Understanding the Meaningful Places for Aging-in-Place: A Human-Centric Approach toward Inter-Domain Design Criteria Consideration in Taiwan.

BACKGROUND: Aging is key to inclusion, and it should be taken into account when designing every place of human activity. However, the implementation of such guidelines often fails the human-centric aspiration as health and design domain interpretation gaps impede the suitable reading and implementation strategies. PURPOSE: This study aimed to understand critical factors in the place-of-aging and to examine the gap in domain interpretation affecting age-friendly housing. METHODS: Using grounded theory as a base, questionnaire interviews were implemented either face-to-face or through an online process by health and design domain experts. Overall, 40 respondents (20 health and 20 design experts) evaluated the key criteria to prioritize according to their value of importance. The factor analysis resulted in the stated deviation, suggesting a necessity to redefine the attributes of the dwelling based on a people, place and process framework. RESULTS: The systemic analysis affirmed the inter-disciplinary gap to enhancing the dwelling provision. The health domain experts consistently ranked the criteria higher or equal than the design domain except for safety and security criteria. Both domains agreed that affordability is a main concern, as elders must be able to afford their dwelling choice. CONCLUSION: The valuable finding of the key criteria in the study is to uphold the value of the urban health resilience implication as the core of this study.

Assessment of knowledge, attitudes, and practices towards Zika virus among healthcare workers in St. Kitts.

BACKGROUND: Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers' characteristics and knowledge, attitudes and practices toward Zika virus. METHODS: This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 - September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. RESULTS: A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24-0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13-0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15-0.79). CONCLUSIONS: Significant association between healthcare workers' sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

The Use of Wearable Sensors for the Movement Assessment on Muscle Contraction Sequences in Post-Stroke Patients during Sit-to-Stand.

Electromyography (EMG) sensors have been used to study the sequence of muscle contractions during sit-to-stand (STS) in post-stroke patients. However, the majority of the studies used wired sensors with a limited number of placements. Using the latest improved wearable technology with 16 sensors, the current study was a thorough investigation to evaluate the contraction sequences of eight key muscles on the trunk and bilateral limbs during STS in post-stroke patients, as it became feasible. Multiple wearable sensors for the detection of muscle contraction sequences showed that the post-stroke patients performed STS with abnormal firing sequences, not only in the primary mover on the sagittal plane during raising, but also in the tibialis anterior, which may affect anticipatory postural adjustment in the gluteus medius, which may affect balance control. The abnormal tibialis anterior contraction until the early ascending phase and the delayed firing of the gluteus muscles highlight the importance of whole-kinetic-chain monitoring of contraction sequences using wearable sensors. The findings can be helpful for the design of therapeutic exercises.

Postural Assessment Scale for Stroke Patients Scores as a predictor of stroke patient ambulation at discharge from the rehabilitation ward.

OBJECTIVE: The Postural Assessment Scale for Stroke Patients (PASS) is used to assess static and dynamic balance of stroke patients. PASS has demonstrated good measurement properties for reliability and validity, but its predictive effect for ambulation in stroke patients has not been investigated. The aim of this study was to investigate the predictive value of PASS for ambulation in patients with stroke after inpatient rehabilitation. METHODS: In this retrospective study, a total of 341 stroke patients were recruited from a rehabilitation ward of a medical university hospital. Patients were assessed at baseline using PASS and observation of rolling ability, and divided into 2 groups at discharge: independently ambulatory (n = 246) and non-ambulatory (n = 95). Receiver operating characteristic curve and adjusted bivariate logistic regression was applied to analyse the predictive value of baseline PASS scores, variables of demographic data, and rolling ability at admission to inpatient rehabilitation. RESULTS: For all stroke patients, mean admission to the rehabilitation ward was 34.40 days after stroke and mean length of hospitalization 18.12 days. The receiver operating characteristic curve was obtained with a cut-off score of 3.5 points for static PASS, 8.5 points for dynamic PASS, and 12.5 points for total PASS, demonstrating the highest percentage of accurately predicted ability of independently walking at discharge. Adjusted bivariate logistic regression found rolling ability, static PASS and dynamic PASS to be predictors for ambulation of stroke patients at discharge. CONCLUSION: Initial static PASS score, dynamic PASS score and rolling can be predictors for independent ambulation of stroke patients after a course of inpatient rehabilitation.

Delphi-based assessment of fall-related risk factors in acute rehabilitation settings according to the International Classification of Functioning, Disability and Health.

OBJECTIVE: To apply the International Classification of Functioning, Disability and Health (ICF) model to fall prevention by developing an ICF core set for fall risks in acute rehabilitation settings. DESIGN: Fall risk factors were identified based on a systematic review of the literature and linked to ICF categories. A consensus process was conducted using a Delphi-based evaluation technique. SETTING: University-based hospital. PARTICIPANTS: Multidisciplinary participants (N=20) from different institutions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A 5-point Likert-type scale was used to weigh the importance of each risk category. The level of agreement for each consensus was assessed based on Spearman rho and semi-interquartile range indices. Categories with a mean score ≥4 in the third round of evaluation were included in this ICF core set. RESULTS: The core set comprised 34 fall risk categories that were distributed as follows: 18 categories on body functions, 2 on body structures, 8 on activities and participation, 4 on environmental factors, and 2 categories on personal factors. CONCLUSIONS: An ICF core set for falls in acute rehabilitation settings was developed in this study. Further validation is required.