Development of a Smart Home Modification Program: A Delphi Survey of Multidisciplinary Health Care Experts.

IMPORTANCE: There is a critical gap between the potential of smart home technologies to enhance the lives of people with physical disabilities (PwPD) and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. OBJECTIVE: To bridge this gap and ensure that PwPD can fully benefit from smart home advancements to improve their daily living and quality of life by developing a smart home modification program. DESIGN: A Delphi survey involving three rounds was conducted with experts in disability and smart home technologies. SETTING: Online survey. PARTICIPANTS: Thirty multidisciplinary health care experts. OUTCOMES AND MEASURES: Experts rated the level of relevance in smart home modification with each survey. Consensus was set at ≥75%, content validity (CVR) was ≥.33, and convergence was ≤.5. RESULTS: The first Delphi result selected 26 items, and the second included 59 items after adjusting for values that fell below a CVR of .33. In the third Delphi survey, 59 items were selected. The final Delphi study had an average CVR of .96 and a coefficient of variation of .10. The last survey's consensus point was .92, indicating a high level of agreement among participants. CONCLUSIONS AND RELEVANCE: On the basis of expert consensus, the study provides a validated framework for smart home modifications to aid PwPD. Plain-Language Summary: This research highlights the role of smart home adaptations to promote responsible, independent living for people with physical disabilities. There is a critical gap between the potential of smart home technologies to improve the lives of people with physical disabilities and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. The study authors developed a smart home modification program with the goal of closing this gap and to ensure that people with physical disabilities can fully benefit from smart home advancements to improve their daily living and quality of life. Based on expert ratings, the study findings provide a validated framework that occupational therapists can use to recommend smart home modifications to help people with physical disabilities. The framework can also be used by occupational therapists to identify people who may need more extensive environmental modifications and interventions.

The Effects of Occupation-Based Community Rehabilitation for Improving Activities of Daily Living and Health-Related Quality of Life of People with Disabilities after Stroke Living at Home: A Single Subject Design.

Objective: The aim of this study is to investigate the effect of occupation-based community rehabilitation on activity daily of living and health-related quality of life of people with disabilities after stroke at home. Method: In this study of three people with disabilities after stroke living at home, A-B-A single-subject design was used. The occupation-based community rehabilitation was implemented during the intervention phase. It included task oriented and feedback, related information education, home environment modification, and community resource network. After applying the intervention, changes in activities of daily living and health-related quality of life were evaluated by the Modified Barthel Index (MBI), the EuroQol-5 dimension (EQ-5D), and the Assessment of Motor and Process Skills (AMPS). Result: After applying the occupation-based community rehabilitation program, all three participants' daily life activities and quality of life improved. In addition, the occupational performance skills in all participants were maintained. Conclusion: It was confirmed that individual occupational-based community rehabilitation had a positive effect on the activities of daily living and quality of life improvement of the people with disabilities after stroke at home.

Applying Latent Profile Analysis to Identify Lifestyle Profiles and Their Association with Loneliness and Quality of Life among Community-Dwelling Middle- and Older-Aged Adults in South Korea.

This study aimed to examine the multi-faceted lifestyle profiles of community-dwelling middle- and older-aged adults based on their physical activity, participation in various activities, and nutrition. It identified the association of lifestyle profiles with demographic variables, quality of life, and mental health. The analysis included 569 participants (mean age = 60.2; SD = 4.3). Latent profile analysis identified three distinctive lifestyle profiles: "inactive and unbalanced" (36.4%), "basic life maintenance" (54.6%), and "active and balanced" (9.1%). Sex (p < 0.001), age (p < 0.001), and regular medication intake (p < 0.01) were statistically significantly different among the three profiles. Of the "inactive and unbalanced" lifestyle group, 63.3% of it was comprised of by females, and a relatively large distribution was aged over 65. In the "basic life maintenance" subgroup, males showed a relatively large distribution, and 92.6% of participants were aged 55-64. People with active and balanced lifestyles demonstrated high quality of life levels (p < 0.001) and low loneliness levels (p < 0.01). Multinomial logistic regression revealed a statistically significant positive association between lifestyle profiles and quality of life (p < 0.001) as well as mental health (p < 0.01). Therefore, health promotion that considers multi-faceted lifestyle factors would need to improve health and quality of life among community-dwelling middle- and older-aged adults in South Korea.

