ObjectiveWe aimed to evaluate the psychometric properties of the IADL measure included in the Dementia Care Assessment Packet (DCAP-IADL) in dementia patients.MethodsThe study involved 112 dementia patients and 546 controls. The DCAP-IADL was scored in two ways: observed score (OS) and predicted score (PS). The reliability of the DCAP-IADL was evaluated by testing its internal consistency, inter-rater reliability and test-retest reliability. Discriminant validity was evaluated by comparing the mean OS and PS between dementia patients and controls by ANCOVA. Pearson or Spearman correlation analysis was performed with other instruments to assess concurrent validity. Receiver operating characteristics curve analysis was performed to examine diagnostic accuracy.ResultsChronbach's α coefficients of the DCAP-IADL were above 0.7. The values in dementia patients were much higher (OS=0.917, PS=0.927), indicating excellent degrees of internal consistency. Inter-rater reliabilities and test-retest reliabilities were statistically significant (p<0.05). PS exhibited higher reliabilities than OS. The mean OS and PS of dementia patients were significantly higher than those of the non-demented group after controlling for age, sex and education level. The DCAP-IADL was significantly correlated with other IADL instruments and MMSE-KC (p<0.001). Areas under the curves of the DCAP-IADL were above 0.9.ConclusionThe DCAP-IADL is a reliable and valid instrument for evaluating instrumental ability of daily living for the elderly, and may also be useful for screening dementia. Moreover, administering PS may enable the DCAP-IADL to overcome the differences in gender, culture and life style that hinders accurate evaluation of the elderly in previous IADL instruments.
When a fire accident accompanied by an explosion occurs, the surrounding firewalls are affected by impact and thermal loads. Damaged firewalls due to accidental loads may not fully perform their essential function. Therefore, this paper proposes an advanced methodology for evaluating the fire resistance performance of firewalls damaged by explosions. The fragments were assumed to be scattered, and fire occurred as a vehicle exploded in a large compartment of a roll-on/roll-off (RO-RO) vessel. The impact velocity of the fragments was calculated based on the TNT equivalent mass corresponding to the explosion pressure. Damage and thermal-structural response analyses of the firewall were performed using Ansys LS-DYNA code. The fire resistance reduction was analyzed in terms of the temperature difference between fire-exposed and unexposed surfaces, temperature increase rate, and reference temperature arrival time. The degree of damage and the fire resistance performance of the firewalls varied significantly depending on impact loads. When naval ships and RO-RO vessels that carry various explosive substances are designed, it is reasonable to predict that the fire resistance performance will be degraded according to the explosion characteristics of the cargo.
Patients with concurrent diabetes and cancer may have physical, psycholosical, financial and family problems. It is important to understand both the individual and family characteristics in relation to diabetes and cancer. In addition, diabetes educators must consider a variety of factors and issues. The social welfare approach to this disease-related issue aims to improve the psychosocial adjustment and quality of life of diabetes patients with cancer. (J Korean Diabetes 2013;14:203-205)
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