The document discusses various screening tools that can be used to assess frailty. It provides descriptions of 20 different frailty screening tools, including what components they assess (such as physical functioning, cognition, nutrition), how they are scored, and their validation results showing sensitivity, specificity and ability to predict frailty. It also includes links to online calculators for tools like the SHARE Frailty Index and provides examples of how to interpret the scores from tools like the Groningen Frailty Index.
Frailty as a Long Term Condition?
Monday 10 November 2014
12noon – 12.45pm
Professor John Young
National Clinical Director for Integration & Frail Elderly, NHS England
&
Beverley Matthews
LTC Programme Lead, NHS Improving Quality
Research Methodology In Medical Research. This presentation gives an comprehensive overview of research methodology in biomedical research also includes different types of medical research and ethics in medical research.
Frailty as a Long Term Condition?
Monday 10 November 2014
12noon – 12.45pm
Professor John Young
National Clinical Director for Integration & Frail Elderly, NHS England
&
Beverley Matthews
LTC Programme Lead, NHS Improving Quality
Research Methodology In Medical Research. This presentation gives an comprehensive overview of research methodology in biomedical research also includes different types of medical research and ethics in medical research.
Randomization is the process by which allocation of subjects to treatment groups is done by chance, without the ability to predict who is in what group. It is done in clinical trials. This presentation describes the methods of randmization used in clinical trials.
Randomization is the process by which allocation of subjects to treatment groups is done by chance, without the ability to predict who is in what group. It is done in clinical trials. This presentation describes the methods of randmization used in clinical trials.
Objectives:
Understand the elements of hypothesis testing for testing a population mean (for large sample):
Identify appropriate null and alternative hypotheses
Select a level of significance
Compute the value of test statistic
Locate a critical or rejection region
Interpret the appropriate conclusion
Inferential Statistics:
It consists of methods for measuring and drawing conclusion about a population based on information obtained from a sample
Estimation (Point & Interval Estimation)
Significance/ Hypothesis Testing
Hypothesis Testing :
Tentative assumption related to certain phenomenon which a researcher want to verify
Allows us to use sample data to test a claim about a population, such as testing whether a population mean equals same number.
Allows us to use sample data to test a claim about a population, such as testing whether a population mean equals same number.
Hypothesis:
Hypothesis: An informed guess or a conjecture about a population parameter, which may or may not be true. It tests whether a population parameter is less than, greater than, or equal to a specified value (hypothetical).
A statement of belief used in the evaluation of a population parameter such as the mean of a population.
Example:
Frequent users of narcotics have a mean anger expression score higher than for non-users.
Types of hypotheses:
There are two types of hypotheses.
Null hypothesis (H0):
A claim that there is no difference between the population parameter and the hypothesized value. For example, the mean of a population equals the hypothesized value .
Alternative or Researcher hypothesis (Ha or H1):
A claim that disagrees with the null hypothesis. For example, the mean of a population is not equal to the hypothesized value.
One tailed hypotheses are directional.
Two-tailed hypothesis is otherwise non-directional.
Underlying assumptions for testing of hypothesis for population mean.
The sample has been randomly selected from the population or process.
The underlying population is normally distributed (or if not normally distributed, then n is large say greater than or equal to 30).
Population variance (2) either known or sample variance (s2) assumed to be approximately equal to population variance, when n is large.
Basic Elements of Testing Hypothesis:
Null Hypothesis
Alternative Hypothesis (Researcher Hypothesis)
Choice of appropriate level of significance
Assumptions
Test Statistic (Formula): Application of sample results in the formula to calculate the value of test statistic use for decision purpose.
Rejection Region (Critical Region): Based on alternative hypothesis and level of significance.
Conclusion: If the calculated value of the test statistic falls in the rejection region, reject H0 in favor of Ha, otherwise fail to reject H0.
Steps of Hypothesis Testing:
Step 1: State the hypothesis and identify the claim.
Step 2: State the Level of Significance.
Step 3: Compute the test value (Test Statistics).
The objective of this in-service presentation was to provided inpatient physical therapists and occupational therapists with the clinical decision making skills to properly evaluate common orthopedic dysfunctions encountered in the acute care setting.