Recent Advances in Fabrication of Flexible, Thermochromic Vanadium Dioxide Films for Smart Windows.

Monoclinic-phase VO2 (VO2(M)) has been extensively studied for use in energy-saving smart windows owing to its reversible insulator-metal transition property. At the critical temperature (Tc = 68 °C), the insulating VO2(M) (space group P21/c) is transformed into metallic rutile VO2 (VO2(R) space group P42/mnm). VO2(M) exhibits high transmittance in the near-infrared (NIR) wavelength; however, the NIR transmittance decreases significantly after phase transition into VO2(R) at a higher Tc, which obstructs the infrared radiation in the solar spectrum and aids in managing the indoor temperature without requiring an external power supply. Recently, the fabrication of flexible thermochromic VO2(M) thin films has also attracted considerable attention. These flexible films exhibit considerable potential for practical applications because they can be promptly applied to windows in existing buildings and easily integrated into curved surfaces, such as windshields and other automotive windows. Furthermore, flexible VO2(M) thin films fabricated on microscales are potentially applicable in optical actuators and switches. However, most of the existing fabrication methods of phase-pure VO2(M) thin films involve chamber-based deposition, which typically require a high-temperature deposition or calcination process. In this case, flexible polymer substrates cannot be used owing to the low-thermal-resistance condition in the process, which limits the utilization of flexible smart windows in several emerging applications. In this review, we focus on recent advances in the fabrication methods of flexible thermochromic VO2(M) thin films using vacuum deposition methods and solution-based processes and discuss the optical properties of these flexible VO2(M) thin films for potential applications in energy-saving smart windows and several other emerging technologies.

Hesperetin Inhibits Expression of Virulence Factors and Growth of Helicobacter pylori.

Helicobacter pylori (H. pylori) is a bacterium known to infect the human stomach. It can cause various gastrointestinal diseases including gastritis and gastric cancer. Hesperetin is a major flavanone component contained in citrus fruits. It has been reported to possess antibacterial, antioxidant, and anticancer effects. However, the antibacterial mechanism of hesperetin against H. pylori has not been reported yet. Therefore, the objective of this study was to determine the inhibitory effects of hesperetin on H. pylori growth and its inhibitory mechanisms. The results of this study showed that hesperetin inhibits the growth of H. pylori reference strains and clinical isolates. Hesperetin inhibits the expression of genes in replication (dnaE, dnaN, dnaQ, and holB) and transcription (rpoA, rpoB, rpoD, and rpoN) machineries of H. pylori. Hesperetin also inhibits the expression of genes related to H. pylori motility (flhA, flaA, and flgE) and adhesion (sabA, alpA, alpB, hpaA, and hopZ). It also inhibits the expression of urease. Hespereti n downregulates major virulence factors such as cytotoxin-associated antigen A (CagA) and vacuolating cytotoxin A (VacA) and decreases the translocation of CagA and VacA proteins into gastric adenocarcinoma (AGS) cells. These results might be due to decreased expression of the type IV secretion system (T4SS) and type V secretion system (T5SS) involved in translocation of CagA and VacA, respectively. The results of this study indicate that hesperetin has antibacterial effects against H. pylori. Thus, hesperetin might be an effective natural product for the eradication of H. pylori.

Facile Sulfurization under Ambient Condition with Na2S to Fabricate Nanostructured Copper Sulfide.

The sulfurization reaction was investigated as a promising fabrication method for preparing metal sulfide nanomaterials. Traditional sulfurization processes generally require high vacuum systems, high reaction temperatures, and toxic chemicals, utilizing complicated procedures with poor composition and morphology controllability. Herein, a facile method is reported for synthesizing nanostructured copper sulfide using a sulfurization reaction with Na2S at room temperature under non-vacuum conditions. Moreover, we demonstrate that the morphology, composition, and optical properties of nanostructured copper sulfides could be controlled by the Na2S solution concentration and the reaction time. Nanostructured copper sulfides were synthesized in nanospheres, nanoplates, and nanoplate-based complex morphologies with various oxidation states. Furthermore, by comparing the optical properties of nanostructured copper sulfides with different oxidation states, we determined that reflectivity in the near infrared (NIR) region decreases with increasing oxidation states. These results reveal that the Na2S solution concentration and reaction time are key factors for designing nanostructured copper sulfides, providing new insights for synthesis methods of metal sulfide nanomaterials.

