Effects of food nutrition labels on the health awareness of school-age children.

BACKGROUND: Overweight and obesity have been described as a global epidemic that seriously affects the health of adults and children. Front of Package (FOP) Nutrition Labeling can increase consumers' awareness of unhealthy foods. The purpose of this study is to find effective deterrence and improve children's health awareness via the FOP. METHODS: This study examined children's health awareness of snack packaging using the four labels: guideline daily amounts (GDA), traffic light system (TLS), Apple label (designed in this study), and Warning label. This study recruited 343 children in the sixth grade, including 223 children living in cities and 120 children living in rural areas. First, 30 children in grades 3 to 6 selected 8 snacks that they often buy. Then, each snack was synthesized into these four labels according to their nutritional content for a total of 32 samples. Finally, a questionnaire was used to evaluate the health of snack packaging and the visibility of nutrition labels. RESULTS: Four results can be drawn: (1) GDA, Apple label and TLS can help children determine healthier snack choices, (2) black Warning label cannot induce children to make healthier choices, (3) children who often buy snacks have low health awareness, and (4) rural children have weak health awareness of snack packaging. CONCLUSIONS: These results can provide a packaging label design, which can effectively improve children's health awareness.

Basolateral amygdalar D2 receptor activation is required for the companions-exerted suppressive effect on the cocaine conditioning.

The presence of companions renders decreases in cocaine-stimulated dopamine release in the nucleus accumbens and cocaine-induced conditioned place preference (CPP) magnitude. Limbic systems are widely believed to underlie the modulation of accumbal dopamine release and cocaine conditioning. Thus, this study aimed to assess whether intact basolateral nucleus of amygdala (BLA), dorsal hippocampus (DH), and dorsolateral striatum (DLS) is required for the companions-exerted suppressive effect on the cocaine-induced CPP. Three cage mates, serving as companions, were arranged to house with the experimental mice in the cocaine conditioning compartment throughout the cocaine conditioning sessions. Approximately 1week before the conditioning procedure, intracranial ibotenic acid infusions were done in an attempt to cause excitotoxic lesions targeting bilateral BLA, DH and DLS. Albeit their BLA, DH, and DLS lesions, the lesioned mice exhibited comparable cocaine-induced CPP magnitudes compared to the intact and sham lesion controls. Bilateral BLA, but not DH or DLS, lesions abolished the companions-exerted suppressive effect on the cocaine-induced CPP. Intact mice receiving intra-BLA infusion of raclopride, a selective D2 antagonist, 30min prior to the cocaine conditioning did not exhibit the companions-exerted suppressive effect on the cocaine-induced CPP. Intra-BLA infusion of Sch23390, a selective D1 antagonist, did not affect the companions-exerted suppressive effect on the CPP. These results, taken together, prompt us to conclude that the intactness of BLA is required for the companions-exerted suppressive effect on the cocaine-induced CPP. Importantly, activation of D2 receptor in the BLA is required for such suppressive effect on the CPP.

Combined association of chronic disease and low skeletal muscle mass with physical performance in older adults in the Sarcopenia and Translational Aging Research in Taiwan (START) study.

BACKGROUND: Multiple chronic conditions and low skeletal muscle mass are common features of aging that are detrimental to physical performance. This study evaluates the simultaneous impact of these conditions on physical performance in older adults. METHODS: Five studies from 2003 to 2012 were pooled to include 2,398 adults aged ≥65 years with diagnosed chronic diseases measured by self-administered questionnaire. Low muscle mass was defined as an appendicular skeletal muscle mass index less than that of the sex-specific lowest quintile in the population of older adults. Poor physical performances were defined as the lowest quintile of grip strength and gait speed in the population of older adults and the slowest sex-specific 20% of Timed Up and Go (TUG) test at each study site. Chi-squared and logistic regression tests were applied for data analysis. RESULTS: Mean age of the study participants, of whom approximately 50% were men, was 74.3 years. Slow gait speed was nearly three times more likely to occur in the presence of low muscle mass coupled with chronic disease than in the absence of both factors after adjustment for study site, age, sex, education, marital status, body mass index, tobacco and alcohol use, and comorbidities. The independent effect of low muscle mass was generally stronger than that of each disease. Participants with more than two chronic diseases and low muscle mass were significantly more likely to perform poorly than those with no risk factors (odds ratio [OR] = 2.51 in patients with low grip strength, OR = 3.89 in patients with low gait speed, and OR = 3.67 in patients with poor TUG test scores, all P < 0 .05) after adjustment. CONCLUSIONS: The combined association of chronic disease and low skeletal mass with physical performance was stronger than the effect of either factor alone.

