Intra-rater reliability of hip abductor isometric strength testing in a standing position in older fallers and non-fallers

Background

Reduced hip muscle strength has been shown to be a major factor related to falls in older persons. However, comprehensive assessment of hip abduction strength in the clinical setting is challenging. The aim of this study was to investigate the feasibility and intra-rater reliability of a quick and simple hip abductor strength test in a functional standing position.

Methods

Individuals over 65 years of age were recruited from the geriatric department of a university hospital and an outpatient clinic. Thirty-two older subjects, including 16 fallers (≥1 fall during the last 12 months) and 16 non-fallers were included. Maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) of the hip abductors of the right leg were evaluated in a standing position using a hand-held dynamometer. Two test-sessions were carried out. All hip strength values were normalized to participants’ weight. Reliability was determined using the intra-class correlation coefficient agreement (ICC_agreement), the standard error of measurement (SEM) and a Bland and Altman analysis (BA).

Results

All participants completed the strength tests, which took a mean 2.47?±?0.49 min (one limb). Intra-rater reliability was higher for MVIS (0.98_{[0.95–0.99]}) than RFG (ICC?=?0.93_{[0.87–0.97]}) for the entire sample. In the non-fallers, ICC was 0.98_{[0.95–1.00]} (SEM?=?0.08 N.kg^??1) for MVIS and 0.88_{[0.75–0.96]} for RFG (SEM?=?1.34 N.kg^-1.s^-1). In the fallers, ICC was 0.94_{[0.89–0.98]} (SEM?=?0.11 N.kg^??1) for MVIS and 0.93_{[0.84–0.98]} (SEM?=?1.12 N.kg^??1.s^??1) for RFG. The BA plot showed that the MVIS and RFG values did not differ across test-sessions, showing that no learning effect occurred (no systematic effect). The mean differences between test-sessions were larger and the LOA smaller in the fallers than in the non-fallers.

Conclusion

Assessment of hip strength in a standing position is feasible, rapid and reliable. We therefore recommend this position for clinical practice. Future studies should investigate the diagnostic value of hip abductor strength in standing to discriminate between fallers and non-fallers, and to determine if change in strength following a falls prevention program reduces the risk of falls.

     

Building capacity of maternity staff to discourage the use of sunlight therapy in the post-partum period and infancy

PURPOSE: To describe the development, implementation and evaluation of an educational intervention that addresses risky beliefs held by midwives and nurses working in maternity areas and new mothers about therapeutic sun exposure. PROCEDURE: In 2002-2003, 59 midwives and nurses from a hospital in northern Queensland participated in an educational intervention to discourage mothers from exposing themselves and their infants to sunlight for therapeutic reasons. Intervention staff attended an educational workshop and/or received educational resources. Resources (posters, pamphlets and bookmarks) were developed for the staff to use for educating mothers. Process evaluation of the quality and usefulness of the workshop and resources was conducted immediately after the workshop and 12 months later. FINDINGS: Intervention staff indicated that the workshop was relevant to their work, and increased their knowledge and confidence in talking to mothers about sunlight exposure. Ninety percent of the 59 participants indicated they had used the workshop information in their interactions with post-partum mothers. Of the resources, pamphlets and bookmarks were used most often. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The educational intervention was successful in developing the knowledge of midwives and nurses to provide sound advice to new mothers about therapeutic sun exposure and in developing resources to support them in their education. Although workshops and resources are useful in the short term, they are impractical to sustain. To improve sustainability, content on this topic needs to be incorporated into midwifery and nursing curricula across Australia.     

The unseen protagonists. Ecuadorians’ daughters between Ecuador and Southern Europe

Scholars consider Latin American migration toward Europe to be a case study in the feminization of international migration. However, these studies have not focused on second-generation girls. Beginning from a gender and intergenerational approach, this paper stresses the agency role played by the reunified teenage daughters of Ecuadorian migrants both in Ecuador as well as in Southern Europe. The discussion is based on two transnational ethnographic studies conducted with Ecuadorian children aged 13–18 and their families in two medium-sized Southern European cities, Genoa and Seville, and in Ecuador between 2008 and 2011. First, the paper shows that girls carry out an essential task as caretakers in the transnational household, both in the point of origin and destination. Despite these responsibilities, they show a higher commitment to school, both in terms of time spent in school and their results. Secondly, it analyses how girls negotiate their role both inside and outside of the family, challenging the parents’ moral and sexual control strategies. The results disclose an identity struggle in the everyday lives of these girls: they participate in the migration project of the transnational family, but simultaneously they implement practices of resistance and renegotiation addressing the traditional division of gender roles.     