Chapter 5The Role of ProbabilityLearning Objec.docxketurahhazelhurst
Chapter 5
The Role of Probability
Learning Objectives
• Define the terms “equally likely” and “at random”
• Compute and interpret unconditional and conditional
probabilities
• Evaluate and interpret independence of events
• Explain the key features of the binomial distribution
model
• Calculate probabilities using the binomial formula
Learning Objectives
• Explain the key features of the normal distribution
model
• Calculate probabilities using the standard normal
distribution table
• Compute and interpret percentiles of the normal
distribution
• Define and interpret the standard error
• Explain sampling variability
• Apply and interpret the results of the Central Limit
Theorem
Two Areas of Biostatistics
Goal: Statistical Inference
POPULATION
SAMPLE
= ?
n, X
Descriptive Statistics
Sampling from a Population
Population
N
n
n
n
n
n
n
n
n
n
n
SAMPLES
Sampling:
Population Size=N, Sample Size=n
• Simple random sample
– Enumerate all members of population N (sampling
frame), select n individuals at random (each has
same probability of being selected)
• Systematic sample
– Start with sampling frame; determine sampling
interval (N/n); select first person at random from
first (N/n) and every (N/n) thereafter
Sampling:
Population Size=N, Sample Size=n
• Stratified sample
– Organize population into mutually exclusive
strata; select individuals at random within each
stratum
• Convenience sample
– Non-probability sample (not for inference)
• Quota sample
– Select a pre-determined number of individuals into
sample from groups of interest
Basics
• Probability reflects the likelihood that outcome will
occur
• 0 < Probability < 1
N
outcomewithNumber
yProbabilit
Example 5.1.
Basic Probability
Age 5 6 7 8 9 10 Total
Boys 432 379 501 410 420 418 2560
Girls 408 513 412 436 461 500 2730
Total 840 892 913 846 881 918 5290
P(Select any child) = 1/5290 = 0.0002
Example 5.1.
Basic Probability
P(Select a boy) = 2560/5290 = 0.484
P(Select boy age 10) = 418/5290
= 0.079
P(Select child at least 8 years of age)
= (846+881+918)/5290
= 2645/5290 = 0.500
Conditional Probability
• Probability of outcome in a specific sub-
population
• Example 5.1,
P(Select 9 year old from among girls) =
P(Select 9 year old|girl)
= 461/2730 = 0.169
P(Select boy|6 years of age)
= 379/892=0.425
Example 5.2.
Conditional Probability
Prostate
Cancer
No Prostate
Cancer
Total
Low PSA 3 61 64
Moderate PSA 13 28 41
High PSA 12 3 15
Total 28 92 120
Example 5.2.
Conditional Probability
P(Prostate Cancer|Low PSA)
= 3/64 = 0.047
P(Prostate Cancer|Moderate PSA)
= 13/41 = 0.317
P(Prostate Cancer|High PSA)
= 12/15 = 0.80
Sensitivity and Specificity
Sensitivity = true positive fraction
= P(test +|disease)
Specificity = true negative fraction
= P(test -|disease free)
False negativ ...
The ppt consists of some basic and most useful outcome measures which are utilised to measure the different variables associated with the performance of an athlete or a player. It helps to evaluate, form diagnosis and to develop a management cum rehabilitation program for an athlete in sports.
Intensive interviewing is a way of generating data for qualitative research.
It typically means a gently guided, one-sided conversation that explores research participants’ perspective on their personal experience with the research topic.
This topic may be broad and fluid such as the life histories of people who grew up during the Cold War era, or much narrower and more focused such as local elementary school teachers’ views of learning assessment policies and practices.
امروزه خانه ها و وسايل آنها به گونه اي طراحي و يا بازسازي مي شوند كه براي همه افراد خانواده، صرف نظر از توانايي هاي فيزيكي آنها، قابل استفاده و راحت باشند. به طور مثال، نصب آينه هاي تمام قد امكان استفاده مناسب را براي كودكان و افرادي كه بر روي ويلچر هستند فراهم مي كند؛ يا نصب دستگيره هاي ميله اي براي حفظ تعادل در دستشويي و حمام مي تواند براي همه مفيد باشد.
بنابراين تقاضاي افراد در آيند هاي نزديك به سمتي مي رود كه خانه ها بايد به گونه اي طراحي و تجهيز شوند كه تجهيزات و وسايل در يك اندازه براي همه افراد قابل استفاده باشد؛ هر چندگاه كاربردهاي اختصاصي
وسايل باعث مي شود تا عمومي شدن كاربرد يك وسيله بسيار دشوار شود.
در این اسلاید شما می توانید به انواع تئوری های آموزشی ارائه شده دسترسی پیدا کنید. در این اسلاید سعی شده تا تمام و کمال به بررسی نظریه های قدیم و جدید در زمینه آموزش پرداخته شود.
common ask question:
Is memory loss a natural part of ageing?
