Regional variations in and correlates of disability-free life expectancy among older adults in China

<p>Abstract</p> <p>Background</p> <p>Considerable socioeconomic and health inequalities have been reported in China. However, because of a lack of appropriate data, limited research has been conducted on variations in disability-free life expectancy (DFLE) among older adults. This study aimed to use the most up-to-date disability survey data to explore geographical variations in DFLE at age 60 in China and to identify the socioeconomic and health care factors that partially account for these variations.</p> <p>Methods</p> <p>This study used 2006 mortality data extrapolated from the 1990 and 2000 Census and disability data from a national disability survey conducted in 2006. Disability was performance based and was diagnosed by trained physicians. DFLE was calculated by region using the Sullivan method. Multiple linear regression models by gender were conducted to explore correlates of DFLE.</p> <p>Results</p> <p>DFLE at age 60 varied widely by region, from 11.2 to 20.8 years in 2006. Per capita gross domestic product, proportion of urban residents, and access to health care were the primary factors associated with geographical variations in DFLE.</p> <p>Conclusion</p> <p>The pattern of differences in DFLE by region mirrors the pattern of regional economic development in China. Countermeasures to decrease regional differences in DFLE include accelerating regional economic development and improving health care distribution.</p

Developing community-based preventive interventions in Hong Kong: a description of the first phase of the family project

<p>Abstract</p> <p>Background</p> <p>This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West.</p> <p>Methods</p> <p>The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships.</p> <p>Results</p> <p>Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff.</p> <p>Conclusions</p> <p>This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for delivery by community agencies, and high acceptability to participants.</p

A Call for Incorporating Social Research in the Global Struggle against Snakebite

In Africa, Asia, Latin America, and parts of Oceania, envenoming after snakebite is a serious public health problem. Conservative data suggest that between 1.2 and 5.5 million people suffer snakebites every year, resulting in 25,000 to 125,000 deaths and leaving approximately 400,000 victims with permanent sequelae. Despite its significant impact on human health, this disease remains largely neglected by national and international health authorities, funding agencies, pharmaceutical companies, patients’ organizations, and health advocacy groupsUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Net contribution and predictive ability of the CUN-BAE body fatness index in relation to cardiometabolic conditions

BACKGROUND: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). METHODS: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. RESULTS: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI?<?25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. CONCLUSIONS: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.Funding: The ENRICA study was funded and financed by Sanofi-Aventis. Specific funding for this analysis came from the governmental Spain FIS PI12/1166 and PI11/01379 projects and from the “UAM Chair in Epidemiology and Control of Cardiovascular Risk”

Randomised Controlled Double-Blind Non-Inferiority Trial of Two Antivenoms for Saw-Scaled or Carpet Viper (Echis ocellatus) Envenoming in Nigeria

Snake bite threatens millions of poor rural folk throughout Africa. In Nigeria, as in many countries of sub-Saharan Africa, it takes a terrible toll on human life and limb. Over the years, the news for those exposed to snake bite has been generally bad: withdrawal of antivenom manufacturers, increasing cost and, most recently, the marketing of ineffective or fake antivenoms in the region. Our paper reports encouraging results achieved by two antivenoms created as a direct consequence of the present crisis in antivenom supply for Africa. They have been assessed in the most powerful trial ever attempted in this field. The trial showed that in people with non-clotting blood following carpet viper bite, the commonest cause of snake bite morbidity and mortality in the West African savannah, administration of the antivenoms- EchiTAb G and EchiTAb Plus-ICP led to permanent restoration of blood clotting in 76% and 83% of the patients within 6 hours, respectively. Generally mild early adverse reactions were recorded in 19% and 26%, respectively. Both antivenoms proved effective and acceptably safe and can be recommended for treating carpet viper envenoming in Nigeria

Targeted Disruption of the PME-1 Gene Causes Loss of Demethylated PP2A and Perinatal Lethality in Mice

Phosphoprotein phosphatase 2A (PP2A), a major serine-threonine protein phosphatase in eukaryotes, is an oligomeric protein comprised of structural (A) and catalytic (C) subunits to which a variable regulatory subunit (B) can associate. The C subunit contains a methyl ester post-translational modification on its C-terminal leucine residue, which is removed by a specific methylesterase (PME-1). Methylesterification is thought to control the binding of different B subunits to AC dimers, but little is known about its physiological significance in vivo.Here, we show that targeted disruption of the PME-1 gene causes perinatal lethality in mice, a phenotype that correlates with a virtually complete loss of the demethylated form of PP2A in the nervous system and peripheral tissues. Interestingly, PP2A catalytic activity over a peptide substrate was dramatically reduced in PME-1(-/-) tissues, which also displayed alterations in phosphoproteome content.These findings suggest a role for the demethylated form of PP2A in maintenance of enzyme function and phosphorylation networks in vivo

