Evaluation Scale applied by the researcher as an evaluation technique during 16 consecutive weeks in 7 municipalities of La Coruña in which dependency was admitted in elderly applicants. The relationship between the personal help received in displacements and age, gender, several health conditions, comorbidity, hospitalization and different architectural barriers was studied. A logistic regression model was constructed to identify predictors of personal support in the activity, including significant variables in the bivariate analysis. Results. A total of 208 scales (68.3% female; median 84 years) were analyzed. In the model, three health conditions (cognitive deterioration and/or dementia, stroke, chronic obstructive pulmonary disease), hospitalization and two barriers (step and narrow door) were significantly associated with the personal assistance received in the displacements. Conclusion. The dependence in the displacements is explained by several health conditions, hospitalization and various barriers. This confirms the influence of the physical environment on daily performance, so that education on home adaptations is necessary

Contramedidas en la suplantación de autoridades de certificación. Certificate pinning

La importancia de asegurar la comunicación entre personas ha crecido a medida que se ha avanzado en la sofisticación y el alcance de los mecanismos provistos para ello. Ahora, en la era digital, el alcance de estas comunicaciones es global y surge la necesidad de confiar en infraestructuras que suplan la imposibilidad de identificar a ambos extremos de la comunicación. Es la infraestructura de autoridades de certificación y la gestión correcta de certificados digitales la que ha facilitado una aproximación más eficiente para cubrir esta demanda. Existen, sin embargo, algunos aspectos de esta infraestructura o de la implementación de algunos de sus mecanismos que pueden ser aprovechados para vulnerar la seguridad que su uso debe garantizar. La presente investigación profundiza en alguno de estos aspectos y analiza la validez de las soluciones propuestas por grandes productores de software frente a escenarios realistas

O grau de rigidez dos custos dos produtos e o pagamento de dividendos no mercado de capital brasileiro

The objective of this research was to analyze the reflection of the degree of rigidity of the products costs sold (CPV) in the dividend payment policy of Brazilian non-financial companies with open capital, from 2005 to 2019. The study is based on the possibility of rigidity in the adjustments of the costs of products for companies that may not follow changes in revenues, including before a scenario of a decrease in the level of activity, compromising the result and its destinations, such as the payment of dividends. Based on the validation of the existence of rigidity in the costs behavior in the selected sample, through a regressive model, an asset intensity proxy was adopted to measure the degree of rigidity and its reflex in the payment of dividends, using the fixed effects panel data technique. As a result, evidence was obtained that CPV varies by 0.96% to increase by 1% in Net Sales Revenue, while it decreases by only 0.89% in the reverse. Whereas the increase in the degree of rigidity of costs reflects a decrease of 0.50 in dividends paid, which are also negatively impacted by financial leverage and positively by operational cash flows, according to research data. Thus, the study inferred that entities with a higher degree of rigidity in the cost structure tend to pay a lower level of dividends.A presente pesquisa teve por objetivo analisar o reflexo do grau de rigidez dos custos dos produtos vendidos (CPV) na política de pagamento de dividendos das companhias brasileiras não financeiras de capital aberto, no período de 2005 a 2019. O estudo parte da possibilidade de existir rigidez nos ajustes dos custos dos produtos para as empresas que podem não acompanhar as variações nas receitas, inclusive diante de um cenário de diminuição no nível de atividade, comprometendo o resultado e suas destinações, como o pagamento de dividendos. A partir da validação da existência de rigidez no comportamento dos custos na amostra selecionada, por intermédio de um modelo regressivo, adotou-se uma proxy de intensidade dos ativos para mensurar o grau de rigidez e seu reflexo no pagamento de dividendos, utilizando a técnica de dados em painel de efeitos fixos. Como resultado, foram obtidos indícios de que o CPV varia em 0,96% para aumento de 1% na Receita Líquida de Vendas, enquanto diminui apenas 0,89% no inverso. Já um aumento no grau de rigidez dos custos reflete uma diminuição de 0,50 nos dividendos pagos, que também são impactados negativamente pela alavancagem financeira e positivamente pelos fluxos de caixa operacionais, de acordo com os dados da pesquisa. Assim, o estudo inferiu que entidades com maior grau de rigidez na estrutura dos custos tendem a pagar um nível menor de dividendos

Homebound Status Among Middle-Aged and Older Adults With Disabilities in ADLs and Its Associations With Clinical, Functional, and Environmental Factors

Brief Report[Abstract] Background. Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown. Objectives. The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants. Methods. This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week. Measures. Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status. Results. The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status. Conclusions. Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status

Spanish Cultural Adaptation and Inter-Rater Reliability of the Test of Playfulness

[Abstract] Aim. To adapt the Test of Playfulness (ToP) to the Spanish context (culturally and linguistically) and analyze the inter-rater reliability of the translated version. Methods. Following a specific methodology for cultural adaptation, direct and back translations were carried out, together with cognitive interviews with pediatric occupational therapists, to analyze the comprehensibility of the translated version. The resulting version was analyzed by a linguistic expert to determine its grammatical and linguistic adequacy. Finally, inter-rater reliability was analyzed in a sample of typically developing children aged between 4 years old and 6 years and 11 months (n = 12). Results. Direct and back translation phases showed a good conceptual equivalence with the original version. The cognitive interviews enabled the identification of difficulties surrounding the understanding and the terminology used in several items. The linguistic expert and the research team revision ensured that final grammatical and conceptual improvements were made. Inter-rater reliability analysis showed an almost perfect degree of agreement (0.82 ≤ κ ≤ 1.00; p < 0.001), as well as stability and a strong positive linear correlation (0.81; p < 0.001). Conclusions. The translated version of the ToP fits the Spanish context and can be used in the clinical setting of pediatric occupational therapy in Spain

Activities of Daily Living in People With Lower Limb Amputation: Outcomes of an Intervention to Reduce Dependence in Pre-Prosthetic Phase

[Abstract] PURPOSE: The main objective was to assess the change in the functional independence in basic activities of daily living (ADL) following a pre-prosthetic intervention in people with lower-limb amputation (LLA). Secondary objectives were to identify the factors contributing to the success of this intervention, and to analyze the effects on the presence of unmet needs for home adaptation. METHOD: The ADL intervention was early and pre-prosthetic; it was focused on six self-care activities. Fifty-two adults with LLA, who required assistance in self-care, were included. Functional independence (Barthel) was assessed at baseline and after intervention (T2). Successful intervention was defined as independent performance of all self-care activities. RESULTS: There was a significant improvement in Barthel scores between baseline and T2 in toileting (p < 0.001), bed-chair transfers (p < 0.001), dressing (p < 0.001), bathing/showering (p < 0.001), and feeding (p = 0.025). The proportion of homes with an unmet need for adaptation decreased significantly in bathroom (p = 0.008) and other internal areas (p = 0.031). Intervention was successful for 61.5% of participants. In a multivariate model, age was significantly associated with successful intervention (OR 0.66, 95%CI 0.52-0.83). CONCLUSIONS: A short and pre-prosthetic ADL intervention improves functional independence and reduces the need for home adaptation. ADL programs should be included in rehabilitation strategies. Implications for Rehabilitation Because basic activities of daily living (ADL) can be seriously compromised after a lower-limb amputation, it is important for this population to improve or maintain their level of independence. A short and pre-prosthetic ADL intervention is an effective method for an early recovery of functional independence in self-care activities and promotes home adaptation. Age is an important determinant of functional recovery, and most subjects can achieve independence in basic ADL regardless of the level of amputation. A pre-prosthetic ADL program should be included in rehabilitation strategies for adults with lower-limb amputation