Environmental impact. Recent research indicates that people who live in environments conducive to walking may walk more. Julie Keysor, a SAR assistant professor of physical therapy, is addressing a related question: how does their physical environment affect the daily activities of people recovering from an illness or living with a chronic physical limitation?
Keysor and a research team that includes Alan Jette, a SAR professor and dean, and Stephen Haley, a SAR professor of rehabilitation sciences, have developed and tested a questionnaire assessing factors in the home and community that affect mobility, communication, and interaction. Jette is the director and Haley the associate director
of SAR’s Health and Disability Research Institute, and they codirect SAR’s Center for Rehabilitation Effectiveness.
Known as the Home and Community Environment instrument (HACE), the questionnaire asks about the physical characteristics of a person’s environment: for instance, the number of stairs in his or her home, the condition of nearby sidewalks, the availability of communication devices such as computers and mobility devices such as wheelchairs or walkers, and the accessibility of public transportation or a car. It also asks about the attitudes of people with whom the person has contact — for example, whether they are willing to help with daily activities like shopping, getting to appointments, or going to the movies.
Having established the reliability of the instrument, Keysor and colleagues at SAR and MED now are using HACE to assess the environment of people with, or at risk for, osteoarthritis of the knee. They will use the scores to understand the relationship between a subject’s environment and his or her activities. Through the study, they hope to better understand how the environment of physically challenged individuals can be improved to encourage their involvement in life activities.
“HACE has both clinical and policy applications,” according to Keysor. “It has the potential to underscore the need for policies that make homes and communities more accessible and to help clinicians find ways to address risk factors, get resources for their patients, and eliminate environmental hazards.”
Eliminating roadblocks. According to the American Social Health Association, 65 million Americans are currently infected with a sexually transmitted disease (STD), and 15 million are newly infected each year. Although early detection and treatment can help control the spread of such diseases and prevent complications, many factors discourage testing. Public health efforts are hampered, for instance, by the fact that tests tend to be too cumbersome to be performed in a doctor’s office and require large blood samples or uncomfortable sample collection methods, and patients have to wait several days or even weeks for results. Such factors pose significant roadblocks to STD testing by discouraging patients from being tested or returning for results, follow-up counseling, and treatment.
However, a new testing device being developed by a team of researchers led by Catherine Klapperich, an ENG assistant professor of manufacturing engineering and biomedical engineering, may clear some of these hurdles. She is prototyping a microfluidic device that will make it possible to quickly test for multiple diseases using a single vacuum tube of blood and get results in under an hour. Made of molded polymers, the device will be inexpensive, disposable, and easy to use. It will also fit into standard blood centrifuges, which are already in nearly all doctors’ offices.
The size of a standard test tube, the device has channels less than one millimeter in diameter connected to small mixing chambers. A syringe loads blood serum into the device, which is centrifuged to mix the correct amount of the serum with tiny amounts of reagents that will bind to human antibodies for the diseases in question. If the antibodies are present, indicating that the person is infected, specific colors will appear in the reaction wells of the device.
Because the device is easy to use, portable, and inexpensive, it is expected to be especially useful in rural and low-income areas in the United States and around the globe. The Provost’s Innovation Fund is supporting the development of the prototype device.
Briefs" is written by Joan Schwartz in the Office of the Provost. To read
more about BU research, visit http://www.bu.edu/research.