Every parent’s worst nightmare: knowledge and attitudes towards meningitis and vaccination

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The Role and Contribution of Philanthropy to the Lives of Older People in Ireland

This paper examines the impact, since 2008, of an international philanthropic organisation on the ageing sector in the Republic of Ireland. Several methods were used in a sector-wide evaluation, including documentary analysis, one-to-one in-depth interviews, a cross-sectional survey of grant-holders, and collaborative work with Northern Ireland. There was a relative lack of strategic focus on older people before the philanthropic work began; evidence for policy and planning was limited and advocacy was small-scale and largely uncoordinated. This may have been because the Republic of Ireland had the lowest proportion of people aged ≥65 in the EU. The findings show that philanthropy has played a pivotal role in enhancing capacity, infrastructure and expertise through large-scale investment in research and training, strengthening older people’s organisations and developing centres of excellence. Important initiatives include a national longitudinal ageing study, a commitment to develop a positive ageing strategy and roll-out of the Age Friendly Counties programme. The sustainability of these notable achievements relies on a sector-wide collaborative ethos, translating evidence into practice, actively involving older people and securing support from the academic, health and government sectors. Overall, the philanthropic organisation has contributed significantly to Ireland’s efforts to develop innovative, evidence-based ageing strategies and policies

Psychological Acceptance: Experimental Analyses and Theoretical Interpretations

There has been a recent explosion of interest in experiential avoidance as a source of human psychopathology and acceptance-based interventions as a means of combating the deleterious effects of such avoidance. Most of this work has focused on clinical outcome measures, but a small body of research has also employed experimental analogs. The first part of the current article reviews the key studies in this analog research and concludes that the results support the argument that acceptance interventions provide some possible advantages over more traditional control- or distraction-based interventions. The second part of the article provides the beginnings of a technical analysis of acceptance in terms of Relational Frame Theory, a modern behavioral approach to human language and cognition

Transition(s) to work: the experiences of people with disabilities in Ireland.

Whilst disability policy in Ireland has advanced in recent years, the under-representation of people with a disability in the workforce continues to be a social and economic challenge. Education and training have been identified as critical factors enabling a move into paid employment yet little is known, in an Irish context, as to the experiences of people living with disabilities as they transition into work. This qualitative study explores the views and perceptions of a diverse group of people with disabilities who are attempting, or have already made, a transition from education or training to work in the context of fluid 21st century labour markets. Key issues identified in the research include self-perceptions of work-readiness, concerns related to disability disclosure and the need for more flexible approaches to work-place accommodations

Time-limited home-care reablement services for maintaining and improving the functional independence of older adults

Background: Reablement, also known as restorative care, is one possible approach to home-care services for older adults at risk of functional decline. Unlike traditional home-care services, reablement is frequently time-limited (usually six to 12 weeks) and aims to maximise independence by offering an intensive multidisciplinary, person-centred and goal-directed intervention. Objectives: To assess the effects of time-limited home-care reablement services (up to 12 weeks) for maintaining and improving the functional independence of older adults (aged 65 years or more) when compared to usual home-care or wait-list control group. Search methods: We searched the following databases with no language restrictions during April to June 2015: the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OvidSP); Embase (OvidSP); PsycINFO (OvidSP); ERIC; Sociological Abstracts; ProQuest Dissertations and Theses; CINAHL (EBSCOhost); SIGLE (OpenGrey); AgeLine and Social Care Online. We also searched the reference lists of relevant studies and reviews as well as contacting authors in the field. Selection criteria: We included randomised controlled trials (RCTs), cluster randomised or quasi-randomised trials of time-limited reablement services for older adults (aged 65 years or more) delivered in their home; and incorporated a usual home-care or wait-list control group. Data collection and analysis: Two authors independently assessed studies for inclusion, extracted data, assessed the risk of bias of individual studies and considered quality of the evidence using GRADE. We contacted study authors for additional information where needed. Main results: Two studies, comparing reablement with usual home-care services with 811 participants, met our eligibility criteria for inclusion; we also identified three potentially eligible studies, but findings were not yet available. One included study was conducted in Western Australia with 750 participants (mean age 82.29 years). The second study was conducted in Norway (61 participants; mean age 79 years). We are very uncertain as to the effects of reablement compared with usual care as the evidence was of very low quality for all of the outcomes reported. The main findings were as follows. Functional status: very low quality evidence suggested that reablement may be slightly more effective than usual care in improving function at nine to 12 months (lower scores reflect greater independence; standardised mean difference (SMD) -0.30; 95% confidence interval (CI) -0.53 to -0.06; 2 studies with 249 participants). Adverse events: reablement may make little or no difference to mortality at 12 months' follow-up (RR 0.97; 95% CI 0.74 to 1.29; 2 studies with 811 participants) or rates of unplanned hospital admission at 24 months (RR 0.94; 95% CI 0.85 to 1.03; 1 study with 750 participants). The very low quality evidence also means we are uncertain whether reablement may influence quality of life (SMD -0.23; 95% CI -0.48 to 0.02; 2 trials with 249 participants) or living arrangements (RR 0.92, 95% CI 0.62 to 1.34; 1 study with 750 participants) at time points up to 12 months. People receiving reablement may be slightly less likely to have been approved for a higher level of personal care than people receiving usual care over the 24 months' follow-up (RR 0.87; 95% CI 0.77 to 0.98; 1 trial, 750 participants). Similarly, although there may be a small reduction in total aggregated home and healthcare costs over the 24-month follow-up (reablement: AUD 19,888; usual care: AUD 22,757; 1 trial with 750 participants), we are uncertain about the size and importance of these effects as the results were based on very low quality evidence. Neither study reported user satisfaction with the service. Authors' conclusions: There is considerable uncertainty regarding the effects of reablement as the evidence was of very low quality according to our GRADE ratings. Therefore, the effectiveness of reablement services cannot be supported or refuted until more robust evidence becomes available. There is an urgent need for high quality trials across different health and social care systems due to the increasingly high profile of reablement services in policy and practice in several countries