Self-reported mobility and instrumental activities of daily living: test-retest reliability and criterion validity.

To determine the test-retest reliability and criterion validity of self-reported function in mobility and instrumental activities of daily living (IADL) in older adults, a convenience sample of 70 subjects (72.9 ± 6.6 yr, 34 male) was split into able and disabled groups based on baseline assessment and into consistently able, consistently disabled, and inconsistent based on repeat assessments over 2 weeks. The criterion validities of the self-reported measures of mobility domain and IADL-physical subdomain were assessed with concurrent baseline measures of 4 mobility performances, and that of the self-reported measure of IADL-cognitive subdomain, with the Mini-Mental State Examination. Test-retest reliability was moderate for the mobility, IADL-physical, and IADL-cognitive subdomains (κ = .51-.66). Those who reported being able at baseline also performed better on physical- and cognitive-performance tests. Those with variable performance between test occasions tended to report inconsistently on repeat measures in mobility and IADL-cognitive, suggesting fluctuations in physical and cognitive performance.

Gait speed measure: the effect of different measuring distances and the inclusion and exclusion of acceleration and deceleration.

The purposes of this study were to examine the effects of different distances and the inclusion and exclusion of acceleration and deceleration distances on the measurement of self-paced and fastest gait speeds in younger and older adults. The self-paced and fastest gait speeds of younger and older adults were measured over 4-m and 10-m walkways with the acceleration and deceleration distances included and excluded in the measuring distance. The results indicated gait speeds (both self-paced and fastest) measured over different distances were comparable only if a distance for acceleration and deceleration was excluded from the measuring distance to obtain stable and comparable gait speeds. Similar results were found for younger and older groups.

A reliability study for standing functional reach test using modified and traditional rulers.

The purposes of the study were (1) to estimate the standing reach distance, test-retest, and interrater reliability of the functional reach test using traditional and modified rulers and (2) to evaluate the difference in the scores based on one trial, the mean of two or of three trials. Sixty-four individuals (M age = 36.3 yr., SD = 19.5, range = 19 to 70 years; 24 men, 40 women) volunteered to participate. Differences in measurements were examined. The intraclass correlation coefficient (ICC) was used to assess the test-retest and interrater reliability. Analysis indicated that the reach score measured by the rulers were not statistically significantly different, but the three measurements were significantly different. Reliability estimates were similar for the two mean scores, the mean of two trials (ICC2,2 = 0.87-1.00) or three trials (ICC2,3 = 0.89-1.00). The standard error of measurement (SEM) was always smaller when the modified ruler was used than when the traditional ruler was used. Performance with the modified ruler is an alternative to that with a traditional ruler. The mean of two trials as a measure of performance of reach distance when standing is recommended with either ruler.

Practice and reflection of participatory design in tableware design for the elderly.

BACKGROUND: In the past, the designers used to dominate and conduct user-centered design and research. The findings of such surveys might not reflect the user needs and produce the best design solutions. OBJECTIVE: This project aimed to use PD to introduce the design curriculum to break through the previous user-centered design thinking, as the designer and the user design together, with the user given the right to lead the entire design process. METHODS: The theme of this research design is tableware; 55 students and 11 elderly (over the age of 65) were invited to participate in this study. Questionnaires divided into the beginning, middle and final stages tested the teaching effectiveness of PD. RESULTS: The results showed that PD effectively improves five points: (1) design concepts and attitudes, (2) design methods, (3) problem solving and communication skills, (4) implementing design concepts, and (5) responding to the variety of user needs. CONCLUSION: This PD teaching model employs a well-established practical process to form an effective teaching routine, which is expected to be universally applied to other related design courses.

Postural Maintenance Is Associated With Walking Ability in People Receiving Acute Rehabilitation After a Stroke.

OBJECTIVES: The Postural Assessment Scale for Stroke Patients (PASS) assesses the ability of people post stroke to maintain or change a given posture from lying to standing, and the items on which people with different walking status perform differently may suggest potential interventions. The purpose of this study was to (1) examine the association of PASS scores at admission for acute rehabilitation with walking status at admission and 3 months post stroke (3 M), and (2) identify PASS items that discriminate walking status. METHODS: In this prospective observational study, 93 people post stroke were assessed with the PASS and a 2.44-m gait speed test at admission, with walking status assessed by telephone interview at 3 M. Those who could walk over a 2.44-m distance without the assistance of a walking aid or another person were considered to be independent in walking; others were considered to be dependent. Those who were dependent at admission were divided into the "regained independence" and "remained dependent" groups based on their status at 3 M. The association of the PASS at admission with 3 levels of walking status (independent at admission, regained independence, and remained dependent) was examined using the Kruskal-Wallis test. For those dependent at admission, the association of PASS score at admission with walking status at 3 M was examined using logistic regression and receiver operating curve analysis. RESULTS: PASS scores at admission differed significantly across the 3 walking status groups and were significantly associated with walking status at 3 M (odds ratio = 0.864; 95% CI = 0.798-0.935) over and above length of stay. People post stroke who were dependent at admission and had PASS scores ≥22 were more likely to regain independence at 3 M. Nine PASS items differed among the 3 groups. CONCLUSIONS: PASS score is significantly associated with walking status at admission and at 3 M. The identified 9 items suggest possible interventions for acute rehabilitation. IMPACT: This study identified 9 PASS items that could guide clinicians in selecting interventions for acute rehabilitation.