Latitudinal gradient in dairy production with the introduction of farming in Atlantic Europe

International audienceThe introduction of farming had far-reaching impacts on health, social structure and demography. Although the spread of domesticated plants and animals has been extensively tracked, it is unclear how these nascent economies developed within different environmental and cultural settings. Using molecular and isotopic analysis of lipids from pottery, here we investigate the foods prepared by the earliest farming communities of the European Atlantic seaboard. Surprisingly, we find an absence of aquatic foods, including in ceramics from coastal sites, except in the Western Baltic where this tradition continued from indigenous ceramic using hunter-gatherer-fishers. The frequency of dairy products in pottery increased as farming was progressively introduced along a northerly latitudinal gradient. This finding implies that early farming communities needed time to adapt their economic practices before expanding into more northerly areas. Latitudinal differences in the scale of dairy production might also have influenced the evolution of adult lactase persistence across Europe

Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters

[EN] Background: Even though virtual reality (VR) is increasingly used in rehabilitation, the implementation of walking navigation in VR still poses a technological challenge for current motion tracking systems. Different metaphors simulate locomotion without involving real gait kinematics, which can affect presence, orientation, spatial memory and cognition, and even performance. All these factors can dissuade their use in rehabilitation. We hypothesize that a marker-based head tracking solution would allow walking in VR with high sense of presence and without causing sickness. The objectives of this study were to determine the accuracy, the jitter, and the lag of the tracking system and its elicited sickness and presence in comparison of a CAVE system. Methods: The accuracy and the jitter around the working area at three different heights and the lag of the head tracking system were analyzed. In addition, 47 healthy subjects completed a search task that involved navigation in the walking VR system and in the CAVE system. Navigation was enabled by natural locomotion in the walking VR system and through a specific device in the CAVE system. An HMD was used as display in the walking VR system. After interacting with each system, subjects rated their sickness in a seven-point scale and their presence in the Slater-Usoh-Steed Questionnaire and a modified version of the Presence Questionnaire. Results: Better performance was registered at higher heights, where accuracy was less than 0.6 cm and the jitter was about 6 mm. The lag of the system was 120 ms. Participants reported that both systems caused similar low levels of sickness (about 2.4 over 7). However, ratings showed that the walking VR system elicited higher sense of presence than the CAVE system in both the Slater-Usoh-Steed Questionnaire (17.6 +/- 0.3 vs 14.6 +/- 0.6 over 21, respectively) and the modified Presence Questionnaire (107.4 +/- 2.0 vs 93.5 +/- 3.2 over 147, respectively). Conclusions: The marker-based solution provided accurate, robust, and fast head tracking to allow navigation in the VR system by walking without causing relevant sickness and promoting higher sense of presence than CAVE systems, thus enabling natural walking in full-scale environments, which can enhance the ecological validity of VR-based rehabilitation applications.The authors wish to thank the staff of LabHuman for their support in this project, especially José Miguel Martínez and José Roda for their assistance. This study was funded in part by Ministerio de Economia y Competitividad of Spain (Project NeuroVR, TIN2013-44741-R and Project REACT, TIN2014-61975-EXP), by Ministerio de Educacion y Ciencia of Spain (Project Consolider-C, SEJ2006-14301/PSIC), and by Universitat Politecnica de Valencia (Grant PAID-10-14).Borrego, A.; Latorre Grau, J.; Llorens Rodríguez, R.; Alcañiz Raya, ML.; Noé, E. (2016). Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters. Journal of NeuroEngineering and Rehabilitation. 13:1-9. https://doi.org/10.1186/s12984-016-0174-1S1913Lee KM. Presence. Explicated Communication Theory. 2004;14(1):27–50.Riva G. Is presence a technology issue? Some insights from cognitive sciences. Virtual Reality. 