Urban biodiversity hotspots are not related to the structure of green spaces: a case study of tenebrionid beetles from Rome,Italy

At global and regional scales, area prioritisation is frequently done by the identification of hotspots based on species extinction risk. The logic of the hotspot identification has never been used in urban contexts. In this paper, the tenebrionid beetles (Coleoptera Tenebrionidae) of urban Rome were studied as an exercise to show how the hotspot approach can be profitably used in an urban area to identify priority areas for biodiversity conservation. For this, tenebrionid species from 16 green spaces were scored according to their vulnerability on the basis of their geographical distribution, habitat specificity and abundance. Species vulnerability scores were then used to calculate two indices of area prioritisation (the Biodiversity Conservation Concern and the Biodiversity Conservation Weight) for each green space. Values of these indices were correlated with site characteristics and compared with those obtained from other, more natural contexts. Except for distance to other sites, no significant correlation was found between conservation values and site characteristics, which indicates that the conservation importance of green spaces cannot be predicted on the basis of their geographical characteristics, but must be established on the basis of the species that they actually host. The importance of urban green spaces for biodiversity conservation may be questioned because of the large presence of ubiquitous and alien species in urban areas. Conservation values obtained for tenebrionids of green spaces in Rome are similar to those of various animal groups in more natural contexts and hence highlight the actual importance of green areas for insect biodiversity conservation.     

Die Implementierung neuer Konzepte zur Beschulung von Flüchtlingen und Asylsuchenden – Herausforderungen und Chancen aus organisationstheoretischer PerspektiveImplementing of education programs for refugees and asylumseekers – Challenges and chances in the lights of organiational theory

During the last year the amount of refugees and asylum seekers has increased tremendously all over the world. Many refugees arrived in Germany asking for help and integration. Politicians were challenged to offer educational programs in particular for the young, (un-) accompanied minors. In Bavaria an extensive vocational education program has been developed and started to be established under tremendous time pressure. However, the implementation process challenges government officials, principals, teachers as well as social workers. Results of our Delphi-Study confirm that these groups of agents had to deal with many problems, but also perceive great opportunities. In this paper chances and problems of implementing this vocational education program all over Bavaria are discussed in the light of organizational approaches. The results show that typical phases of unfreezing, moving and refreezing emerged simultaneously. Currently, we see many indicators of the moving phase and some of the refreezing phase. However, it is not possible to predict the end of the refreezing phase.     

Anerkennung der beruflichen Kompetenzen von Flüchtlingen – Ein Beitrag zur IntegrationRecognition of professional competences of refuges – a contribution to their integration

In the coming years the integration of refugees in Germany will be a major challenge. The paper initially employs psychological theories, such as the self-determination theory, social identity theory and latent functions of employment, to reveal why the integration of refugees into the national labor market is an important factor for their integration into society as a whole. The labor market, confronting a shortage of skilled professionals caused by demographic change, shows a high potential for the integration of refugees. However, it appears that formal requirements in the current recognition process of occupational qualifications, for example in the craft industry, are still very high. The paper describes – on the basis of case studies – an optimized recognition process of occupational qualifications, in which, in addition to the mere checking of documents, the professional competences among the refugees are assessed on site at the business.     

Skew Dyck paths

In this paper we study the class S$\mathbb{S}$ of skew Dyck paths, i.e. of those lattice paths that are in the first quadrant, begin at the origin, end on the x-axis, consist of up steps  U=(1,1)$U=(1,1)$, down steps  D=(1,-1)$D=(1,-1)$, and left steps  L=(−1,-1)$L=(-1,-1)$, and such that up steps never overlap with left steps. In particular, we show that these paths are equinumerous with several other combinatorial objects, we describe some involutions on this class, and finally we consider several statistics on S$\mathbb{S}$.     

Expectations About Future Economic Prospects and Satisfaction with Democracy: Evidence from European Countries during the COVID-19 Crisis

Social Indicators Research - Recent studies highlight that economic expectations are a crucial determinant of citizens’ satisfaction with democracy (SWD). This article relies on a...     

Sing for me,Mama! Infants' discrimination of novel vowels in song

When adults speak or sing with infants, they sound differently than in adult communication. Infant-directed (ID) communication helps caregivers to regulate infants' emotions and helps infants to process speech information, at least from ID-speech. However, it is largely unclear whether infants might also process speech information presented in ID-singing. Therefore, we examined whether infants discriminate vowels in ID-singing, as well as potential differences with ID-speech. Using an alternating trial preference procedure, infants aged 4–6 and 8–10 months were tested on their discrimination of an unfamiliar non-native vowel contrast presented in ID-like speech and singing. Relying on models of early speech sound perception, we expected that infants in their first half year of life would discriminate the vowels, in contrast to older infants whose non-native sound perception should deteriorate, at least in ID-like speech. Our results showed that infants of both age groups were able to discriminate the vowels in ID-like singing, while only the younger group discriminated the vowels in ID-like speech. These results show that infants process speech sound information in song from early on. They also hint at diverging perceptual or attentional mechanisms guiding infants' sound processing in ID-speech versus ID-singing toward the end of the first year of life.