The Effectiveness of Technology-Mediated Dance Interventions and Their Impact on Psychosocial Factors in Older Adults: A Systematic Review and Meta-Analysis

Background: Engaging in physical activity contributes to healthy aging; however, adherence to exercise programs is often low among older adults. Technology-mediated dance systems, which can be used at home, and dance as a way of keeping physically active have been receiving attention as a means of not only enabling physical activity among older people but may also address key psychosocial factors that are amenable to change. Objectives: To assess the effectiveness of technology-mediated dance interventions and their impact on psychosocial factors in older adults (aged 65 or older). Methods: A systematic review of randomized controlled trials from January 2000 to February 2017 using key search terms. Two independent reviewers screened articles using predetermined selection criteria. Risk of bias of selected articles was assessed in accordance with the Cochrane guidelines. Results: From an overall 264 articles, six articles (ve studies) were found, which assessed the impact of technology-mediated dance interventions on psychosocial factors in older adults. Studies' quality ratings were low, with exception of one study that was considered of moderate quality. None of the studies considered psychosocial factors as primary outcomes. Secondary outcomes assessed fear of falling, depression, and training enjoyment, but no study showed evidence of an effective impact on these variables. The meta-analysis revealed low quality evidence that there was little or no difference above that of the comparison groups for fear of falling (standardized mean difference [SMD] −0.02, 95% condence interval [CI] −0.37 to 0.33; P = 0.91; ve trials). Similarly, there was little or no difference on depression (SMD −0.06, 95% CI −0.59 to 0.47; P = 0.83; three trials). Conclusion: Existing evidence to support the effectiveness of technology-mediated dance interventions and their impact on psychosocial factors in older adults is weak and with a high risk for bias. The ndings of this review may inform future, more rigorous research in the area

Variables associated with distress amongst informal caregivers of people with lung cancer: A systematic review of the literature

Objective Informal caregivers of people with lung cancer often experience a substantial care burden and associated negative consequences due to the often-contracted course of the disease. The objective of this review was to systematically examine the evidence on the factors associated with lung cancer caregiver distress. Methods Five databases (MEDLINE, CINAHL, EMBASE, PsychINFO and Web of Science) were searched for studies investigating factors associated with distress amongst caregivers of people with lung cancer. Empirical studies published up to July 2020 were included if they measured distress using a valid and reliable measure and examined its association with at least one other factor, with a sample of 50 or more caregivers. Results Thirty publications describing 27 studies (16 cross-sectional; 6 prospective; 8 intervention) involving 3744 caregivers (primarily spouse or adult child) were included. A narrative synthesis of the findings is presented due to heterogeneity in study design, variables measured and analyses conducted. Patient variables associated with greater distress included: stage of cancer and quality of spousal relationship. Caregiver variables associated with higher distress included: social support, coping strategies and self-efficacy. Conclusions Several variables were associated with distress amongst lung cancer caregivers. Understanding these variables could inform the development of interventions that will enable caregivers to care effectively while maintaining their own well-being. Screening for distress among caregivers may identify those caregivers who would benefit from early intervention

