Cross-sectional associations between replacing sedentary behavior with physical activity by accelerometer-measured and depression in frail older adults: An Isotemporal Substitution approach / 体力科学

The purpose of the present study was to examine the associations of replacing accelerometer-measured sedentary behavior (SB) with physical activity (PA) and depression in a sample of Japanese frail older adults using an Isotemporal Substitution (IS) model. Among 139 frail older adults, accelerometer was utilized to identify the daily average time spent in SB, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA). Depression was assessed using the Geriatric Depression Scale-Short Version-Japanese (GDS-S-J). The relationship between SB, LPA, and MVPA with depression was examined with three models of multiple regression analysis: single factor model, partition model, and IS model. As results, LPA times was negatively associated with GDS-S-J scores in the single factor model (B = -0.09, p = 0.007) and the partition model (B = -0.13, p < 0.001). In the IS model, replacement of 10 minutes of SB with an equal amount of LPA time showed a significant negative association with GDS-S-J scores (B = -0.09, p=0.003). These results suggest that replacing a small amount of SB with LPA may be associated with an improvement in depression in frail older adults.

The Report on Toyama City Care Prevention Center in These 10 Years / 日本温泉気候物理医学会雑誌

  This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

The AsthmaID Tool in Singapore: Four Simple Questions to Detect Patients in need of an Asthma Review by a Specialist

@#A rising prevalence of asthma in Singapore translates to a more considerable patient care burden for general practitioners. Along with diagnosing and managing the treatment of asthma, general practitioners must recognise when referral to a respiratory specialist is necessary. Although mild to moderate asthma is generally manageable in the primary care setting, patients with poorly controlled, difficult-to-treat, or severe asthma may benefit from referral to a specialist. Currently, many of these patients are not receiving optimal care, which places them at risk of asthma exacerbations and unnecessary systemic corticosteroid use. AsthmaID was developed as a tool for general practitioners to identify patients with asthma for whom a specialist evaluation could help improve asthma symptom control and optimise treatment strategies. Using four questions developed by asthma experts and rooted in the Global Initiative for Asthma report, AsthmaID quickly identifies patients who may benefit from a specialist referral without requiring additional patient assessments or testing modalities. Implementation of AsthmaID in clinical practice has the potential to transform the patient care pathway, thereby improving the quality of care for patients with asthma.

The Report on Toyama City Care Prevention Center in These 10 Years / 日本温泉気候物理医学会雑誌

  This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

Cuidados de mulheres para o controle e a prevenção da hipertensão arterial no ambiente familiar / The care of women in the control and prevention of arterial hypertension in the family environment

Objetivo: Identificar os cuidados realizados por mulheres hipertensas para o controle deste agravo e sua prevenção no ambiente familiar. Método: Estudo descritivo, sendo entrevistadas 126 mulheres em unidade ambulatorial, em Salvador-BA. Resultados: Constatou-se elevada frequência de ingestão de alimentos ricos em sódio (66,6%), hábito de preparar o feijão com carnes salgadas (63,5%), sedentarismo (72,2%), não fracionamento das refeições (73,8%) e baixo consumo de alimentos integrais (74,6%). Apesar de 34,1% residirem com algum familiar hipertenso, 64,1% não conversavam com familiares sobre a prevenção e controle da doença, 73,0% não os orientavam para a aferição da pressão arterial e 50% não reduziam o sal para toda a família. Conclusão: A maioria não realizava o autocuidado necessário ao controle da doença e não estendia à família os cuidados referentes à prevenção. É preciso conhecer crenças e barreiras para adesão à terapêutica e compartilhar com as mulheres uma proposta de cuidado que possa ser estendida à família.

Objective: To identify the care performed by hypertensive women for the control of this grievance and its prevention in the family environment. Method: Descriptive study with the interview of 126 women in an outpatient clinic, in Salvador-BA. Results: The following was verified: a high frequency of ingestion of food with elevated levels of sodium (66.6%), the habit of preparing bens with salted meat (63.5%), sedentary lifestyles (72.2%), not fractioning meals (73.8%) low consumption of whole foods (74.6%). Despite 34.1% living with some hypertensive family member, 64.1% did not talk with the family about prevention and control of the disease, 73.0% did not guide them to check their blood pressure and 50% did not reduce the content of salt for the whole family. Conclusion: Most did not perceive the self-care necessary for the control of the disease and did not extend to the family the cares related to prevention. It is necessary to understand the beliefs and barriers for adhesion to the therapeutics and share with the women a proposal for the care that can be extended to the family.