Why can’t I remember as well as my wife?
Is it normal to write notes to myself?
Why can’t I remember names?
Is it normal to forget why I went into the kitchen?
Sometimes my mind just goes blank, normal?
Can I slow age related memory changes?
King's theory
Historical background.
Origin of the Conceptual Model
Strategies for Knowledge Development of the system framework.
King's theory Assumptions.
World View
Unique focus of the model
Basic paradigm concepts.
The three dimensional Nursing Process based on King's Theory.
Relationship Among the four Process of nursing .
Propositions of the model.
Concepts and Components of the framework.
Influences from other scholars.
Model of transaction
Objectives for this present are to define:
terminology
explain principles of drug action
describe pharmacokinetic functions
principles of pharmacodynamics
identify adverse drug reactions
Aging is associated with cognitive decline, and older subjects can have demonstrable cognitive impairment without crossing the threshold for dementia.
This condition has been termed “mild cognitive impairment” (MCI), and these patients have an increased risk of developing dementia, especially Alzheimer disease (AD).
Studies conducted in referral clinics have shown that patients with MCI progress to AD at a rate of 10% to 15% per year, and 80% of these patients have converted to AD after approximately 6 years of follow-up.
The identification and classification of MCI can be a major challenge.
Bibliometrics literally means "book measurement" but the term is used about all kinds of documents (with journal articles as the dominant kind of document).
What is measured are not the physical properties of documents but statistical patterns in variables such as authorship, sources, subjects, geographical origins, and citations.
Irrespective of study design, the first step in the process of avoiding any type of bias is the proper definition and articulation of the research question.
Consequently, this step will lead to a number of questions that need to be adequately addressed by the investigator during the planning stage of research:
what kind of information are required to answer this question in the study in terms of exposure, outcome, and possible confounders?
what is the most appropriate method to collect these information?
how to achieve comparable accuracy of data collection between the study groups?
روایی سازه بیشتر از روایی محتوایی و روایی ملاکی جنبه نظری دارد. بنا به تعریف، یک آزمون در صورتی دارای روایی سازه است که نمرات حاصل از اجرای آن به مفاهیم یا سازههای نظریه مورد نظر مربوط باشد. برای مثال یک آزمون یا پرسشنامه اضطراب در صورتی دارای روایی سازه است که نمرات حاصل از آن به سازههایی که در نظریههای اضطراب آمدهاند، ارتباط داشته باشد.
یکی از روشهایی که برای دستهبندی دادهها به کار میرود روش آنالیز عامل است. در این روش گزینههایي که به هم نزدیکترند، در یک عامل جمع میشوند و بدين صورت سازههای داخل یک ابزار مشخص میگردد. تحلیل عاملی یک روش آماری است که بهعنوان روشی شناختهشده برای تعیین دسته سؤالات مربوط به هم بکار میرود. این روش برای مشخص کردن و گروهبندی اندازههای متفاوت بعضی صفات مهم و برای تشخیص آنها از صفات مختلف به کار میرود. بهطورکلی آنالیز عاملی به دو نوع تقسیم میشود.
1- آنالیز عاملی اکتشافی Exploratory Factor Analysis
2- آنالیز عاملی تأییدی Confirmatory Factor Analysis
Self-management: using behavior modification procedures to change one’s own behavior.
“Behave today, to manage behavior tomorrow.”
“Take action now, to prevent problems later.”
“A little effort now, for a larger gain later.”
All these statements are suggestive of self-management.
Behavior modification procedures used by a person to change his or her own behavior
Education and learning are assumed to be important factors in facilitating participation and allowing adults to enjoy a positive quality of life as they .
Participation within the broader community is important purely for enjoyment and recreation, and also to allow older people to adapt to changes within the environment in areas such as technology, lifestyle, finances and health.
The ability to solve problems and adapt to change are strong predictors of active ageing.
The two-process model
The sleep-wake system is thought to be regulated by the interplay of two major processes, one that promotes sleep (process S) and one that maintains wakefulness (process C).
Process S is the homeostatic drive for sleep.
The need for sleep (process S) accumulates across the day, peaks just before bedtime at night and dissipates throughout the night.
Caring physically for the elderly
A: Plan Ahead
B: Keep your loved one active
C: Exercise Program
D: Keep an eye on their physical and mental health
E: Speak to your loved one's pharmacist
F: Get help with driving
Discuss finances
H: Discuss legal issues
H: Find shared meals or make food for them
I: Consider a home caregiver to help the elderly person
J: Consider a senior home or center.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Are you frail?
