Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluation

BACKGROUND: Fear of falling and associated avoidance of activity are common among older people and may have negative consequences in terms of functional decline, quality of life and institutionalisation. We evaluated the effects of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity among older persons. This intervention showed favourable effects on fear of falling, avoidance of activity, daily activity, and several secondary outcomes. The aim of the present study is to assess the feasibility of this cognitive behavioural group intervention for participants and facilitators. METHODS: The intervention consisted of eight weekly group sessions lasting two hours each and a booster session after six months. Self-administered questionnaires, registration forms and interviews were used to collect data from participants (n = 168) and facilitators (n = 6) on the extent to which the intervention was performed according to protocol, participant attendance, participant adherence, and participants' and facilitators' opinion of the intervention. Quantitative data from the questionnaires and registration forms were analysed by means of descriptive statistics. Qualitative data were categorised based on matching contents of the answers. RESULTS: Facilitators reported no major protocol deviations. Twenty-six percent of the participants withdrew before the start of the programme. Of the persons who started the programme, 84% actually completed it. The participants reported their adherence as good, but facilitators had a less favourable opinion of this. The majority of participants still reported substantial benefits from the programme after six and twelve months of follow-up (71% and 61% respectively). Both participants and facilitators provided suggestions for improvement of the intervention. CONCLUSION: Results of this study show that the current cognitive behavioural group intervention is feasible for both participants and facilitators and fits in well with regular care. Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency. Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care. TRIAL REGISTRATION: ISRCTN43792817

Timescales of Quartz Crystallization and the Longevity of the Bishop Giant Magma Body

Supereruptions violently transfer huge amounts (100 s–1000 s km3) of magma to the surface in a matter of days and testify to the existence of giant pools of magma at depth. The longevity of these giant magma bodies is of significant scientific and societal interest. Radiometric data on whole rocks, glasses, feldspar and zircon crystals have been used to suggest that the Bishop Tuff giant magma body, which erupted ∼760,000 years ago and created the Long Valley caldera (California), was long-lived (>100,000 years) and evolved rather slowly. In this work, we present four lines of evidence to constrain the timescales of crystallization of the Bishop magma body: (1) quartz residence times based on diffusional relaxation of Ti profiles, (2) quartz residence times based on the kinetics of faceting of melt inclusions, (3) quartz and feldspar crystallization times derived using quartz+feldspar crystal size distributions, and (4) timescales of cooling and crystallization based on thermodynamic and heat flow modeling. All of our estimates suggest quartz crystallization on timescales of <10,000 years, more typically within 500–3,000 years before eruption. We conclude that large-volume, crystal-poor magma bodies are ephemeral features that, once established, evolve on millennial timescales. We also suggest that zircon crystals, rather than recording the timescales of crystallization of a large pool of crystal-poor magma, record the extended periods of time necessary for maturation of the crust and establishment of these giant magma bodies

A Very Young Radio-loud Magnetar

The magnetar Swift J1818.0–1607 was discovered in 2020 March when Swift detected a 9 ms hard X-ray burst and a long-lived outburst. Prompt X-ray observations revealed a spin period of 1.36 s, soon confirmed by the discovery of radio pulsations. We report here on the analysis of the Swift burst and follow-up X-ray and radio observations. The burst average luminosity was L burst ~ 2 × 1039 erg s−1 (at 4.8 kpc). Simultaneous observations with XMM-Newton and NuSTAR three days after the burst provided a source spectrum well fit by an absorbed blackbody (${N}_{{\rm{H}}}$ = (1.13 ± 0.03) × 1023 cm−2 and kT = 1.16 ± 0.03 keV) plus a power law (Γ = 0.0 ± 1.3) in the 1–20 keV band, with a luminosity of ~8 × 1034 erg s−1, dominated by the blackbody emission. From our timing analysis, we derive a dipolar magnetic field B ~ 7 × 1014 G, spin-down luminosity ${\dot{E}}_{\mathrm{rot}}\sim 1.4\times {10}^{36}$ erg s−1, and characteristic age of 240 yr, the shortest currently known. Archival observations led to an upper limit on the quiescent luminosity <5.5 × 1033 erg s−1, lower than the value expected from magnetar cooling models at the source characteristic age. A 1 hr radio observation with the Sardinia Radio Telescope taken about 1 week after the X-ray burst detected a number of strong and short radio pulses at 1.5 GHz, in addition to regular pulsed emission; they were emitted at an average rate 0.9 min−1 and accounted for ~50% of the total pulsed radio fluence. We conclude that Swift J1818.0–1607 is a peculiar magnetar belonging to the small, diverse group of young neutron stars with properties straddling those of rotationally and magnetically powered pulsars. Future observations will make a better estimation of the age possible by measuring the spin-down rate in quiescence

Intervention characteristics associated with a reduction in fear of falling among community-dwelling older people: A systematic review and meta-analysis of randomized controlled trials