Relationship between healthy elderly individual social capital and health according to ward level in Tomi City, Nagano Prefecture: an ecological study / Journal of Rural Medicine

Objectives: The aims of this study were 1) to elucidate the relationship between social capital and health by ward in Tomi City, Nagano Prefecture, in order to clarify the regional social resources available to support long-term care prevention utilizing self- and mutual support of regional residents and 2) to comprehensively investigate the activation of regional networks.Materials and Methods: We analyzed elderly (aged 65 years or older) individual survey data from 7,199 residents from all wards within Tomi City in 2014 (number of valid responses: 5,546; valid response rate: 77.0%). The social capital indicators used for the analysis included participation in community activities, regional managerial position experience, and general trust. The health indicators included self-rated mental health, activities of daily living, and depression. Standards for a “good” result for each indicator were established, and the percentages of each were tallied up by ward. Spearman’s rank correlation coefficient and principal component analysis were used to investigate correlations between social capital and health.Results: The results for overall respondents indicated correlations between participation in sports and hobbies and activities of daily living (p<0.01) and self-rated mental health (p<0.05). Participation in nonprofit organizations/volunteer activities and participation in community center workshops exhibited correlations with activities of daily living (both p<0.05). In respondents aged 65–74 years, participation in community center workshops and general trust were found to be correlated with activities of daily living (both p<0.05). Meanwhile, in respondents aged 75 years or older, correlations were noted between participation in sports and hobbies and participation in nonprofit organizations/volunteer activities and activities of daily living (p<0.05 and p<0.01, respectively). By creating a distribution map using principal component analysis, we were able to grasp the characteristics of the distribution of “community participation/connections with people” and “health” in each ward.Conclusions: Our results point the way forward for future long-term care prevention support in Tomi City by clarifying the correlation between social capital and health by ward.

ENFOQUE DE ENFERMERÍA EN LA ATENCIÓN PRIMARIA DE DIABETES Y CORAZÓN COMO HERRAMIENTA FUNDAMENTAL PARA LA PREVENCIÓN, CUIDADO Y PROMOCIÓN / NURSING APPROACH IN PRIMARY CARE OF DIABETES AND HEART AS A KEY TOOL FOR PREVENTION, CARE AND PROMOTION

Actualmente, es evidente el impacto de la atención primaria a las personas con diabetes y la convicción de que la educación diabetológica es indispensable en su abordaje terapéutico, ya que así se puede contribuir a un plan individualizado por paciente, que permita su consecuente tratamiento y la preservación de su salud. Por esto, el profesional de enfermería y la familia deben ejercer un rol protagónico, realizando actividades preventivas, educadoras, rehabilitadoras y de atención, a través de la construcción de estrategias individuales y comunitarias. En la siguiente guía se encontrará una serie de intervenciones en atención primaria, como lo son: El papel de la enfermera y la visión de esta en la diabetes, valoración y seguimiento, aplicación del modelo de Callista Roy, proceso de atención de enfermería, recomendaciones nutricionales e indicadores sobre el paciente y la familia, con el fin de disminuir factores de riesgo y prevenir enfermedades de este tipo.

Currently, it is clear the impact of primary care for people with diabetes and the belief that education about this disease is indispensable in the therapeutic approach, as this can contribute to an individualized patient plan that allows their subsequent treatment and the preservation of their health. Therefore, the nursing professional and the family should play a leading role, in performing preventive and educational activities, and rehabilitative care through building individual and community strategies. In the following guide you will find a series of interventions in primary care, such as: the role of the nurse and the vision of her in diabetes, assessment, monitoring and implementation of the model of Callista Roy, nursing care process, nutritional recommendations and indicators about the patient and family; in order to decrease risk factors and prevent such diseases.

Effects of community-based intervention on cognitive function and hand finger dexterity in older adults at different levels of time to go out / 体力科学

<p>The present study aimed to examine the effects of community-based intervention on cognitive function and hand finger dexterity in older adults at different levels of time to go out. Forty men and women (age, 73 ± 1 years) participated in supervised group activity and seated exercise for 60 min per session, once each week during an 8-week intervention. The participants wore an activity monitor for 1 week to determine baseline values and for the 8 weeks of intervention. Mini-mental state examination (MMSE) and pegboard test, which is related to cognitive function, were assessed before and after the intervention. Based on the total time to go out at baseline, the participants were assigned to Control group (> 60 min/day, n = 18) or Short group (≦ 60 min /day, n = 22), and then analyzed. After the 8 weeks of intervention, the Control and Short groups improved physical fitness parameters such as handgrip strength. Although MMSE in the both groups did not reach statistically significant level, these values tended to increase slightly from the baseline. Interestingly, two-way repeated-measures analysis of variance indicated significant interaction of pegboard test, and the score significantly increased only in the Short group. Total physical activity and moderate-vigorous physical activity in the both groups did not change significantly between the baseline and intervention periods. Therefore, these results suggest that the trainability of pegboard test, which is an index of hand finger dexterity and is related to cognitive function, would differ depending on the time to go out at baseline in older adults.</p>