Factors Associated with Attitudes toward Aging among Taiwanese Middle-Aged and Older Adults: Based on Population-Representative National Data.

In middle-aged and older adults, attitude toward aging (ATA) exerts significant influences on their current and future health. For health promotion to be successful, participants' ATA requires health care providers' attention. Knowing the factors associated with ATA can facilitate future studies to investigate effective interventions. The aim of this study was to identify the factors associated with ATA in middle-aged and older adults. This cross-sectional study analyzed data of a nationally representative sample of adults aged 58 years and older collected in a population-based longitudinal study: the Taiwan Longitudinal Study on Aging (TLSA). To identify the factors associated with ATA, we investigated demographic factors (age, gender, education, marital and cohabitation status, and financial satisfaction status) and health-related factors (number of co-morbidities, depression, physical function dependency) with bivariate analysis and multiple regression analysis. To identify the activities beneficial to ATA over and above demographic and health-related factors, various activities (exercise, volunteer service, and leisure activities) were each examined individually by multiple regression analysis. The factors detrimental to ATA were advanced age, a higher number of co-morbidities, living alone, depression, and dependence on physical function. Those beneficial to ATA were higher education, financial satisfaction, physical exercise, volunteer service, and six leisure activities.

Use of photo diary and focus group to explore needs for digital disease management program among community older adults with chronic disease.

As technology advanced, new e-health solutions are evolved to empower people to manage their care at home. This study explored the needs for disease management in activity tracking using photo diary through older adults' subjective perspective. It further aimed to suggest which lifestyle measures, symptoms and behaviours would be meaningful to include in such a digital diseases care management program for technology design. Both photo diary and focus group discussion were used, 11 older adults with multiple metabolism-related chronic diseases (Mean age, 72.5 ± 6.14 years) were recruited and asked to carry out the photo diary to trace their living situation and needs using a tablet camera. A focus group discussion was applied to identify the needs of chronic disease management, based on the results of living context tracing. Five themes, regular physical activity, smart management of healthy behaviors, healthy diet, regular daily routine and social connection, were identified by content analysis from photo diary and the focus group discussion. The results indicated that the photo diary program can raise awareness and promotes positive behavior changes. It is believed that the E-approach can be applied to the effectively enhance older adults' self-management by monitoring their health status and their daily routine activities.

Comparison of virtual reality versus physical reality on movement characteristics of persons with Parkinson's disease: effects of moving targets.

OBJECTIVE: To compare the performance of reaching for stationary and moving targets in virtual reality (VR) and physical reality in persons with Parkinson's disease (PD). DESIGN: A repeated-measures design in which all participants reached in physical reality and VR under 5 conditions: 1 stationary ball condition and 4 conditions with the ball moving at different speeds. SETTING: University research laboratory. PARTICIPANTS: Persons with idiopathic PD (n=29) and age-matched controls (n=25). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Success rates and kinematics of arm movement (movement time, amplitude of peak velocity, and percentage of movement time for acceleration phase). RESULTS: In both VR and physical reality, the PD group had longer movement time (P<.001) and lower peak velocity (P<.001) than the controls when reaching for stationary balls. When moving targets were provided, the PD group improved more than the controls did in movement time (P<.001) and peak velocity (P<.001), and reached a performance level similar to that of the controls. Except for the fastest moving ball condition (0.5-s target viewing time), which elicited worse performance in VR than in physical reality, most cueing conditions in VR elicited performance generally similar to those in physical reality. CONCLUSIONS: Although slower than the controls when reaching for stationary balls, persons with PD increased movement speed in response to fast moving balls in both VR and physical reality. This suggests that with an appropriate choice of cueing speed, VR is a promising tool for providing visual motion stimuli to improve movement speed in persons with PD. More research on the long-term effect of this type of VR training program is needed.

