1,721,413 research outputs found
Factors that influence older adults’ participation in physical activity: A systematic review of qualitative studies
No full textIntroduction: despite the myriad advantages associated with physical activity (PA), older adults are often insufficiently active to maximise health benefits. Understanding factors that influence engagement in PA will support practitioners in providing well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adult’s engagement in PA.Method: four electronic databases were searched: CINAHL, Embase, MEDLINE and PsycINFO. Inclusion criteria were community-dwelling older adults (≥70 years), and studies including qualitative method. Exclusion criteria were studies examining a single disease group, individuals with cognitive impairment, care home residents, and PA interventions. The Critical Appraisal Skills Programme (CASP) checklist was used to assess methodological rigour. Framework synthesis using the COM-B model was applied to analyse data, and the GRADE-CERQual approach was used to assess confidence in findings. (PROSPERO: CRD42021160503).Results: twenty-one studies were included in the review. Participants (N = 3,955; mean age 78.9 years) included 64% female and 36% male older adults. Most studies were methodologically rigorous (17/21 scored ≥8 CASP). We identified 32 themes mapped against the COM-B framework (16 high confidence). Older adult’s perceived capability was influenced by their functional capacity, illness symptoms and perceived risk of injury from PA. PA was motivated by identifying as an ‘exerciser’, health gains and positive emotions (e.g. enjoyment), while negative sensations reduced motivation (e.g. pain). Opportunity was impacted by the weather, the environment ‘fit’, and the availability of social interaction during PA. Moreover, social opportunity was impacted by socio-cultural ageing stereotypes and discourses, influencing older adults’ PA through media outlets, social norms, and self-stigma.Conclusion: the review found a complex web of interacting factors that influenced older people’s PA between the sub-domains of capability, motivation, and opportunity. Future initiatives to increase PA in older adults should focus on social influences, environmental barriers, and physical limitations
Physical activity among hospitalised older people: The feasibility and acceptability of a volunteer-led mobility intervention
No full textPhysical inactivity among older inpatients is associated with worsening physical functionand increasing dependence in activities of daily living. Studies have shown thatinterventions using paid staff to improve physical activity levels may reduce the risk ofsome of these harmful effects. However, few studies have explored the use of volunteersin this role. The aim of this study was to assess the feasibility and acceptability of usingtrained volunteers to encourage older inpatients to be physically active.Physical activity levels of inpatients aged ≥ 70 years on three study wards receiving usualcare were measured using two accelerometers. An evidence-based training programmefor volunteers was developed with therapy colleagues. The volunteer-led activity sessionswere implemented on the study wards with repeat measurement of physical activity.Finally, the acceptability of the intervention was assessed through interviews and focusgroups among patients, volunteers, nurses and therapists.42 participants (mean age 87.5 years, SD 4.6) receiving usual care had their physicalactivity measured. The median daily step count was 636 steps (IQR 298 – 1468), and themean daily acceleration was 9.1milligravity (mg) (SD 3.3). 17 volunteers were recruitedand volunteer retention at the end of the study period was 70% (12 volunteers). 310activity sessions were offered to 50 participants and 230 sessions (74%) were completed.No adverse event was reported. 25 participants including patients, volunteers, nurses andtherapists were interviewed. Findings from the interviews demonstrated that theintervention was well-received among patients, nurses and therapists.Volunteers can be trained and retained to safely encourage older inpatients to be moreactive. Further research is required on the impact of the volunteer-led intervention onpatient outcomes
Age and frailty are independently associated with increased covid-19 mortality and increased care needs in survivors: results of an international multi-centre study
No full textIntroduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54 83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18 49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54 5.02), frailty (CFS 8 versus 1 3: HR 3.03, CI 2.29 4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1 3: odds ratio 7.00, CI 5.27 9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge.The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.</p
Southampton Mobility Volunteer Feasibility Study Dataset
No full textThis dataset contains data from the Southampton Mobility Volunteer Feasibility study. </span
The effectiveness of volunteer-led physical activity interventions in improving health outcomes for community-dwelling older people: a systematic review
No full textIntroduction: physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people.Methods: following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity.Results: twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions.The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention.Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability.Conclusions: trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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