Improving Physical Activity and Health of Older People Involved in a Social Farming Regional Preventative Multidimensional Programme in Italy

Physical exercise and social activities play a role of primary importance in the prevention of diseases and in maintaining functional abilities in old age, nevertheless, maintaining a regular habit of exercise is considered a challenge during the aging process. Motivation to start and maintain physical activity is an essential factor. In the case of older people, promoting exercise by means of activities intrinsically pleasurable is preferable to physical activity programs based on health improvements. From this perspective, our study is aimed to understand if preventative interventions combining physical activity, self-efficacy, and social participation in the context of a natural environment might be of help in increasing the level of physical activity. The sample was composed of 95 subjects, of which 40 were excluded because declared to be already engaged in regular physical activity at baseline. Considering the final sample of 55 subjects with low or no physical activity at baseline, 21 subjects (38.2%) improved the intensity of their physical activity at follow-up. They were younger (52.4% with age >=70 vs 82.4; p=0.017), mostly women (85.7% vs 58.8%; p = 0.036), and had a higher balance test score with respect to the others (3.6 ± 0.7 vs 2.8 ± 1.0; p=0.005). Results should be able to strengthen the concept that having a good level of physical conditions, such as good balance, facilitates the path for greater physical improvements and better quality of life among older adults. Balance issues may be cause of fear of falling and psychological difficulties which may have limited the effects of the programme

Outcome of liver transplantation with grafts from brain-dead donors treated with dual hypothermic oxygenated machine perfusion, with particular reference to elderly donors

Prompted by the utilization of extended criteria donors, dual hypothermic oxygenated machine perfusion (D‐HOPE) was introduced in liver transplantation to improve preservation. When donors after neurological determination of death (DBD) are used, D‐HOPE effect on graft outcomes is unclear. To assess D‐HOPE value in this setting and to identify ideal scenarios for its use, data on primary adult liver transplant recipients from January 2014 to April 2021 were analyzed using inverse probability of treatment weighting, comparing outcomes of D‐HOPE‐treated grafts (n = 121) with those preserved by static cold storage (n = 723). End‐ischemic D‐HOPE was systematically applied since November 2017 based on donor and recipient characteristics and transplant logistics. D‐HOPE use was associated with a significant reduction of early allograft failure (OR: 0.24; 0.83; p = .024), grade ≥3 complications (OR: 0.57; p = .046), comprehensive complication index (−7.20 points; p = .003), and improved patient and graft survival. These results were confirmed in the subset of elderly donors (>75‐year‐old). Although D‐HOPE did not reduce the incidence of biliary complications, its use was associated with a reduced severity of ischemic cholangiopathy. In conclusion, D‐HOPE improves postoperative outcomes and reduces early allograft loss in extended criteria DBD grafts

A Psychosocial Intervention for Supporting Informal Caregivers of Older People With Alzheimer Disease: Protocol for the InnFamiglia Randomized Controlled Trial

BackgroundDementia is a neurodegenerative syndrome characterized by impaired cognitive functions associated with psychological and behavioral disorders. The informal caregiver has a central role in the life of the person with dementia. Committing a large part of the day to caring for the assisted person inevitably has an effect on the caregiver’s life. ObjectiveThe aim of this study is to analyze the impact of a psychosocial intervention dedicated to a group of informal caregivers of patients with Alzheimer disease. The intervention will be guided by a trained psychologist who will facilitate the participants’ expression of their emotional states, as compared to a traditional self-help group. MethodsThe intervention described in this paper was designed and developed for the project INNovazione sociale e tecnologica per le FAMIGLIE che assistono malati affetti da Alzheimer (InnFamiglia). The study is designed as a randomized controlled trial (RCT). The RCT includes an experimental group, in which the participants will undertake the psychosocial intervention, and a control group, where participants will receive support according to traditional self-help methodology. Interventions for both groups will last 4 months and will be comprised of 16 sessions. ResultsParticipant recruitment, enrollment, and data collection began in 2021. Enrollment continued until September 2022, at which time the last group began the intervention. Data collection will be completed by December 2022, and data analysis will be completed by March 2023. The study findings will be published in peer-reviewed scientific journals and will be presented at scientific meetings. Summaries of the results will also be made available to investigators for dissemination within their clinics. ConclusionsWe hypothesize that the experimental group will be more effective in managing caregiver burden and coping strategies and that this will improve the perception of well-being, anxiety, and depression among caregivers. Our study aims to compare two groups receiving different interventions: a self-help group and a psychosocial group with elements of emotional support. This study may also give us more information about the most appropriate ways to support and help caregivers of people with dementia. International Registered Report Identifier (IRRID)DERR1-10.2196/3749