2009;13(3):159–69.Banos RM, et al. Immersion and emotion: their impact on the sense of presence. Cyberpsychol Behav. 2004;7(6):734–41.Llorens R, et al. Tracking systems for virtual rehabilitation: objective performance vs. subjective experience. A practical scenario. Sensors (Basel). 2015;15(3):6586–606.Navarro MD, et al. Validation of a low-cost virtual reality system for training street-crossing. A comparative study in healthy, neglected and non-neglected stroke individuals. Neuropsychol Rehabil. 2013;23(4):597–618.Parsons TD. Virtual reality for enhanced ecological validity and experimental control in the clinical, affective and social neurosciences. Front Hum Neurosci. 2015;9:660.Cameirao MS, et al. Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. J Neuroeng Rehabil. 2010;7:48.Llorens R, et al. Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke. Clin Rehabil. 2015;29(3):261–8.Llorens R, et al. Videogame-based group therapy to improve self-awareness and social skills after traumatic brain injury. J Neuroeng Rehabil. 2015;12:37.Fong KN, et al. Usability of a virtual reality environment simulating an automated teller machine for assessing and training persons with acquired brain injury. J Neuroeng Rehabil. 2010;7:19.Levin MF, Weiss PL, Keshner EA. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles. Phys Ther. 2015;95(3):415–25.Llorens R, et al. Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(3):418–25. e2.Cruz-Neira C, et al. Scientists in wonderland: A report on visualization applications in the CAVE virtual reality environment. In: 1993. Proceedings IEEE 1993 Symposium on Research Frontiers in Virtual Reality. 1993.Juan MC, Perez D. Comparison of the levels of presence and anxiety in an acrophobic environment viewed via HMD or CAVE. Presence. 2009;18(3):232–48.Yang YR, et al. Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial. Gait Posture. 2008;28(2):201–6.Cho KH, Lee WH. Virtual walking training program using a real-world video recording for patients with chronic stroke: a pilot study. Am J Phys Med Rehabil. 2013;92(5):371–84.Darter BJ, Wilken JM. Gait training with virtual reality-based real-time feedback: improving gait performance following transfemoral amputation. Phys Ther. 2011;91(9):1385–94.Yang S, et al. Improving balance skills in patients who had stroke through virtual reality treadmill training. Am J Phys Med Rehabil. 2011;90(12):969–78.Walker ML, et al. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. Arch Phys Med Rehabil. 2010;91(1):115–22.Riley PO, et al. A kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. Gait Posture. 2007;26(1):17–24.Alton F, et al. A kinematic comparison of overground and treadmill walking. Clin Biomech. 1998;13(6):434–40.Lee SJ, Hidler J. Biomechanics of overground vs. treadmill walking in healthy individuals. J Appl Physiol. 2008;104(3).Slater M. Measuring presence: a response to the witmer and Singer presence questionnaire. Presence. 1999;8(5):560–5.Viau A, et al. Reaching in reality and virtual reality: a comparison of movement kinematics in healthy subjects and in adults with hemiparesis. J Neuroeng Rehabil. 2004;1(1):11.Parsons TD, et al. The potential of function-led virtual environments for ecologically valid measures of executive function in experimental and clinical neuropsychology. Neuropsychol Rehabil. 2015;11:1–31. doi: 10.1080/09602011.2015.1109524 .Aravind G, Lamontagne A. Perceptual and locomotor factors affect obstacle avoidance in persons with visuospatial neglect. J Neuroeng Rehabil. 2014;11:38.Darekar A, Lamontagne A, Fung J. Dynamic clearance measure to evaluate locomotor and perceptuo-motor strategies used for obstacle circumvention in a virtual environment. Hum Mov Sci. 2015;40:359–71.Whittle MW. Chapter 4 - Methods of gait analysis. In: Whittle MW, editor. Gait analysis. Edinburgh: Butterworth-Heinemann; 2007. p. 137–75.Hodgson E, et al. WeaVR: a self-contained and wearable immersive virtual environment simulation system. Behav Res Methods. 2015;47(1):296–307.Akizuki H, et al. Effects of immersion in virtual reality on postural control. Neurosci Lett. 2005;379(1):23–6.Thies SB, et al. Comparison of linear accelerations from three measurement systems during "reach & grasp". Med Eng Phys. 2007;29(9):967–72.Fiala M. Designing highly reliable fiducial markers. IEEE Trans Pattern Anal Mach Intell. 2010;32(7):1317–24.Garrido-Jurado S, et al. Automatic generation and detection of highly reliable fiducial markers under occlusion. Pattern Recognition. 