Suchergebnisse

Objective To explore whether the optimal objective function weightings change when using a digital human model (DHM) to predict origin and destination lifting postures under unfatigued and fatigued states. Background The ability to predict human postures can depend on state-based influences (e.g., fatigue). Altering objective function weightings within a predictive DHM could improve the ability to predict tasks specific lifting postures under unique fatigue states. Method A multi-objective optimization-based DHM was used to predict origin and destination lifting postures for ten anthropometrically scaled avatars by using different objective functions weighting combinations. Predicted and measured postures were compared to determine the root mean squared error. A response surface methodology was used to identify the optimal objective function weightings, which was found by generating the posture that minimized error between measured and predicted lifting postures. The resultant weightings were compared to determine if the optimal objective function weightings changed for different lifting postures or fatigue states. Results Discomfort and total joint torque weightings were affected by posture (origin/destination) and fatigue state (unfatigued/fatigued); however, post-hoc differences between fatigue states and lifting postures were not sufficiently large to be detected. Weighting the discomfort objective function alone tended to predict postures that generalized well to both postures and fatigue states. Conclusion Lift postures were optimal predicted using the minimization of discomfort objective function regardless of fatigue state. Application Weighting the discomfort objective can predict unfatigued postures, but more research is needed to understand the optimal objective function weightings to predict postures during a fatigued state.

Concerns about the quality of care in US nursing homes led to 1987 federal regulations mandating a national standardized resident assessment. This assessment, or Minimum Data Set (MDS), is performed by nurses on all residents and includes items to detect oral health problems. As yet, however, there are few data on the utility of these MDS oral health evaluations. In this study, we analyzed data from Minnesota nursing homes to determine the prevalence of oral health problems ("triggers") requiring dental referral from the MDS, version 1 (Items L and M). We also analyzed the relationship between these MDS assessments and subsequent dental care. Data came from a 1994 Minnesota nursing home dental utilization study containing information on 466 residents (dental users and non‐users) sampled from 21 nursing homes. Nurses identified 3.2% of residents as having oral debris, 3.0% with broken, loose, or carious teeth, and only four (0.9%) residents with gum inflammation/soft tissue problems. Only one resident (0.2%) was identified with mouth pain. Regression analyses of data from 135 residents admitted since 1992 revealed no relationship between the presence of MDS "triggers" and subsequent utilization measured in visits/year and gross charges/year. Nurses' MDS assessments identified few oral health problems, and those problems identified did not translate into dental treatment, raising questions about the utility of the current approach.

Disability services in Australia are undergoing large-scale, systemic reform. In recent years, to improve outcomes for people with disabilities and the efficiency of services, Commonwealth, State and Territory agencies have developed and trialled a range of market-based funding models within which 'choice' and 'control' are key principles. This report is concerned with the impact of these funding models on disability services workers, with particular focus on their capacity to provide high quality services. The findings suggest service quality and workforce capacity may be best safeguarded where: direct employment and contracting models are carefully managed or avoided; overall levels of government funding and payments to consumers and service provider organisations are sufficient to support decent pay and safe working conditions; workers are supported to upgrade and develop their skills; and there is a properly resourced strategy to build workforce capacity and sustainability. The findings provide food for thought in the context of the design and launch of the National Disability Insurance Scheme.

This study assessed the effects of increased visits by older dental patients on alternative measures of time‐ and dollar‐based practice productivity. The Minnesota Dental Practice Analysis System was used for analysis of data from 31 practices (12,818 patient visits) reporting increased visits by older adults between June, 1980, and December, 1984. Results suggested that the productivity effects associated with older patient visits were highly dependent on the practice output measure selected. While increased visits by patients age 70 and over were associated with increased monetary productivity per patient visit, time and monetary productivity per practice day were found to decline. An association between increased proportions of older patient visits and increased dentist minutes per visit appeared to account for this. This econometric analysis tends to support the notion that dental practices are less productive with older patients

Semantic differential items were reconfigured to assess relationship satisfaction across separate positive and negative attitude dimensions. Study 1 (N = 1,656) supported a 2‐factor model for the Positive and Negative Semantic Differential (PN–SMD), as well as its convergent, criterion‐related, and incremental validity over the 16‐item Couples Satisfaction Index (CSI; J. L. Funk & R. D. Rogge, 2007) using known correlates of relationship satisfaction as criteria. Study 2 (N = 89) replicated the convergent, criterion‐related, and incremental validity findings of Study 1 using different criterion measures, the CSI, a bipolar semantic differential measure designed for assessing relationship satisfaction, and an existing 2‐dimensional measure of relationship satisfaction. The authors demonstrated across studies that the PN–SMD captures criterion‐relevant information about ambivalence versus indifference toward the relationship—associations that are only detectable when using a 2‐dimensional satisfaction measure.