An Analysis of COVID-19 Global Guidelines Published in the Early Phase of the Pandemic for People with Disabilities.

PURPOSE: COVID-19 guidelines for persons with disabilities published globally during the early phase of the pandemic by non-governmental organizations and federal agencies were reviewed and analyzed by trends of information provided under various settings. METHOD: The Google search engine was used by applying the following search terms: COVID-19, Coronavirus 2019, Disability, and Guidelines. Search efforts yielded 514 records from 1 December 2019 to 16 May 2020. The selected 26 guidelines were classified for analysis by organizations (NGOs, non-profit, and governmental institutions), information provided (risks, prevention, and countermeasures), target group (people with disability, service and support providers, and family members), and environmental setting (hospital, community, and home). RESULTS: Government agencies from eight countries published results. Eight of the 26 guidelines were presented by non-governmental organizations, and 18 were not. There were 15 guidelines for individuals with disabilities; seven for service providers, staff, and families providing care; and four addressing both the individuals with a disability and care providers. In terms of appropriate environment and scope, there were 19 guidelines produced for community, government, home, and hospital. The information predominantly presented regarded the prevention of COVID-19 with 22 sources, followed by general information containing risks and response strategies. CONCLUSION: The majority of the published guidelines focused primarily on the risks and prevention of COVID-19 for people with disabilities. Future procedures should include specific methods in guiding COVID-19 response strategies for the disabled and caregivers who provide essential health services with access to online resources in multiple languages and dialects.

Zerumbone Inhibits Helicobacter pylori Urease Activity.

Helicobacter pylori (H. pylori) produces urease in order to improve its settlement and growth in the human gastric epithelium. Urease inhibitors likely represent potentially powerful therapeutics for treating H. pylori; however, their instability and toxicity have proven problematic in human clinical trials. In this study, we investigate the ability of a natural compound extracted from Zingiber zerumbet Smith, zerumbone, to inhibit the urease activity of H. pylori by formation of urease dimers, trimers, or tetramers. As an oxygen atom possesses stronger electronegativity than the first carbon atom bonded to it, in the zerumbone structure, the neighboring second carbon atom shows a relatively negative charge (δ-) and the next carbon atom shows a positive charge (δ+), sequentially. Due to this electrical gradient, it is possible that H. pylori urease with its negative charges (such as thiol radicals) might bind to the ß-position carbon of zerumbone. Our results show that zerumbone dimerized, trimerized, or tetramerized with both H. pylori urease A and urease B molecules, and that this formation of complex inhibited H. pylori urease activity. Although zerumbone did not affect either gene transcription or the protein expression of urease A and urease B, our study demonstrated that zerumbone could effectively dimerize with both urease molecules and caused significant functional inhibition of urease activity. In short, our findings suggest that zerumbone may be an effective H. pylori urease inhibitor that may be suitable for therapeutic use in humans.

Antidiabetic effects of betulinic acid mediated by the activation of the AMP-activated protein kinase pathway.

Betulinic acid (BA) is a naturally arising pentacyclic triterpenoid that has anti-malarial, anti-retroviral, anti-inflammatory, and anti-cancer biological effects. More recently, it has been reported to possess anti-obesity activity mediated by the activation of AMP-activated protein kinase (AMPK). We further investigated antidiabetic activity of BA in mouse tissues at the cellular and systemic levels. We found that BA stimulated AMPK in a similar fashion to the known AMPK activators, such as 5-aminoimidazole-4-carboxamide-1-ß-D-ribofuranoside and metformin. Notably, the level of glucose uptake by BA was not altered by wortmannin, suggesting that this activation did not depend on phosphoinositide 3-kinase. Furthermore, BA diminished blood glucose levels in alloxane-treated ICR mice and in untreated mice during the glucose tolerance test. BA also stimulated mRNA expression of glucose transporter 4, which could partly explain increased glucose uptake. BA also increased AS160 phosphorylation by insulin-independent mechanisms in the extensor digitorum longus muscle. These results indicate that BA may serve as a promising therapeutic agent for diabetes by activating AMPK, like metformin. Notably, BA also enhanced mouse endurance capacity, indicating that it also affects metabolic regulation in addition to its antidiabetic activity.