2014;47(6):2280–92.Kim K, et al. Effects of virtual environment platforms on emotional responses. Comput Methods Programs Biomed. 2014;113(3):882–93.Slater M, Steed A. A virtual presence counter. Presence. 2000;9(5):413–34.Witmer BG, Singer MJ. Measuring presence in virtual environments: a presence questionnaire. Presence Teleop Virt. 1998;7(3):225–40.Martín-Gutiérrez J, et al. Design and validation of an augmented book for spatial abilities development in engineering students. Comput Graph. 2010;34(1):77–91.Lopez-Mir F, et al. Design and validation of an augmented reality system for laparoscopic surgery in a real environment. Biomed Res Int. 2013;2013:758491.Abawi DF, Bienwald J, Dorner R. Accuracy in optical tracking with fiducial markers: an accuracy function for ARToolKit. In: Third IEEE and ACM International symposium on mixed and augmented reality, ISMAR 2004. 2004.Malbezin P, Piekarski W, Thomas BH. Measuring ARTootKit accuracy in long distance tracking experiments. In: The first IEEE International workshop augmented reality toolkit. 2002.Paquette C, Paquet N, Fung J. Aging affects coordination of rapid head motions with trunk and pelvis movements during standing and walking. Gait Posture. 2006;24(1):62–9.Graham JE, et al. Walking speed threshold for classifying walking independence in hospitalized older adults. Phys Ther. 2010;90(11):1591–7.Gorea A. A refresher of the original Bloch’s Law paper (bloch, july 1885). i-Perception. 2015;6:4.Moss JD, Muth ER. Characteristics of head-mounted displays and their effects on Simulator sickness. Hum Factors. 2011;53(3):308–19.Draper MH, et al. Effects of image scale and system time delay on Simulator sickness within head-coupled virtual environments. Hum Factors. 2001;43(1):129–46.Fujisaki W. Effects of delayed visual feedback on grooved pegboard test performance. Front Psychol. 2012;3:61.Keshner EA, et al. Augmenting sensory-motor conflict promotes adaptation of postural behaviors in a virtual environment. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:1379–82.Slaboda JC, Keshner EA. Reorientation to vertical modulated by combined support surface tilt and virtual visual flow in healthy elders and adults with stroke. J Neurol. 2012;259(12):2664–72.Tossavainen T. Comparison of CAVE and HMD for visual stimulation in postural control research. Stud Health Technol Inform. 2004;98:385–7.Akiduki H, et al. Visual-vestibular conflict induced by virtual reality in humans. Neurosci Lett. 2003;340(3):197–200.Duh HBL, et al. Effects of field of view on balance in an immersive environment. In: Virtual Reality, 2001. Proceedings. IEEE. 2001.Krijn M, et al. Treatment of acrophobia in virtual reality: the role of immersion and presence. Behav Res Ther. 2004;42(2):229–39.Mania K, Chalmers A. The effects of levels of immersion on memory and presence in virtual environments: a reality centered approach. Cyberpsychol Behav. 2001;4(2):247–64.Gorini A, et al. The role of immersion and narrative in mediated presence: the virtual hospital experience. Cyberpsychol Behav Soc Netw. 2011;14(3):99–105.Fromberger P, et al. Virtual viewing time: the relationship between presence and sexual interest in androphilic and gynephilic Men. PLoS One. 2015;10(5), e0127156.Slater M, et al. Visual realism enhances realistic response in an immersive virtual environment. IEEE Comput Graph Appl. 2009;29(3):76–84.Nir-Hadad SY, et al. A virtual shopping task for the assessment of executive functions: Validity for people with stroke. Neuropsychol Rehabil. 2015;11:1–26. doi: 10.1080/09602011.2015.1109523 .Vasilyeva M, Lourenco SF. Development of spatial cognition. Wiley Interdiscip Rev Cogn Sci. 2012;3(3):349–62.Banakou D, Groten R, Slater M. Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes. Proc Natl Acad Sci U S A. 2013;110(31):12846–51.Yee N, Bailenson JN, Ducheneaut N. The proteus effect: implications of transformed digital self-representation on online and offline behavior. Commun Res. 2009;36(2):285–312.Baylor AL. Promoting motivation with virtual agents and avatars: role of visual presence and appearance. Philos Trans R Soc Lond B Biol Sci. 2009;364(1535):3559–65.Clemente M, et al. Assessment of the influence of navigation control and screen size on the sense of presence in virtual reality using EEG. Expert Sys App. 2014;41(4, Part 2):1584–92.Clemente M, et al. An fMRI study to analyze neural correlates of presence during virtual reality experiences. 2013. Interacting with Computers