Frailty screening tool
Mohammad-Sajjad Lotfi
Ph.D student in gerontology
In the Name of GOD
2. • (Frailty[Title]) AND tool[Title]=23
• (Frailty[Title]) AND Diagnostic[Title]=7
• (Frailty[Title]) AND screening[Title]= 65
• (Frailty[Title]) AND instrument[Title]=18
• ((validation[Title/Abstract]) AND index[Title]) AND
Frailty[Title]=18
•
8. • A frailty score was calculated for each participant by dividing the sum of the
health deficit scores by the total number of health deficits measured. This resulted
in a score between 0 (no deficits present) and 1 (all deficits present).
• For example, if a person has six points out of 32, the LASA–FI score was 6/32 =
0.19. The LASA–FI may be used as a continuous score, or as a dichotomous
variable by applying a generally used cutoff point of C0.25 to indicate frailty
• Using the natural log of the FI in linear regression, the overall slope of the deficit
accumulation in relation to age was 0.035 (SE = 0.002, p0.001), which means that
the log-transformed FI score increased on average 3.5% per year.
9. Frailty index (FI)
A standard
procedure
for creating a
frailty index
Kenneth Rockwood*
10.
11.
12. • the value of the variable at which, on average people had a frailty
score of 0.2 or higher, was denoted as that deficit's cut-point. The
value 0.2 on the frailty index is recognized by multiple frailty
measures as approaching a frail state
19. Gérontopôle Frailty
Screening Tool (GFST)
GF
ST
Psycholog
ical
functionin
g
Exhaustio
n
sedentary
behavior
slow gait
speed
poor
handgrip
strengthPatients aged 65 years and older without both
functional disability (Activities of Daily
Living score ≥5/6) and current acute disease.
20. Individuals presenting three or more of these criteria are onsidered as frail, those
with one or two are pre-frail, and those having no criterion robust.
21. • The GFST showed a sensitivity of 71.0%, a specificity of 70.2%, a
positive predictive value of 75.9% and a negative predictive value of
64.7% at the identification of non-disabled frail elders. The positive
and negative likelihood ratios were 2.38 and 0.41, respectively. In
logistic regression models only slow gait speed (odds ratio [OR]:
19.65, 95% confidence interval [95% CI]: 4.69–82.35) and mobility
issues (OR: 18.04, 95% CI: 3.11–104.78) were significantly
associated with the condition of frailty in the absence of disability
29. • The scores range from 0 to 10, with 0 to 2 points for each
component. Our preliminary studies have suggested that a
score equal to or greater than 4 is predictive of sarcopenia and
pooroutcomes.
35. • The cut-off point of 3 on the VES-13 had:
• 72.7% sensitivity
• 85.7% specificity
• highly predictive in identifying impairment (ROC AUC 0.8977) when
compared to the CGA.
36.
37. Frailty GIR Evaluation
(FRAGIRE )
FRAGIRE
Age
GLOBAL
HEALTH
STATUS
Psychologi
cal
COGNITI
VE
SOCIO-
CULTURA
L
BURDEN
OF HELP
EXAMINE
R
MOBILIT
Y
NUTRITI
ONAL
SEXUAL
ENVIRON
MENTAL
38. Dimension GLOBAL HEALTH STATUS – Physiological well-being
How you describe your health status? (Q1)
0 1 2 3 4 5 6 7 8 9 10
(0 -the worst health you can imagine,10 - the best health you can imagine)
How many times have you been hospitalized within the last 6 months? (Q4)
0 / 1-2 times / more than 2 / I don’t know
39.
40.
41.
42.
43.
44.
45. • The FRAGIRE prognostic score, calculated for each subject,
was normalized on a 0 to 100 scale with the highest score
representing the most frail.
• You should 𝐍𝐨𝐫𝐦𝐚𝐥𝐢𝐳𝐞𝐝 𝐏𝐫𝐨𝐠𝐧𝐨𝐬𝐭𝐢𝐜 𝐬𝐜𝐨𝐫𝐞
47. • The final grid showed fair discrimination ability to predict frailty
(area under the curve (AUC) = 0.85) and good calibration
(Hosmer-Lemeshow P-value = 0.580), reflecting a good
agreement between the prediction by the final model and actual
observation.
• The Cronbach's alpha for the developed tool scored as high as
0.69 (95% Confidence Interval: 0.64 to 0.74). The final
prognostic score was excellent, with an AUC of 0.756.