Evodiamine Inhibits Helicobacter pylori Growth and Helicobacter pylori-Induced Inflammation.

Helicobacter pylori (H. pylori) classified as a class I carcinogen by the World Health Organization (WHO) plays an important role in the progression of chronic gastritis and the development of gastric cancer. A major bioactive component of Evodia rutaecarpa, evodiamine, has been known for its anti-bacterial effect and anti-cancer effects. However, the inhibitory effect of evodiamine against H. pylori is not yet known and the inhibitory mechanisms of evodiamine against gastric cancer cells are yet to be elucidated concretely. In this study, therefore, anti-bacterial effect of evodiamine on H. pylori growth and its inhibitory mechanisms as well as anti-inflammatory effects and its mechanisms of evodiamine on H. pylori-induced inflammation were investigated in vitr. Results of this study showed the growth of the H. pylori reference strains and clinical isolates were inhibited by evodiamine. It was considered one of the inhibitory mechanisms that evodiamine downregulated both gene expressions of replication and transcription machineries of H. pylori. Treatment of evodiamine also induced downregulation of urease and diminished translocation of cytotoxin-associated antigen A (CagA) and vacuolating cytotoxin A (VacA) proteins into gastric adenocarcinoma (AGS) cells. This may be resulted from the reduction of CagA and VacA expressions as well as the type IV secretion system (T4SS) components and secretion system subunit protein A (SecA) protein which are involved in translocation of CagA and VacA into host cells, respectively. In particular, evodiamine inhibited the activation of signaling proteins such as the nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) and the mitogen-activated protein kinase (MAPK) pathway induced by H. pylori infection. It consequently might contribute to reduction of interleukin (IL)-8 production in AGS cells. Collectively, these results suggest anti-bacterial and anti-inflammatory effects of evodiamine against H. pylori.

Effects of occupational balance on subjective health, quality of life, and health-related variables in community-dwelling older adults: A structural equation modeling approach.

Occupational balance is an important variable associated with health and quality of life. This study aimed to investigate the influence of occupational balance on health, quality of life, and other health-related variables using structural equation modeling. We analyzed data from 208 adults over 55 years old. Mean age of the participants was 70.21 years (SD 7.22). The research model for analysis was based on the results of previous studies addressing occupational balance and related variables such as stress, leisure satisfaction, life satisfaction, subjective health, quality of life, and participation. General fit indices of the final model were acceptable (x2/df = 1.708, p < .001, RMSEA = .058, TLI = .923, CFI = .929, and SRMR = .067). Although the size of effect was small to medium (.157-.249), occupational balance was identified as an independent variable directly or indirectly affecting subjective health, quality of life, and health-related variables in the final model. Our results showed that it is possible to improve subjective health and quality of life by promoting better occupational balance. Further studies developing an intervention program based on occupational balance are required to confirm the feasibility of the intervention and its effect on older adults' health and quality of life in real-life circumstances.

Substantiating Clinical Effectiveness and Potential Barriers to the Widespread Implementation of Spinal Cord Injury Telerehabilitation: A Systematic Review and Qualitative Synthesis of Randomized Trials in the Recent Past Decade.

