Implementation of Virtual Reality Motivated Physical Activity via Omnidirectional Treadmill in a Supported Living Facility for Older Adults: A Mixed-Methods Evaluation.: Virtual reality to motivate physical activity for older adults

Virtual reality (VR) can support healthy ageing, but few devices have been trialed with frail older adults to increase physical activity. We conducted a preliminary mixed-methods implementation evaluation of an omnidirectional VR treadmill and a static VR experience with seven older adults over a six-week period in a supported living facility. Frequency of use and pre-post physical functioning measures were collected, mainly to establish technology suitability based on person characteristics. Diary entries following technology use, resident focus group and staff interview revealed technology acceptance and perceived potential for increasing physical activity, health and wellbeing through accessing virtual environments, which motivated continued activity. Results demonstrated technology suitability for a range of older adults with various mobility and physical impairments. However, residents noted interest in a seated treadmill for physical activity without perceived risks of falls with standing treadmills. Staff raised considerations around care home implementations including usability, cost and space

Implementation of Virtual Reality Motivated Physical Activity via Omnidirectional Treadmill in a Supported Living Facility for Older Adults: A Mixed-Methods Evaluation.: Virtual reality to motivate physical activity for older adults

Virtual reality (VR) can support healthy ageing, but few devices have been trialed with frail older adults to increase physical activity. We conducted a preliminary mixed-methods implementation evaluation of an omnidirectional VR treadmill and a static VR experience with seven older adults over a six-week period in a supported living facility. Frequency of use and pre-post physical functioning measures were collected, mainly to establish technology suitability based on person characteristics. Diary entries following technology use, resident focus group and staff interview revealed technology acceptance and perceived potential for increasing physical activity, health and wellbeing through accessing virtual environments, which motivated continued activity. Results demonstrated technology suitability for a range of older adults with various mobility and physical impairments. However, residents noted interest in a seated treadmill for physical activity without perceived risks of falls with standing treadmills. Staff raised considerations around care home implementations including usability, cost and space

Best practice guidelines for environmental DNA biomonitoring in Australia and New Zealand

Environmental DNA (eDNA)- based methods are increasingly used by government agencies to detect pests and threatened species, and for broader biodiversity monitor-ing. Given rapid technological advances and a growing number of commercial service providers, there is a need to standardize methods for quality assurance and to main-tain confidence in eDNA- based results. Here, we introduce two documents to pro-vide best- practice guidelines for Australian and New Zealand eDNA researchers and end- users (available from https://sedna socie ty.com/publications ): the Environmental DNA protocol development guide for biomonitoring provides minimum standard consid-erations for eDNA and environmental RNA projects across the complete workflow, from ethical considerations and experimental design to interpreting and communicat-ing results. The Environmental DNA test validation guidelines outline key steps to be used in assay development and validation for species-specific testing and metabar-coding. Both guidelines were developed as an initiative of the Australian Government Department of Agriculture, Fisheries and Forestry and led by the Southern eDNA Society in a collaborative process including multiple consultation rounds with eDNA experts, end-users, and stakeholders to adapt the guidelines to Australian and New Zealand needs. The aim of these guidelines is not to be prescriptive, but to set mini-mum standards to support a consistent and best- practice approach to eDNA testing. We anticipate that the guidelines will be reviewed and regularly updated as required. Our aspiration is that these best- practice guidelines will ensure environmental man-agers are provided with robust scientific evidence to support decision- making

Patterns of High-Dose and Long-Term Proton Pump Inhibitor Use: A Cross-Sectional Study in Six South Australian Residential Aged Care Services

