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Purpose
The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale.
Methods
For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland–Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated.
Results
The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = −0.78, p < 0.001) with an excellent discrimination between community-dwelling older people and a younger control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off <20 points) showed a sensitivity of 0.45 and a specificity of 0.69, the AMBI a sensitivity of 0.64 and a specificity of 0.46 (cut-off >5 points).
Conclusion
The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA Scale. However, both measurement sets showed shortcomings in discrimination between fallers and non-fallers based on a self-reported retrospective falls-status.
The light-addressable potentiometric sensor (LAPS) has the unique feature to address different regions of a sensor surface without the need of complex structures. Measurements at different locations on the sensor surface can be performed in a common analyte solution, which distinctly simplifies the fluidic set-up. However, the measurement in a single analyte chamber prevents the application of different drugs or different concentrations of a drug to each measurement spot at the same time as in the case of multi-reservoir-based set-ups. In this work, the authors designed a LAPS-based set-up for cell culture screening that utilises magnetic beads loaded with the endotoxin (lipopolysaccharides, LPS), to generate a spatially distributed gradient of analyte concentration. Different external magnetic fields can be adjusted to move the magnetic beads loaded with a specific drug within the measurement cell. By recording the metabolic activities of a cell layer cultured on top of the LAPS surface, this work shows the possibility to apply different concentrations of a sample along the LAPS measurement spots within a common analyte solution.
Light-addressable potentiometric sensor as a sensing element in plug-based microfluidic devices
(2016)
A plug-based microfluidic system based on the principle of the light-addressable potentiometric sensor (LAPS) is proposed. The LAPS is a semiconductor-based chemical sensor, which has a free addressability of the measurement point on the sensing surface. By combining a microfluidic device and LAPS, ion sensing can be performed anywhere inside the microfluidic channel. In this study, the sample solution to be measured was introduced into the channel in a form of a plug with a volume in the range of microliters. Taking advantage of the light-addressability, the position of the plug could be monitored and pneumatically controlled. With the developed system, the pH value of a plug with a volume down to 400 nL could be measured. As an example of plug-based operation, two plugs were merged in the channel, and the pH change was detected by differential measurement.
Neben dem durch Unfälle und Krankheiten entstehenden menschlichen Leids und der daraus resultierenden moralischen Verpflichtung, sich und seine Mitmenschen vor Schaden zu bewahren, ist der Arbeits- und Gesundheitsschutz auch ein Gebot wirtschaftlichen Handelns, da Arbeitsunfälle und Berufskrankheiten Ausfallzeiten und Kosten verursachen. So gehören Arbeits- und Gesundheitsschutz zu den wichtigen Aufgaben eines Unternehmens.
Kalkulation
(2016)
Das Kapitel behandelt die Kosten- und Preisermittlung, die Kostenvorgabe und Kostenkontrolle.
Der Angebotspreis wird aufgeschlüsselt in die Einzelkosten der Teilleistungen, die Baustellengemeinkosten, die Allgemeinen Geschäftskosten und einen Zuschlag für Wagnis und Gewinn. Auf der Basis der Angebotskalkulation werden die Vorgaben für die Kostenkontrolle entwickelt.
Betriebsorganisation
(2016)
Das Kapitel behandelt, ausgehend von Begriffen und Aufgaben der Betriebsorganisation, die Aufbau- und Ablauforganisation der Bauunternehmung sowie die Gestaltung einer Projekt-organisation. Es folgt eine Darstellung der Managementsysteme für Qualität, Umwelt und Arbeitsschutz, die sich zunehmend als sog. integrierte Managementsysteme (IMS) auch in Bauunternehmen etablieren. Grundlagen des Personalmanagements und des betrieblichen Rechnungswesens, die für eine(n) Baubetriebler(in) relevant sein können, ergänzen das Kap. Betriebsorganisation. Den Abschluss bilden Hinweise zum Berichtswesen der Baustelle.
Schalung und Gerüste
(2016)
Systemschalungen und Systemgerüste haben den Baustellenbetrieb in vielen Bereichen sehr vereinfacht. Dennoch sind Kenntnisse in diesen Feldern für eine erfolgreiche und effektive Bauleitung unverzichtbar. In diesem Kapitel werden Hinweise und Empfehlungen für die Bemessung und Einsatz von Schalungen, Trag- und Arbeitsgerüsten für den Baustellenbetrieb gegeben.
Boden, Baugrube, Verbau
(2016)
Die Lösung den Baugrund betreffender Fragestellungen beginnen i. d. R. mit der Durchführung von Baugrunderkundungen, um alle notwendigen Parameter zu erhalten, die für die Planung und Durchführung von Bauvorhaben notwendig sind. Im Folgenden werden die wichtigsten Erkundungen in Abhängigkeit der erforderlichen Güteklasse der Proben beschrieben und vorgestellt.