Introduction: Telemedicine across many specialties in clinical practice has been established in the literature regarding technology platforms, privacy issues, cost, and clinical effectiveness. However, the lack of data in these areas applicable to spinal cord injury telerehabilitation (teleSCI) still exists. The gaps in these knowledge areas continue to hinder its widespread implementation and serve as pathways for focused efforts in teleSCI research. Objective: This systematic review aims to substantiate the clinical effectiveness and potential barriers to teleSCI implementation by verifying the statistical significance of various clinical outcomes from randomized trials published within the recent past decade. Methods: A qualitative synthesis of randomized studies, conducted across various regions, was systematically reviewed after identifying relevant records from database search engines. Applied filters in the search included publication dates (2010-2020), humans, full-text, and no language preference. The 13 studies were selected per Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram, and the risk of bias across studies was evaluated by using the Physiotherapy Evidence Database scale of quality assessment. Results: Quantitative outcome measurements demonstrated positive impact across studies: 79.1% (34/43) of all measurements were statistically significant for positive outcomes and 18.6% (8/43) yielded no effect but were significant. Primary outcomes addressed various spinal cord injury (SCI) management areas; 38.5% (5/13) of studies also assessed secondary outcomes. Interventional platforms were conventional technologies used in telemedicine. One study (7.7%) achieved data encryption; no studies presented cost-analysis data. Conclusion: The majority of studies demonstrated significant positive outcomes to validate teleSCI clinical effectiveness through conventional technology. These results further expand our understanding of teleSCI's impact and its demonstrated potential for improving SCI individuals' lives. However, heterogeneity of selected studies limits the conclusive recommendations to address potential barriers to its widespread implementation. Moreover, the development of new data is warranted to promote "buy-in" of widespread teleSCI implementation.

Stakeholder perspectives on research and development priorities for mobility assistive-technology: a literature review.

PURPOSE: Over one billion people with disabilities (PWDs) and older adults with mobility impairment are currently in need of assistive technology devices (ATDs) and only 10% of those population have ordinarily access to them. The need for advancement in mobility-assistive technology is growing to address the gap in ATDs provision globally. The purpose of this review is to identify potential future areas of development and research in mobility-assistive technology. METHOD: Publications were identified using scientific and medical electronic databases. Also, a limited grey literature search was conducted to muster a variety of sources. A combination of keyword search terms was used, corresponding to the medical subject heading (MeSH) terms. RESULTS: A total of 392 articles were identified, of which 75 were selected for detailed review. Twenty-eight articles were identified that met the review's inclusion criteria. Future areas of research for mobility-assistive technology were identified by grouping the publications into four main categories. The findings of this review identified several areas of research and development in ATDs in general and mobility-assistive technology, in particular, with special attention to the importance of engaging users and stakeholders in the process of research and design. CONCLUSIONS: It is apparent that users' needs and priorities vary between regions within countries. The majority of studies were noted to mainly identify consumers' perspectives on a national basis. The authors, therefore, suggest that further research should be conducted on a global level to determine the knowledge and perspectives concerning future research and development needs and priorities in mobility-assistive technologies.Implication for RehabilitationDespite the benefits derived from the use of ATDs, only 10% of people with disabilities have access to them.Increasing access, quality and affordable ATDs in all countries is global demand.Identifying mobility consumers' needs and priorities would help in enhancing their quality of life by translating research into new technologies that meet their environment and culture needs.Users' involvement in research and design process is a crucial approach to re-shape the future research agenda.

The Effect of Fermented Porcine Placental Extract on Fatigue-Related Parameters in Healthy Adults: A Double-Blind, Randomized, Placebo-Controlled Trial.

BACKGROUND: Fatigue is one of the major health conditions induced by excessive stress or abnormal immune function or defective antioxidant systems. Placental extract has been reported to have various effects such as immune modulation and cellular regeneration. Fermented porcine placenta (FPP) is a safe nontoxic material, which is highly valuable as a functional food. The aim of this study was to investigate the anti-fatigue effects of FPP supplementation compared with a placebo product. METHODS: In this double-blind, parallel, randomized, and placebo-controlled trial 84 healthy males and females, aged between 30 and 60 years were randomized to 320 mg of FPP once daily or placebo. The main outcome measures included efficacy of fatigue-inducing treadmill exercise on physical fatigue and fatigue-related parameters based on the questionnaire administered. RESULTS: The IL-1ß mRNA expression and fatigue severity scale were changed significantly after 8 weeks of treatment with fermented porcine placenta compared with placebo (p < 0.05). Cortisol levels were significantly improved in participants younger than 45 years following treatment with FPP compared with placebo. Furthermore, the lactate and myoglobin levels were improved significantly in participants with BMI ≥ 23 kg/m2 (p = 0.045 and p = 0.011, respectively) following treatment with FPP versus placebo. CONCLUSIONS: Our study showed that FPP supplementation significantly ameliorated fatigue-related parameters and subjective symptoms in healthy adults. Therefore, our results indicate that FPP supplementation induced anti-fatigue effect by regulating the inflammatory response.