Effects of a Group Exercise Activity Managed by Elderly Volunteers on the Physical Function of Community-dwelling Older Women who Had Recently Completed an Exercise Program Led by Fitness Experts / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>The purpose of this study was to investigate the effects that a group exercise activity managed by elderly volunteers would have on the physical function of older women after they participated in a formal exercise program taught by fitness experts.</p><p><b>Methods: </b>Subjects were 47 community-dwelling older women who had completed a 3-month exercise program led by expert instructors in Kasama City, Ibaraki. After completing this exercise program, 28 subjects continued to participate in a group exercise activity led by elderly volunteers for approximately 11 months. The remaining 19 subjects did not join the group activities after the formal program. In both the initial, expert-led exercise program and the subsequent, volunteer-led group activity, subjects mainly engaged in the square-stepping exercise, which is a novel exercise for improving lower extremity physical function. In order to assess participants' physical function, we conducted five physical performance tests at both the baseline and follow-up; the former is the last day of the exercise program and the latter is approximately a year after the baseline.</p><p><b>Results: </b>Two-way ANOVA demonstrated a significant interaction in the timed up and go test (P=0.003). The performance of subjects who had participated in the volunteer-managed group activity improved between the baseline and follow-up tests (P=0.007).</p><p><b>Conclusion: </b>Participating in a group exercise activity managed by elderly volunteers can improve mobility skills of older women who had previously completed a formal exercise program led by expert instructors.</p>

Impact of Having Action Plan and Self Efficacy Score on Physical Activity Action Change after One Year / 日本プライマリ・ケア連合学会誌

<b>Introduction</b>: The present study was conducted to identify the influence of self-efficacy score and having an action plan on “stages of change” for exercise after one year.<br><b>Methods</b>: Physical functions and psychological factors at baseline and after one year in 105 elderly individuals who participated in a preventive care program. The subjects were classified into four groups by using the stages of change scale for physical activity.<br>The cause related to impact on physical activity and action stage change (stage) after one year later with having or not having action plan for preventive care program in elderly at home in community as well as sense of self efficacy was investigated.<br><b>Results</b>: Self-efficacy scored significantly higher in the usual activity group with continuity of stage activity both at baseline and one year later. The relative risk of having an action plan at baseline for exercise after one year was 2 . 90 (95% CI: 1.52-5.55). This value significantly influenced the maintenance of physical activity after one year.<br><b>Conclusion</b>: The results of this study suggest that showing an action plan was effective in maintenance of physical activity.

Management of neonatal jaundice in primary care

The Clinical Practice Guidelines on Management of Neonatal Jaundice 2003 was updated by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2014. A systematic review of 13 clinical questions was conducted using evidence retrieved mainly from Medline and Cochrane databases. Critical appraisal was done using the Critical Appraisal Skills Programme checklist. Recommendations were formulated based on the accepted 103 evidences and tailored to local setting as stated below.

Use of Senior Center and the Health-Related Quality of Life in Korean Older Adults / 예방의학회지

OBJECTIVE: The purpose of the present study was to examine the relationship between the use of senior center and health-related quality of life in Korean older adults. METHODS: A questionnaire survey was conducted to two types of older adults who lived in Busan, Korea: 154 older adults who used a senior center and 137 older adults who did not use a senior center. The Korean version of short-form 36-item health survey was administered to assess the health-related quality of life. Demographic variables were obtained from a questionnaire. These were gender, age, family status, marital status, education, monthly income, present illness, body mass index and physical activity. RESULTS: The 8-domain scales of physical function and role-physical were significantly higher in the users of the senior center compared with the non-users (F=4.87, p=0.027 and F=7.02, p=0.009, respectively). The 8-domain scales of vitality was also significantly higher in the users of the senior center compared with the non-users (F=7.48, p=0.007). CONCLUSIONS: The present study showed that the users of the senior center have higher physical function, role-physical and vitality compared with the non-users. These findings suggest that although the results are unable to specify causal relationships using the senior center may lead to some improvement in health-related quality of life.