Experiential avoidance and aversive visual images: Response delays and event-related potentials on a simple matching task

In Experiment 1, participants high (n ¼ 15) or low in avoidance (n ¼ 14), as measured by the Acceptance and Action Questionnaire, completed a simple matching task that required them to choose whether or not to look at an aversive visual image. Only the high-avoidance participants took longer to emit a correct response that produced an aversive rather than a neutral picture. Additionally, the high-avoiders reported greater levels of anxiety following the experiment even though they rated the aversive images as less unpleasant and less emotionally arousing than their low-avoidant counterparts. In Experiment 2, three groups, representing high-, mid- and low-avoidance (n ¼ 6 in each) repeated the matching task with the additional recording of event-related potentials (ERPs). The findings of Experiment 1 were replicated in terms of reaction times and subjective ratings. The ERPs confirmed that the participants attended to the content of the images and differentiated between the aversive and neutral image types. The ERPs also showed significantly greater negativity for electrodes over the left hemisphere relative to the midline for only the high-experiential avoidance (EA) group. Given the left hemisphere dominance for language, the data suggest that the high-EA group engaged in verbal strategies to regulate their emotional responses

Who uses NHS health checks? Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks

Background NHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England. Through the systematic assessment of an individual’s ten year disease risk, this programme aims to provide early identification and subsequent management of this risk. However, there is limited evidence on how socio-demographic factors impact on uptake and what influence the invitation method has on uptake to this programme. Methods NHS Health Check data from April 2013 to March 2014 was analysed (N = 50,485) for all 30 GP Practices in Luton, a culturally diverse town in England, UK. Data was collected for age, ethnicity, uptake (attendance and non attendance) and invitation method (letter written, verbal face-to-face, telephone). Actual usage of NHS Health Checks was determined for each ethnic group of the population and compared using Chi-square analysis. Results The overall uptake rate for Luton was 44 %, markedly lower that the set target of 50–75 %. The findings revealed a variation of uptake in relation to age, gender, level of deprivation. Ethnicity and gender variations were also found, with ‘White British’ ‘Black Caribbean’ and ‘Indian’ patients most likely to take up a NHS Health Check. However, patients from ‘Any Other White Background’ and ‘Black African’ were significantly less likely to uptake an NHS Health Check compared to all other ethnic groups. Ethnicity and gender differences were also noted in relation to invitation method. Conclusions The findings revealed that different invitation methods were effective for different ethnic and gender groups. Therefore, it is suggested that established protocols of invitation are specifically designed for maximizing the response rate for each population group. Future research should now focus on uncovering the barriers to uptake in particular culturally diverse population groups to determine how public health teams can better engage with these communities

Biomechanical but not timed performance asymmetries persist between limbs 9 months after ACL reconstruction during planned and unplanned change of direction

© 2018 Elsevier Ltd Whilst anterior cruciate ligament injury commonly occurs during change of direction (CoD) tasks, there is little research on how athletes execute CoD after anterior cruciate ligament reconstruction (ACLR). The aims of this study were to determine between-limb and between-test differences in performance (time) and joint kinematics and kinetics during planned and unplanned CoD. One hundred and fifty-six male subjects carried out 90° maximal effort, planned and unplanned CoD tests in a 3D motion capture laboratory 9 months after ACLR. Statistical parametric mapping (2 × 2 ANOVA; limb × test) was used to identify differences in CoD time and biomechanical measures between limbs and between tests. There was no interaction effect but a main effect for limb and task. There was no between-limb difference in the time to complete both CoD tests. Between-limb differences were found for internal knee valgus moment, knee internal rotation and flexion angle, knee extension and external rotation moment and ankle external rotation moment with lower values on the ACLR side (effect size 0.72–0.5). Between test differences were found with less contralateral pelvis rotation, distance from centre of mass to the ankle in frontal plane, posterior ground reaction force and greater hip abduction during the unplanned CoD (effect size 0.75–0.5). Findings demonstrated that kinematic and kinetic differences between limbs are evident during both CoD tests 9 months after surgery, despite no statistical differences in performance time. Biomechanical differences between tests were found in variables, which have previously been associated with ACL injury mechanism during unplanned CoD