Aim: While proton pump inhibitors (PPIs) are generally considered safe and well tolerated, frail older people who take PPIs long term may be susceptible to adverse events. This study characterized PPI use and determined factors associated with high-dose use among older adults in residential aged care services (RACSs).Methods: A cross-sectional study of 383 residents of six South Australian RACSs within the same organization was conducted. Clinical, diagnostic, and medication data were collected by study nurses. The proportions of residents who took a PPI for > 8 weeks and without documented indications were calculated. Factors associated with high-dose PPI use compared to standard/low doses were identified using age- and sex-adjusted logistic regression models.Results: 196 (51%) residents received a PPI, with 45 (23%) prescribed a high dose. Overall, 173 (88%) PPI users had documented clinical indications or received medications that can increase bleeding risk. Three-quarters of PPI users with gastroesophageal reflux disease or dyspepsia had received a PPI for > 8 weeks. High-dose PPI use was associated with increasing medication regimen complexity [odds ratio (OR) 1.02; 95% confidence interval (CI) 1.01–1.04 per one-point increase in Medication Regimen Complexity Index score] and a greater number of medications prescribed for regular use (OR 1.11; 95% CI 1.01–1.21 per additional medication).Conclusions: Half of all residents received a PPI, of whom the majority had documented clinical indications or received medications that may increase bleeding risk. There remains an opportunity to review the continuing need for treatment and consider “step-down” approaches for high-dose PPI users.</p

Generations Active Together: an example of using physical activity promotion and digital technology to bring together adolescents and older people in Stirling, Scotland

The Generations Active Together (GAT) program, delivered by Active Stirling in central Scotland, is an intergenerational physical activity (PA) program for adolescents in high school and older adults in care homes and community groups. The Generating Older Active Lives Digitally (GOALD) Research Team sought to use GAT to examine how digital technology developed for the purpose of PA and sports-based reminiscence can be used to improve social connectedness for older adults. This paper details the challenges and successes of delivering the GAT program and describes the differences between in-person pre-pandemic delivery of GAT with the attempted digital delivery during the pandemic. The transferable lessons learned from GAT delivery to GOALD project planning and implementation included, but are not limited to, the importance of in-person activities for both generations and using digital technology as a complementary, rather than a replacement tool for PA delivery. CONTRIBUTION TO THE FIELD Intergenerational activities focusing on PA involving adolescents and older adults is possible with attention to reciprocal inputs and benefits for all generations and are potentially more effective and easier to deliver in person. Where in-person PA delivery is impossible, digital-only PA is arguably better than no interaction but requires support in setting up technology to deliver PA effectively. Digital technology is likely to be more effective in supporting intergenerational PA when complemented by in-person interactions. Adolescents and older adults in care homes can engage in beneficial interaction, but attention should be paid to school commitments at this age and stage, as well as the practical aspects of travel and scheduling of this kind of contact

Asthma in changing environments - chances and challenges of international research collaborations between South America and Europe - study protocol and description of the data acquisition of a case-control-study

<p>Abstract</p> <p>Background</p> <p>Asthma in children is an emerging public health problem in South America. So far, research in this part of the world is limited. This paper presents the methodology and description of the data acquisition of an asthma case-control study conducted in the Central South of Chile.</p> <p>Methods/Design</p> <p>A hospital-based case-control study about asthma (188 cases, 294 controls) in children (6-15 years) was carried out in Valdivia, Chile between November 2008 and December 2009. Data on asthma risk factors were collected by computer-assisted personal interview using validated questions from e.g. ISAAC phase II. Data on household dust exposure (endotoxin, allergen analyses), skin prick tests to most common allergens, stool examinations for parasitic infection, and blood samples (total IgE, genetics) were collected. Additionally, 492 randomly chosen blood donors were recruited in order to assess allele frequencies in the population of Valdivia.</p> <p>Discussion</p> <p>Overall 1,173 participants were contacted. Response was 82% among cases and 65% among controls. Atopic sensitization was high (78% among cases, 47% among controls). Cases had a statistically significantly (p < .0001) increased self-reported 12-month prevalence of symptoms of rhinitis (82% vs. 51%) and wheeze (68% vs. 16%). The study is well placed to address current hypotheses about asthma and its correlates in the South American context. Results of this study might help develop novel, innovative and individualized prevention strategies in countries in transition with respect to the South American context.</p