• sensitivity of 81%, specificity of 61%, positive predictive value of
93%, negative predictive value of 34%, and a global predictive
value of 78%.
48. Postal Screening Tool For
Frailty
Red Flag
• This is because ‘yes’ answers to Q6–Q10
would be classed as red flags yet often
very little could be done to change this.
49.
50.
51.
52. • The ability of the questionnaire summary score to predict frailty
was adequate, with an AUC of 0.695, a sensitivity of 71%, and a
specificity of 58%.
53. Frailty Index for Physical
Activity Questionnaire (EFIP)
EFIP
Physical
functioning
Psychologi
cal
functioning
Social
functioning
General
health
Other
59. Frailty Index for Physical Activity Questionnaire (EFIP)
• Calculation method:
• Questions 1–19 and 38–43: each Yes1 point, except in question 8, 9,
18, and 19; then No1 point.
• Questions 20–34: Most of the time1 point, Sometimes0.5 points, and
Rarely0 points, except in questions 22, 25, 29, 31, and 34 for which
Rarely
• 1 point and Most of the time0 points.
• Questions 35 and 36: Poor1 point, Fair0.75 points, Good0.5 points,
Very good0.25 points, and Excellent0 points.
• Questions 44–50: Yes1 point, Suspect0.5 points, and No0 points.
60. Frailty Index for Physical Activity Questionnaire (EFIP)
• Interrater reliability (Cohen kappa0.72, ICC.96) and intrarater reliability
(Cohen kappa0.77 and 0.80, ICC.93 and .98) were good.
• Considering validity, a significant Spearman correlation with the EFIP of
.61 (P.00), .70 (P.00), and 0.66 (P.00) was found with the TUG, the POMA,
and the CIRS-G, respectively.
64. • It’s a good tools.
• Its internet base.
• SHARE-FI CALCULATOR for male:
• file:///C:/Users/sadra/Desktop/frail/SHARE-
FI%20calculator%20-%20females/SHARE-
FI%20calculator%20-%20females.htm
• file:///C:/Users/sadra/Desktop/frail/SHARE-
FI%20calculator%20-%20males/SHARE-FI%20calculator%20-
%20males.htm
65. • In females, relative to the non-frail class, the unadjusted OR
was 3.7 (2.7 - 5.0) in the pre-frail and 14.1 (10.4 - 19.2) in the
frail. The age-adjusted OR was 2.5 (1.9 - 3.5) in the pre-frail
and 6.9 (4.9 - 9.7) in the frail.
• In males, relative to the non-frail class, the unadjusted OR was
4.8 (3.9 - 5.9) in the pre-frail and 14.4 (11.0 - 18.9) in the frail.
The age-adjusted OR was 3.8 (3.1 - 4.8) in the pre-frail and
10.0 (7.4 - 13.4) in the frail.
66. • In women, SHARE-FI had an area under the curve (AUC) of
0.77 (95% confidence interval, CI: 0.73 – 0.81; standard error,
SE = 0.02; P < 0.001). Ncriteria had an AUC of 0.75 (95% CI:
0.71 – 0.79; SE = 0.02; P < 0.001).
• In men, the SHARE-FI had an AUC of 0.76 (95% CI: 0.73 –
0.79; SE = 0.02; P < 0.001), and Ncriteria had an AUC of 0.72
(95% CI: 0.69 – 0.76; SE = 0.02; P < 0.001).
69. • The FiND questionnaire presented a 95% specificity (95%CI
75.1–99.2%) and 76% (95%CI 54.9–90.6%) in the identification
of non-disabled frail participants.
70. Score:
• If A+B ≥1, the individual is considered as "disabled".
• If A+B=0 and C+D+E ≥1, the individual is considered as “frail”.
• If A+B+C+D+E=0, the individual is considered as “robust".
77. 1) “Do you get tired when taking a short (15–20 min) walk outside?”
(positive answers included both “yes,” and “can’t do it”)
2) “Have you suffered any general fatigue or tiredness over the last
3 months?”
3) “Have you fallen these last 3 months?” and “Are you afraid of falling?”
(positive answers included “yes, a bit,” “yes,” and “yes, very afraid”); and
4) “Do you need assistance in either getting to the store, managing
obstacles (such as staircases) to and from the store, or in choosing, paying
for, or bringing home groceries?”
5) having three or more emergency department (ED) visits over the last
12 months?
Subjects were considered to be at risk of frailty by answering “yes” to two or
more of these five questions.