Digital platforms to facilitate physical activities for people with physical or sensory disabilities: A scoping review.

BACKGROUND: People with disabilities (PWD) commonly experience difficulties in accessing their environments, which can lead to restricted participation in outdoor leisure-time physical activity. Participating in outdoor leisure-time physical activity (OLTPA) provides health and social benefits to PWD and benefits to the communities in which they live. OBJECTIVE: The aim of the study was to identify features existing in digital platforms that facilitate access to OLTPA for PWD. METHODS: A scoping review was conducted in four library databases and in Google advance search to identify relevant scientific and grey literature, and websites. Each step of the review was independently conducted by two co-authors who confirmed consensus of results. Descriptive data analyses were performed. RESULTS: Seven scientific studies and ten websites were included in the scoping review. Seven presented mobile apps, nine presented a website and one presented an online database. Sources reported five main obstacles to using digital platforms that support access to physical activities (e.g., lack of digital literacy, technical issues, unintuitive design), and 10 facilitators (e.g., possibility to personalize your online space, accessibility features of the navigation). Among these sources, a trend emerged in the most important factors and features to consider for the visuals and navigation of the platforms. CONCLUSION: The features of digital platforms that facilitate access to OLTPA include intuitive design compliant with accessibility guidelines and supported by navigation tools, personalization of the online space, and features for social interactions.

The state of knowledge on technologies and their use for fall detection: A scoping review.

BACKGROUND: Globally, populations are aging with increasing life spans. The normal aging process and the resulting disabilities increase fall risks. Falls are an important cause of injury, loss of independence and institutionalization. Technologies have been developed to detect falls and reduce their consequences but their use and impact on quality of life remain debatable. Reviews on fall detection technologies exist but are not extensive. A comprehensive literature review on the state of knowledge of fall detection technologies can inform research, practice, and user adoption. OBJECTIVES: To examine the extent and the diversity of current technologies for fall detection in older adults. METHODS: A scoping review design was used to search peer-reviewed literature on technologies to detect falls, published in English, French or Spanish since 2006. Data from the studies were analyzed descriptively. RESULTS: The literature search identified 3202 studies of which 118 were included for analysis. Ten types of technologies were identified ranging from wearable (e.g., inertial sensors) to ambient sensors (e.g., vision sensors). Their Technology Readiness Level was low (mean 4.54 SD 1.25; 95% CI [4.31, 4.77] out of a maximum of 9). Outcomes were typically evaluated on technological basis and in controlled environments. Few were evaluated in home settings or care units with older adults. Acceptability, implementation cost and barriers were seldom addressed. CONCLUSIONS: Further research should focus on increasing Technology Readiness Levels of fall detection technologies by testing them in real-life settings with older adults.

Effective mucosal immunization against respiratory syncytial virus using purified F protein and a genetically detoxified cholera holotoxin, CT-E29H.

We exploited the powerful adjuvant properties of cholera holotoxin (CT) to create a mucosally administered subunit vaccine against respiratory syncytial virus (RSV). A genetically detoxified mutant CT with an E to H substitution at amino acid 29 of the CT-A1 subunit (CT-E29H) was compared to wild type CT for toxicity and potential use as an intranasal (IN) adjuvant for the natural fusion (F) protein of RSV. When compared to CT the results demonstrated that: (1) CT-E29H binding to GM1 ganglioside was equivalent, (2) ADP-ribosylation of agmatine was 11.7%, and (3) toxicity was attenuated in both Y-1 adrenal (1.2%) and patent mouse gut weight assays. IN vaccination with F protein formulated with CT-E29H induced serum anti-CT and anti-F protein antibodies that were comparable to those obtained after vaccination with equivalent doses of CT. Vaccinations containing CT-E29H at doses of 0.1 microg were statistically equivalent to 1.0 microg in enhancing responses to F protein. Antigen-specific mucosal IgA and anti-RSV neutralizing antibodies were detected in nasal washes and sera, respectively, of mice that had received F protein and 0.1 or 1.0 microg of CT-E29H. Anti-F protein IgA was not detected in the nasal washes from mice IN vaccinated with 0.01 microg CT-E29H or IM with F protein adsorbed to AlOH adjuvant. In addition, the formulation of purified F protein and CT-E29H (0.1 and 1.0 microg) facilitated protection of both mouse lung and nose from live RSV challenge. Collectively, the data have important implications for vaccine strategies that use genetically detoxified mutant cholera holotoxins for the mucosal delivery of highly purified RSV antigens.

A novel and effective intranasal immunization strategy for respiratory syncytial virus.