Two Major Medicinal Honeys Have Different Mechanisms of Bactericidal Activity

Honey is increasingly valued for its antibacterial activity, but knowledge regarding the mechanism of action is still incomplete. We assessed the bactericidal activity and mechanism of action of Revamil® source (RS) honey and manuka honey, the sources of two major medical-grade honeys. RS honey killed Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa within 2 hours, whereas manuka honey had such rapid activity only against B. subtilis. After 24 hours of incubation, both honeys killed all tested bacteria, including methicillin-resistant Staphylococcus aureus, but manuka honey retained activity up to higher dilutions than RS honey. Bee defensin-1 and H2O2 were the major factors involved in rapid bactericidal activity of RS honey. These factors were absent in manuka honey, but this honey contained 44-fold higher concentrations of methylglyoxal than RS honey. Methylglyoxal was a major bactericidal factor in manuka honey, but after neutralization of this compound manuka honey retained bactericidal activity due to several unknown factors. RS and manuka honey have highly distinct compositions of bactericidal factors, resulting in large differences in bactericidal activity

Computerised cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: external pilot trial

<p>Abstract</p> <p>Background</p> <p>People with multiple sclerosis (MS) are at high risk of depression. We undertook a pilot trial of computerised cognitive behavioural therapy (CCBT) for the treatment of depression in people with MS to test the feasibility of undertaking a full trial.</p> <p>Methods</p> <p>Participants with a diagnosis of MS and clinical levels of depression were recruited through out-patient clinics and postal screening questionnaires at two UK centres and randomised to CCBT or usual care. Clinical outcomes included the Beck Depression Inventory (BDI-II) and Multiple Sclerosis Impact Scale (MSIS-29) at baseline, 8 and 21 weeks. Feasibility outcomes included: recruitment rate; reasons for refusal, withdrawal and dropout; feasibility and acceptability of the proposed outcome measures; sample size estimation and variation in and preferences for service delivery.</p> <p>Results</p> <p>Twenty-four participants were recruited. The recruitment rate, calculated as the proportion of those invited to fill in a screening questionnaire who were consented into the trial, was 4.1%. Recruitment through out-patient clinics was somewhat slower than through screening questionnaire mail-out but the overall recruitment yield was similar. Of the 12 patients in the CCBT arm, 9 (75%) completed at least four, and 6 completed all 8 CCBT sessions. For completers, the median time (IQR) to complete all eight CCBT sessions was 15 (13 to 20) weeks. Participants expressed concern about the face validity of the Beck Depression Inventory II for the measurement of self-reported depression in people with MS. The MSIS-29 was the patient-reported outcome measure which participants felt best reflected their concerns. The estimated sample size for a full trial is between 180 and 390 participants. NHS partners were not delivering CCBT in community facilities and participants preferred to access CCBT at home, with no one expressing a preference for use of CCBT in an alternative location.</p> <p>Conclusions</p> <p>A definitive trial, with a recruitment window of one year, would require the participation of around 13 MS centres. This number of centres could be reduced by expanding the eligibility criteria to include either other neurological conditions or people with more severe depression. The MSIS-29 should be used as a patient-important outcome measurement.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN81846800">ISRCTN81846800</a></p

Diagnosis and management in Rubinstein-Taybi syndrome:first international consensus statement

Rubinstein-Taybi syndrome (RTS) is an archetypical genetic syndrome that is characterised by intellectual disability, well-defined facial features, distal limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in either of two genes (CREBBP, EP300) which encode for the proteins CBP and p300, which both have a function in transcription regulation and histone acetylation. As a group of international experts and national support groups dedicated to the syndrome, we realised that marked heterogeneity currently exists in clinical and molecular diagnostic approaches and care practices in various parts of the world. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria for types of RTS (RTS1: CREBBP; RTS2: EP300), molecular investigations, long-term management of various particular physical and behavioural issues and care planning. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimisation of diagnostics and care.</p

Diagnosis and management in Rubinstein-Taybi syndrome:first international consensus statement

Rubinstein-Taybi syndrome (RTS) is an archetypical genetic syndrome that is characterised by intellectual disability, well-defined facial features, distal limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in either of two genes (CREBBP, EP300) which encode for the proteins CBP and p300, which both have a function in transcription regulation and histone acetylation. As a group of international experts and national support groups dedicated to the syndrome, we realised that marked heterogeneity currently exists in clinical and molecular diagnostic approaches and care practices in various parts of the world. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria for types of RTS (RTS1: CREBBP; RTS2: EP300), molecular investigations, long-term management of various particular physical and behavioural issues and care planning. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimisation of diagnostics and care.</p