The Use of Wearable Technology to Measure Energy Expenditure, Physical Activity and Sleep Patterns in Dementia.

Project Description Unexplained weight loss is frequently observed in dementia leading to further cognitive decline, frailty and disability. Apparent mechanisms that could lead to weight loss (lower energy intake and/or higher expenditure) remain unresolved and may be different in the various stages and types of dementia. During the progression of the illness, the extent to which altered sleep duration and variable physical activity patterns (intermittent or constant pacing/lying down) could affect weight loss is unknown. We have used an innovative light weight physical activity monitor (Sensewear TM Armband, Body Media, Pittsburgh, PA) to objectively determine total energy expenditure (TEE), sleep duration, physical activity and number of steps in people with dementia living in care homes. The armband was placed around the left upper triceps for up to 7 days. The device measures tri-axial acceleration, skin temperature, galvanic skin response and heat flux and has been shown to be valid in resting, exercise and free-living conditions in older people. The mean age of the residents (n=20) was 78.5 (58-99) years, 50% were women with confirmed diagnosis of a range of dementia types. Body Mass Index (BMI) was 23.0 (range 13.7-30.0) kg/m2 with 40% classified as underweight, 50% normal range, 10% overweight. Duration of sleeping ranged from 0.4-12.5 (mean 5.9) hrs/d and time spent lying down was 1.0-16.0 (8.1) hrs/d. On average residents spent 17.4 (6.0-23.7) hrs/d undertaking sedentary activity. Sleeping duration was inversely related to body weight (r= -0.46, p<0.05) and TEE (r= -0.59, P<0.01). There was an inverse association between time lying down for both body weight (r= -0.45, p<0.05) and TEE (r= -0.62, p<0.01).TEE was positively correlated with number of steps per day (r= 0.45, p<0.05). There was no relationship between TEE or BMI and the amount of physical activity. Variable patterns of physical activity and sleep duration demonstrates the need to recognise the influence of these factors on meeting energy requirements and the challenge of providing appropriate food and nutrition within the care home environment. Thus wearable technology has the potential to offer real-time feedback to support better nutritional management and improve efforts to prevent weight loss in dementia

Understanding the strategies required to meet hydration needs of people living with dementia.

BackgroundDementia can increase the risk of dehydration as cognitive impairment and old age reduce the ability to recognise thirst. Dehydration can cause further deterioration in cognitive function and other health problems. There is no consensus on recommended fluid intakes for dementia but generally 1500 ml per day is regarded as sufficient. However the challenges of meeting appropriate hydration continue to be reported. The aim of this study, using quantitative and qualitative methods was to gain a deeper understanding of the strategies required to understand hydration needs of people living with dementia.MethodsQuantitative measures of fluid intake were recorded over a period of five days in residents (n=18) who were living in care homes. The mean age of the residents was 79 (104-58) years, 50% were women with a diagnosis of a range of dementia types. Qualitative research using a blend of nine focus groups and five semi structured interviews were conducted with all those involved in the care of people with dementia, including nurses, managers, chefs, care workers, family members, dietitians and speech and language therapists. Thematic analysis of transcripts enabled core themes to be explored.ResultsThe daily intake of fluid was 1065 ± 836 ml (mean ± 2 standard deviations). Fifteen (83%) residents did not meet the recommended fluid intake. The qualitative themes highlighted ways to overcome poor fluid intake and included alternative ways to improve hydration; a person centred approach to delivering fluid with a recognition of psychosocial and cultural influences; communication between front-line staff and key healthcare professionals.ConclusionsUsing this combined methodological approach, the results show that new strategies are needed to meet the hydration needs, with a person centred approach to care for people living with dementia. It is important to ensure all staff are well trained and competent to encourage sufficient fluid intake

The Vehicle, Spring 1975

Vol. 17, No. 1 Table of Contents Fiction CurrentsTed Baldwinpage 5 A Rat in the TablaStanley Guillpage 14 The Birthday VisitCindy Russellpage 25 Poetry Dance of the LoonsDarlene Sourilepage 11 Ne Psalms PasDarlene Sourilepage 12 eulogy to a roseDarlene Sourilepage 13 FrictionLou Ann Hazelwoodpage 20 On My Grandmother\u27s DeathLou Ann Hazelwoodpage 21 (haiku)Stanley Guillpage 35 a love poem (by approximation)Ted Baldwinpage 37 WoundTed Baldwinpage 38 UntitledBarbara Ann Robinsonpage 40 Tundra FoxKay Murphypage 41 Another Wednesday NightKay Murphypage 42 Art Robb Brenneckecover Stanley Guillpage 4, 36, 43 Greg Shoulderspage 22, 23, 24https://thekeep.eiu.edu/vehicle/1032/thumbnail.jp