In designing subunit vaccination strategies for respiratory syncytial virus (RSV), immunization by mucosal routes may present a realistic alternative to parenteral administration for inducing protective immune responses. To this end, we have utilized the BALB/c mouse model and an adjuvant formulation containing caprylic/capric glycerides (CCG) and polyoxyethylene-20-sorbitan monolaurate (PS). The intranasal (i.n.) delivery of purified natural F protein (3 microg per vaccine) formulated with CCG-PS resulted in the generation of statistically heightened serum anti-F protein immunoglobulin G (IgG), IgG1, IgG2b, and IgA antibodies. In addition, the presence of locally produced anti-F protein IgA was demonstrated in both vaginal and nasal washes of vaccinated mice. That production of specific serum and mucosal immunoglobulins resulted in functional immune responses was shown in neutralizing antibody assays and protection of mouse lungs against subsequent live virus challenge. Consequently, we propose a novel vaccine formulation composed of purified natural RSV F protein in CCG-PS as a viable intranasal immunogen to stimulate anti-RSV immune responses in humans.

Innovative approach in rehabilitation nursing: providing primary care to tertiary care patients.

In 1998 health care legislation in Ontario changed and allowed Primary Health Care Nurse Practitioners the possibility to expand their practice. At a rehabilitation centre, where spinal cord injured patients would seek primary health care services, a new amalgamated role was implemented to meet those needs. This article will described the advanced practice role that was developed, define the scope of practice, and demonstrate an innovative approach to service delivery. The role serves as a concrete link between primary health care services and tertiary care patients needs.

Catheter cleaning for re-use in intermittent catheterization: new light on an old problem.

Clean intermittent catheterization is a common method of urinary elimination for people with Spinal Cord Injuries. The methods of catheter cleaning for re-use, however, have not been validated with research studies. This study compared the effectiveness of Hydrogen Peroxide, vinegar, dishwashing detergent, and tap water alone to clean catheters contaminated with Pseudomonas aeruginosa and Escherichia coli. The effect of rinsing and drying before cleaning was also examined, as well as the effect of storage in paper or plastic bags after cleaning. Results indicated that rinsing and drying catheters immediately after use was the most effective at reducing bacteria to very near zero. Elements of a procedure are outlined, as well as plans for further development and testing of a rinse & dry procedure for catheter cleaning and re-use.

Messenger RNAs for neurokinin and histamine receptor subtypes in isolated canine colonic crypts.

Functional subtyping of neurokinin and histamine receptors on the canine proximal colon suggested that different receptors were involved in mediating the neural and non-neural effects on ion transport. If the non-neural effects involved direct stimulation of the transporting epithelial cells, mRNA for specific receptor subtypes should be present in colonic crypt cells. Pharmacological data predicted that RNA from such cells would include mRNAs for neurokinin (NK-1) and histamine (H1 and H2) receptors but not for NK-2 or NK-3 receptors. Using published sequences for the above receptors and reverse-transcription polymerase chain reaction, we have noted that isolated canine colonic crypts had mRNA for NK-1 and NK-2 receptors but not for NK-3 receptors. Messenger RNAs for both H1 and H2 receptors were present. The muscularis mucosa and submucosal plexuses had mRNAs for NK-1, NK-3, H1 and H2 receptors but not for NK-2 receptors. The circular and longitudinal muscles expressed mRNA for all three neurokinin and both histamine receptors. Messenger RNA levels for the alpha-1 isoform of the catalytic subunit of the sodium pump were higher in crypts and lower in muscularis mucosa and muscle preparation. Thus these observations provide further evidence for the existence of different receptor subtypes in the canine colon.

Norepinephrine release in rat vas deferens. Effect of rauwolscine and BHT 920.

Norepinephrine (NE) overflow from field-stimulated rat was deferens preparations was quantified directly by electrochemical detection using high performance liquid chromatography. The effect of agonist (BHT 920) and antagonist (rauwolscine) of prejunctional alpha 2-adrenoceptors on NE overflow was assessed and compared with their effect on the smooth muscle mechanical response to field stimulation. Increasing the stimulation frequency from 2 to 30 Hz resulted in an increase in muscle tension together with an increase in NE overflow. Addition of 1 microM rauwolscine to the medium resulted in a significant increase in muscle contraction to field stimulation which reached a maximum at 5 Hz. On the other hand, NE overflow increased linearly with the frequency of stimulation within the range studied. Addition of 0.1 microM BHT 920 to the medium significantly decreased the amplitude of contractions at lower stimulation frequencies (2 to 10 Hz) but elicited no significant changes at high frequencies. BHT 920 did not significantly affect NE overflow for all range of stimulation frequency. The simultaneous recording of field-stimulation induced contractions and NE overflow indicates that in the rat vas deferens, rauwolscine acts like a pure alpha 2 adrenoceptor antagonist at a prejunctional level. BHT 920 did not appear to affect selectively prejunctional alpha 2 adrenoceptors but also may activate postjunctional alpha 1 adrenoceptors.

The relationship between convergence insufficiency and school achievement.

Schoolchildren (735) between the ages of 7 and 14 were examined for convergence ability. Nine percent had an objective near point of convergence of more than 10 cm and 10% had a subjective near point of convergence of more than 10 cm. The recovery point was greater than 15 cm for 9% of the subjects when measured objectively and 12% subjectively. The sample was analyzed with regard to age, sex, and IQ. There was no significant difference between children who showed convergence insufficiency and those who did not with regard to school results in their mother tongue and in their grade point average.