Effects of virtual reality training on functional reaching movements in people with Parkinson's disease: a randomized controlled pilot trial.

OBJECTIVE: To investigate whether practising reaching for virtual moving targets would improve motor performance in people with Parkinson's disease. DESIGN: Randomized pretest-posttest control group design. SETTING: A virtual reality laboratory in a university setting. PARTICIPANTS: Thirty-three adults with Parkinson's disease. INTERVENTIONS: The virtual reality training required 60 trials of reaching for fast-moving virtual balls with the dominant hand. The control group had 60 practice trials turning pegs with their non-dominant hand. MAIN OUTCOME MEASURES: Pretest and posttest required reaching with the dominant hand to grasp real stationary balls and balls moving at different speeds down a ramp. Success rates and kinematic data (movement time, peak velocity and percentage of movement time for acceleration phase) from pretest and posttest were recorded to determine the immediate transfer effects. RESULTS: Compared with the control group, the virtual reality training group became faster (F = 9.08, P = 0.005) and more forceful (F = 9.36, P = 0.005) when reaching for real stationary balls. However, there was no significant difference in success rate or movement kinematics between the two groups when reaching for real moving balls. CONCLUSION: A short virtual reality training programme improved the movement speed of discrete aiming tasks when participants reached for real stationary objects. However, the transfer effect was minimal when reaching for real moving objects.

Effect of a home exercise program on dynamic balance in elderly with a history of falls.

OBJECTIVE: To determine exercise efficacy in improving dynamic balance in community-dwelling elderly with a fall history. METHODS: Thirty-five participants were randomly assigned to a treatment (TG; n = 19, 77 ± 7 yr) or control group (CG; n = 16, 75 ± 8 yr). The TG received an individualized home exercise program, and the CG received phone calls twice per week for 12 weeks. Participants' dynamic-balance abilities- directional control (DC), endpoint excursion (EE), maximum excursion (ME), reaction time (RT), and movement velocity (MV)-were measured using the Balance Master at 75% limits of stability. Functional reach (FR) was also measured. RESULTS: At 12 weeks the TG demonstrated significant improvements in DC (p < .0025), EE (p < .0005), and ME (p < .0005), but the CG did not. No significant group differences were found for MV, RT, or FR. CONCLUSIONS: Excursion distances and directional control improved but not reaction time, suggesting that exercises requiring quick responses may be needed.

The influence of semantic relevance on the discernment of product appearance and function.

BACKGROUND: This study investigated the impact of semantic relevance on the ability to comprehend the appearance and function of a product, as presented in images. METHODS: The images used the constructs of Simile, Metaphor and Analogy to correspond to congruent, related and incongruent semantic structures, and measured the amplitude of Event-Related Potentials (ERPs) to compare these images with Landscape images. Sixteen participants with design-related educational backgrounds were invited to join in the ERP experiment. RESULTS: The results found that the image depicting the Metaphor showed a stronger N600 amplitude in the right anterior region of the brain than the Landscape image and the Analogy image induced a stronger N600 effect in the left anterior and right anterior part of the brain than the Landscape image. However, the Simile image did not trigger the N600. The N600 was triggered when the meaning of the Metaphor and Analogy being presented could not be understood. This indicates that a greater processing effort to comprehend them than was required for Simile. Analogy has a wider N600 distribution than Metaphor in the anterior area, suggesting that Analogy would require higher-level thinking processes and more complex semantic processing mechanisms than Metaphor. CONCLUSIONS: The N600 implicated that an assessment method to detect the semantic relationship between appearance and function of a product would assist in determining whether a symbol was suitable to be associated with a product.

Early Rehabilitation in Acute Care Inpatient Wards May Be Crucial to Functional Recovery 3 Months After Ischemic Stroke.

OBJECTIVE: Early rehabilitation in acute care inpatient wards may maximize functional outcome at 3 months after stroke in survivors of stroke. It is unknown whether functional change during acute care hospitalization is significantly associated with functional recovery at 3 months in survivors of acute stroke. The purposes of this study were to examine the association of the Barthel Index (BI) at 3 months with functional change as measured with the Barthel Index (ΔBI) in an acute care inpatient ward and to identify the factors associated with ΔBI and who could benefit from an early rehabilitation program. METHODS: In this prospective longitudinal study, 76 patients with ischemic stroke in an acute care inpatient ward received early rehabilitation of up to 2 sessions per day for 5 d/wk during their stay. Therapy density was calculated as the proportion of total therapy sessions completed. At admission and discharge, they were assessed with the BI and the Postural Assessment Scale for Stroke Patients (PASS). Demographic and health-related information was also collected. The Barthel Index (BI) was reassessed at 3 months. RESULTS: ΔBI in the acute care inpatient ward significantly predicted the BI at 3 months, over and above the other significant variables; in addition, therapy density and change in PASS were significantly associated with ΔBI. Patients with moderate initial functional dependence had the largest ΔBI, followed by the group with a more severe condition. CONCLUSIONS: ΔBI in acute care inpatient wards may be an important predictor of the BI at 3 months. Therapy density and change in PASS were significantly associated with ΔBI. IMPACT: Survivors of acute stroke who receive up to 2 rehabilitation sessions per day for 5 d/wk early in their hospitalization have better functional recovery at 3 months after stroke.