The consequences of tobacco tax on household health and fi nances in rich and poor smokers in China: an extended cost-eff ectiveness analysis

Background In China, there are more than 300 million male smokers. Tobacco taxation reduces smoking-related premature deaths and increases government revenues, but has been criticised for disproportionately aff ecting poorer people. We assess the distributional consequences (across diff erent wealth quintiles) of a specifi c excise tax on cigarettes in China in terms of both fi nancial and health outcomes. Methods We use extended cost-eff ectiveness analysis methods to estimate, across income quintiles, the health benefi ts (years of life gained), the additional tax revenues raised, the net fi nancial consequences for households, and the fi nancial risk protection provided to households, that would be caused by a 50% increase in tobacco price through excise tax fully passed onto tobacco consumers. For our modelling analysis, we used plausible values for key parameters, including an average price elasticity of demand for tobacco of –0·38, which is assumed to vary from –0·64 in the poorest quintile to –0·12 in the richest, and we considered only the male population, which constitutes the overwhelming majority of smokers in China. Findings Our modelling analysis showed that a 50% increase in tobacco price through excise tax would lead to 231 million years of life gained (95% uncertainty range 194–268 million) over 50 years (a third of which would be gained in the lowest income quintile), a gain of US$703 billion ($616–781 billion) of additional tax revenues from the excise tax (14% of which would come from the lowest income quintile, compared with 24% from the highest income quintile). The excise tax would increase overall household expenditures on tobacco by $376 billion ($232–505 billion), but decrease these expenditures by $21 billion (–$83 to $5 billion) in the lowest income quintile, and would reduce expenditures on tobacco-related disease by$24·0 billion ($17·3–26·3 billion, 28 income quintile). Finally, it would provide fi nancial risk protection worth$1·8 billion ($1·2–2·3 billion), mainly concentrated (74%) in the lowest income quintile. Interpretation Increased tobacco taxation can be a pro-poor policy instrument that brings substantial health and fi nancial benefi ts to households in China

The Grizzly, February 7, 1986

Refrigerators are Still a Hot Issue • Bridge Reopens • Nursing Homes: Investigation II • Letters: Controversial Issue has no Basis; Space Shuttle: Tragedy Turned Spectacle; Times are Changing • USGA Election Candidates • Mer Chicks Take Two • Mermen Drown W. Maryland • Bears No. 2 in MAC • Lady Bears Thrash Haverford • Gymnasts Take Bryn Mawr • A Tough Job Gets Recognition • Track Team Impressive at Widener • Lab Manual to be Rewritten • Open Dialog: Women Ministers • Coulter Chosen MVPhttps://digitalcommons.ursinus.edu/grizzlynews/1156/thumbnail.jp

Prospectus, October 5, 1983

MALES OUTNUMBERED AT PC; News Digest; Lohroff visits communist countries; Opinions; Williams heads election results; Sargent suggests; Tv questionnaire; Artifacts collected by instructor; PATH needs your sunshine; Trip planned; Students transfer; Students give opinions on the insanity plea: Question: Should people be let off of their crimes by pleading insanity ?; Helping people get involved is Karch\u27s main objective; Dogs receive new hearts; Circus brings back pleasant memories; Hughes aids terminally ill; Classified; Plato aids; ABC/NBC new fall schedule has variety; Second album is a hit for Belew; Lady Cobras win tournament in style; Bowling; Fast Freddy Contesthttps://spark.parkland.edu/prospectus_1983/1009/thumbnail.jp

Prospectus, April 27, 1983

TUITION HIKE SEEN AS NECESSARY; Submit petitions now!; News Digest; 11 in race for StuGo positions; Time to vote!; StuGo candidates offer platforms; Audience prompts reaction from student; PC is a \u27special place\u27; Students prefer national issues over local; Annex plans student exhibit during April 29 open house; Arbor Day offers planting ceremony; Students to perform at talent show; Ag students win national awards; C-U Happenings; Students petition for added course; Uneasy riders given help; Secretaries recieve national recognition; Acid rain becoming a dangerous problem; Gray honored for research; Team participates in livestock judging; Parkland saltues its secretaries; Classified; Skylines; Branigan joins sell-out crowd; Trivia quiz; Stumped?; Clapton emerges as major blues artist; Mini-smoker arrives; PC women\u27s team takes two from Danville; Team takes honors; Golf coach resigns; Sports schedule; Reminder!; Notice to Sports page readershttps://spark.parkland.edu/prospectus_1983/1018/thumbnail.jp

Student engagement in the teaching and learning of grammar: A case study of an earlycareer secondary school English teacher

This article reports a study of coauthor Laur