ICT-Based Health Care Services for Individuals with Spinal Cord Injuries: A Feasibility Study.

In the Republic of Korea, 90.5% of those living with spinal cord injury (SCI) are faced with medical complications that require chronic care. Some of the more common ones include urinary tract infections, pressure sores, and pain symptomatology. These and other morbidities have been recognized to deteriorate the individual's health, eventually restricting their community participation. Telerehabilitation, using information and communication technology, has propelled a modern-day movement in providing comprehensive medical services to patients who have difficulty in mobilizing themselves to medical care facilities. This study aims to verify the effectiveness of health care and management in the SCI population by providing ICT-based health care services. We visited eight individuals living with chronic SCI in the community, and provided ICT-based health management services. After using respiratory and urinary care devices with the provision of home visit occupational therapy, data acquisition was achieved and subsequently entered into a smart device. The entered information was readily accessible to the necessary clinicians and researchers. The clients were notified if there were any concerning results from the acquired data. Subsequently, they were advised to follow up with their providers for any immediate medical care requirements. Digital hand-bike ergometers and specialized seating system cushions are currently in development. The ICT-based health care management service for individuals with SCI resulted in a favorable expected level of outcome. Based on the results of this study, we have proposed and are now in preparation for a randomized clinical trial.

The Effects of Sulglycotide on the Adhesion and the Inflammation of Helicobacter Pylori.

Helicobacter pylori (H. pylori) is a primary etiologic factor in gastric diseases. Sulglycotide is a glycopeptide derived from pig duodenal mucin. Esterification of its carbohydrate chains with sulfate groups creates a potent gastroprotective agent used to treat various gastric diseases. We investigated the inhibitory effects of sulglycotide on adhesion and inflammation after H. pylori infection in human gastric adenocarcinoma cells (AGS cells). H. pylori reference strain 60190 (ATCC 49503) was cultured on Brucella agar supplemented with 10% bovine serum. Sulgylcotide-mediated growth inhibition of H. pylori was evaluated using the broth dilution method. Inhibition of H. pylori adhesion to AGS cells by sulglycotide was assessed using a urease assay. Effects of sulglycotide on the translocation of virulence factors was measured using western blot to detect cytotoxin-associated protein A (CagA) and vacuolating cytotoxin A (VacA) proteins. Inhibition of IL-8 secretion was measured using enzyme-linked immunosorbent assay (ELISA) to determine the effects of sulglycotide on inflammation. Sulglycotide did not inhibit the growth of H. pylori, however, after six and 12 hours of infection on AGS cells, H. pylori adhesion was significantly inhibited by approximately 60% by various concentrations of sulglycotide. Sulglycotide decreased H. pylori virulence factor (CagA and VacA) translocation to AGS cells and inhibited IL-8 secretion. Sulglycotide inhibited H. pylori adhesion and inflammation after infection of AGS cells in vitro. These results support the use of sulglycotide to treat H. pylori infections.

Inhibitory Effects of ß-Caryophyllene on Helicobacter pylori Infection In Vitro and In Vivo.

The human specific bacterial pathogen Helicobacter pylori (H. pylori) is associated with severe gastric diseases, including gastric cancer. Recently, the increasing resistance makes the usage of antibiotics less effectively. Therefore, development of a new antimicrobial agent is required to control H. pylori infection. In the current study, the inhibitory effect of ß-caryophyllene on H. pylori growth, as well as the antibacterial therapeutic effect, has been demonstrated. ß-caryophyllene inhibited H. pylori growth via the downregulation of dnaE, dnaN, holB, and gyrA and also downregulated virulence factors such as CagA, VacA, and SecA proteins. ß-caryophyllene inhibited expression of several T4SS components, so that CagA translocation into H. pylori-infected AGS gastric cancer cells was decreased by ß-caryophyllene treatment. ß-caryophyllene also inhibited VacA entry through the downregulation of T5aSS. After ß-caryophyllene administration on Mongolian gerbils, the immunohistochemistry (IHC) and Hematoxylin&Eosin stains showed therapeutic effects in the treated groups. Hematological data, which was consistent with histological data, support the therapeutic effect of ß-caryophyllene administration. Such a positive effect of ß-caryophyllene on H. pylori infection potently substantiates the natural compound as being capable of being used as a new antimicrobial agent or functional health food to help patients who are suffering from gastroduodenal diseases due to H. pylori infection.