First report of human infection caused by Colletotrichum chlorophyti occurring in a post-corneal transplant patient with endophthalmitis.

Keratomycosis or mycotic keratitis is recognized as one of the major causes of ophthalmic morbidity worldwide. The most common organisms linked to keratomycosis include Candida spp., Fusarium spp., and Aspergillus spp. However, varieties of saprobic fungi have been reported as causative agents of keratomycosis. Amongst these are members of the genus Colletotrichum. Herein we present the first reported case of C. chlorophyti infection in a post-corneal transplant patient, suggesting an increasing role for Colletotrichum species as emerging human pathogens, particularly in the transplant population.

Molecular evidence of SARS-CoV-2 in New York before the first pandemic wave.

Numerous reports document the spread of SARS-CoV-2, but there is limited information on its introduction before the identification of a local case. This may lead to incorrect assumptions when modeling viral origins and transmission. Here, we utilize a sample pooling strategy to screen for previously undetected SARS-CoV-2 in de-identified, respiratory pathogen-negative nasopharyngeal specimens from 3,040 patients across the Mount Sinai Health System in New York. The patients had been previously evaluated for respiratory symptoms or influenza-like illness during the first 10 weeks of 2020. We identify SARS-CoV-2 RNA from specimens collected as early as 25 January 2020, and complete SARS-CoV-2 genome sequences from multiple pools of samples collected between late February and early March, documenting an increase prior to the later surge. Our results provide evidence of sporadic SARS-CoV-2 infections a full month before both the first officially documented case and emergence of New York as a COVID-19 epicenter in March 2020.

Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks.

OBJECTIVE: To examine the test-retest reliability of grip strength when using the mean value, the best value, and the first value of 2 grip strength measurements and to determine the cutoff value for separating those who were able or unable to perform a heavy task with their hands in a group of Taiwanese adults. DESIGN: Cross-sectional test-retest study. SETTING: Local community centers. PARTICIPANTS: Community-dwelling older adults (N=469; age, ≥60y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported measure of ability to perform heavy tasks with their hands and grip strength. RESULTS: The test-retest reliability of grip strength in older adults was good (intraclass correlation coefficient ≥.85) when using the mean value, the best value, or the first of 2 measurements. Optimum cutoff values were 28.5 and 18.5kg, and values with 75% sensitivity were 34 and 22kg for men and women, respectively. CONCLUSIONS: The test-retest reliability of grip-strength measurement in a group of Taiwanese older adults was acceptable when the best value, the mean value, or the first of 2 measurements was used. The reported mean and cutoff values for grip strength also could serve as reference values for the public to monitor their grip strength performance and identify those at risk for early intervention.

Hand dominance and grip strength of older Asian adults.

Hand dominance in a group of Asian adults 60 to 89 years old was examined. Participants were independently living in the community; free of pain, injury, and disease of the upper limbs; and had no restrictions on use of upper extremities in daily activities. The grip strengths of both hands were measured with a Jamar hand dynamometer. Analysis showed that being male, of younger age, and using the dominant hand were significantly associated with stronger grip than being female, of older age, and using the nondominant hand. The dominant to nondominant grip ratio varies from 1.05 to 1.10 across age-sex subgroups.

Intrarater reliability and the value of real change for waist and hip circumference measures by a novice rater.

Intrarater reliability and measurement error associated with waist and hip circumference measures performed by a novice rater with one measurement were examined and compared among Body Mass Index (BMI) subgroups in a convenience sample of 76 participants (25 men, 51 women; M age = 47.2 yr., SD = 14.2). A rater blinded to the purpose of the study, as well as to the tape measure results, received training and then performed hip and waist circumference measures twice with a 10-min. interval. Intrarater reliability of the measures was acceptable (ICC3,1 > .95) across the BMI subgroups; measurement error was found to be greater in the overweight and obese subgroups. If a test-retest change score is greater than 3.0 cm in waist circumference and 2.0 cm in hip circumference, it can be assumed to be a true change with 95% confidence.