The Development of Leisure Participation Assessment Tool for the Elderly.

OBJECTIVES: This study is aimed at developing multidimensional leisure participation assessment tool for the elderly to achieve quantitative and qualitative assessment of leisure participation and leisure exploration. METHODS: This study collected preliminary items through literature review, statistical office data, and survey of the elderly's leisure activities and considered the list of leisure activities as assessment items by conducting a Delphi survey. Reliability was verified through internal consistency and test-retest reliability. The assessment tool was finally confirmed using content validity and discriminant validity. RESULTS: A total of 81 leisure items classified into 8 categories and 22 subcategories were obtained through data collection and Delphi survey. Cronbach's α value was 0.939, and Intraclass Correlation Coefficient was 0.941. A content validity test was confirmed by validating that I-CVI was 0.78 or more and the S-CVI was 0.95. According to the result of discriminant validity, there was a difference in the number of participating leisure activities and leisure activities with participation intention by age. CONCLUSION: The leisure participation assessment tool for the elderly developed in this study can obtain information on the overall view of the leisure of the elderly by measuring leisure exploration, leisure participation, and interference factor affecting leisure participation.

Development and reliability of the Korean version of the Feeding Abilities Assessment.

OBJECTIVE: The purpose of this study is to introduce a standardised assessment tool by verifying the reliability of the translated Korean version of the Feeding Abilities Assessment (K-FAA), which was developed to suit Korean culture. METHODS: The research subjects were 65 patients with dementia living in nursing homes. The K-FAA was completed by verifying the suitability of translation and reverse translation. The validity of the K-FAA was established through content validity, while its reliability was analysed based on internal consistency reliability for the items, test-retest reliability and inter-rater reliability. RESULTS: The content validity index determined, based on the assessment of professors, occupational therapists, and nurses, was more than .70. Cronbach's α was more than .929, showing good internal consistency. A test-retest reliability of .884 was derived using Pearson's correlation coefficient (p < .01), and an inter-rater reliability of .800 was derived using the kappa coefficients; intraclass correlation coefficient was .897, which also indicated good reliability. CONCLUSION: The K-FAA was modified to fit the Korean domestic situation, and this assessment had high reliability. Therefore, K-FAA can evaluate the feeding ability of patients with dementia. Future studies should focus on providing evidence-based data to maintain or supplement the feeding ability of patients with dementia in Korea.

Inhibitory Effects of Menadione on Helicobacter pylori Growth and Helicobacter pylori-Induced Inflammation via NF-κB Inhibition.

H. pylori is classified as a group I carcinogen by WHO because of its involvement in gastric cancer development. Several reports have suggested anti-bacterial effects of menadione, although the effect of menadione on major virulence factors of H. pylori and H. pylori-induced inflammation is yet to be elucidated. In this study, therefore, we demonstrated that menadione has anti-H. pylori and anti-inflammatory effects. Menadione inhibited growth of H. pylori reference strains and clinical isolates. Menadione reduced expression of vacA in H. pylori, and translocation of VacA protein into AGS (gastric adenocarcinoma cell) was also decreased by menadione treatment. This result was concordant with decreased apoptosis in AGS cells infected with H. pylori. Moreover, cytotoxin-associated protein A (CagA) translocation into H. pylori-infected AGS cells was also decreased by menadione. Menadione inhibited expression of several type IV secretion system (T4SS) components, including virB2, virB7, virB8, and virB10, that are responsible for translocation of CagA into host cells. In particular, menadione inhibited nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) activation and thereby reduced expression of the proinflammatory cytokines such as IL-1ß, IL-6, IL-8, and TNF-α in AGS as well as in THP-1 (monocytic leukemia cell) cell lines. Collectively, these results suggest the anti-bacterial and anti-inflammatory effects of menadione against H. pylori.