Data availability statement: data can be viewed at: https://osf.io/v89an/?view_only=8711c954c6b746428cec4d06ef5cfd08.A correction has been published: The Gerontologist, Volume 62, Issue 10, December 2022, Page e629, https://doi.org/10.1093/geront/gnac131Supplementary data: Supplementary data are available online at https://academic.oup.com/gerontologist/article/61/6/e269/5817811#supplementary-dataCopyright © The Author(s) 2020. Background and Objectives: Fear of falling (FoF) is associated with decreased physical functioning and an increased fall risk. Interventions generally demonstrate moderate effects and optimized interventions are needed. Intervention characteristics, such as setting or delivery method may vary. We investigated which overarching intervention characteristics are associated with a reduction in FoF in community-dwelling older people. Research Design and Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) in community-dwelling older people without specific diseases was performed. Associations between intervention characteristics and standardized mean differences (SMD) were determined by univariate meta-regression. Sensitivity analyses were performed. Results: Data on 62 RCTs were extracted, 50 intervention groups were included in the meta-analysis. Most intervention characteristics and intervention types were not associated with the intervention effect. Supervision by a tai chi instructor (SMD: −1.047, 95% confidence interval [CI]: −1.598; −0.496) and delivery in a community setting (SMD: −0.528, 95% CI: −0.894; −0.161) were—compared to interventions without these characteristics—associated with a greater reduction in FoF. Holistic exercise, such as Pilates or yoga (SMD: −0.823, 95% CI: −1.255; −0.392), was also associated with a greater reduction in FoF. Delivery at home (SMD: 0.384, 95% CI: 0.002; 0.766) or with written materials (SMD: 0.452, 95% CI: 0.088; 0.815) and tailoring were less effective in reducing FoF (SMD: 0.687, 95% CI: 0.364; 1.011). Discussion and Implications: Holistic exercise, delivery with written materials, the setting and tailoring potentially represent characteristics to take into account when designing and improving interventions for FoF in community-dwelling older people. PROSPERO international prospective register of systematic reviews, registration ID CRD42018080483.This study was funded by Maastricht University in The Netherlands. The authors received no specific further funding

Disentangling interventions to reduce fear of falling in community-dwelling older people: a systematic review and meta-analysis of intervention components

© 2021 The Author(s). Purpose: Fear of falling (FoF) is a common and debilitating problem for older people. Most multicomponent interventions show only moderate effects. Exploring the effective components may help in the optimization of treatments for FoF. Materials and methods: In a systematic review of five scientific literature databases, we identified randomized controlled trials with older community-dwelling people that included FoF as an outcome. There was no restriction on types of interventions. Two reviewers extracted information about outcomes and content of interventions. Intervention content was coded with a coding scheme of 68 intervention components. We compared all studies with a component to those without using univariate meta-regressions. Results: Sixty-six studies, reporting on 85 interventions, were included in the systematic review. In the meta-regressions (n = 49), few components were associated with intervention effects at the first available follow up after the intervention, but interventions with meditation, holistic exercises (such as Tai Chi or Pilates) or body awareness were significantly more effective than interventions without these components. Interventions with self-monitoring, balance exercises, or tailoring were less effective compared to those without these components. Conclusions: The identified components may be important for the design and optimization of treatments to reduce FoF.Implications for rehabilitation Fear of falling (FoF) is a common and debilitating issue among older people and multicomponent interventions usually show only small to moderate effects on FoF. This review and meta-analysis investigated 68 intervention components and their relation to intervention effects on FoF. Interventions with meditation, holistic exercises (such as Tai Chi), or body awareness are more effective than interventions without these components. Clinicians aiming to reduce FoF may recommend selected interventions to older people taking into account the current knowledge of intervention components.Maastricht University

Some factors affecting dairy she-camel performance

Abstract In order to determine the effect of some factors, as different levels of energy and protein, milking interval, lactation stage, and lactation rank on she-camel performance after weaning of camel-calves, 20 lactating shecamels were divided into four groups, 5 animals each, according to age and weight at last parturition. Groups had randomly allocated to one of four treatments diets. Group A received diet with 13% Crude Protein (CP) and 2.4 MCal Metabolisable Energy (ME). Group B received diet with 13% CP and 3.0 MCal ME. Group C and D received diet with 15% CP and 2.4, 3.0 MCal ME respectively. Diets contain 35/65 (roughage/concentrate, respectively). After 14 days of adaptation period, individual feed offered and orts had been recorded, daily and continued up to entire experimental period of 10 months. Milk yield was recorded two milking time from three consecutive days. The results show that diet (B) gave higher milk yield (MY), Fat Corrected Milk (FCM), Energy Corrected Milk (ECM) and Feed Conversion Ratio (FCR) 8.32, 11.77, 7.47, and 1.38 respectively. Diet (A) has higher fat % content when comparing with the other diets. Treatment did not affect milk composition except on fat and ash percentage. Milk secretion rate for 10 hours milking interval &quot;evening milking&quot; was higher comparing with 14 hours milking interval &quot;morning milking&quot; 397, 353 g/h respectively. Maximum MY, FCM and ECM were at mid lactation. In late lactation MY, FCM, ECM decreased. Higher milk productivity was at 3rd and 6th season of lactation

Carbon storage in Ghanaian cocoa ecosystems

Background: The recent inclusion of the cocoa sector as an option for carbon storage necessitates the need to quantify the C stocks in cocoa systems of Ghana. Results: Using farmers’ fields, the carbon (C) stocks in shaded and unshaded cocoa systems selected from the Eastern (ER) and Western (WR) regions of Ghana were measured. Total ecosystem C (biomass C + soil C to 60 cm depth) ranged from 81.8 to 153.9 Mg C/ha. The bulk (~89 %) of the systems’ C stock was stored in the soils. The total C stocks were higher in the WR (137.8 ± 8.6 Mg C/ha) than ER (95.7 ± 8.6 Mg C/ha). Conclusion: Based on the cocoa cultivation area of 1.45 million hectares, the cocoa sector in Ghana potentially could store 118.6–223.2 Gg C in cocoa systems with cocoa systems aged within 30 years regardless of shade management. Thus, the decision to include the cocoa sector in the national carbon accounting emissions budget of Ghana is warranted

Prácticas del enfermero en el contexto de la atención básica: scoping review

Objective: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession’s legal and programmatic frameworks and by the Brazilian Unified Health System. Method: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included. Results: the review comprised 30 studies published between 2005 and 2014. Three categories emerged from the analysis: practices in the service; practices in the community; and management and education practices. Conclusion: the challenges faced by nurses are complex, as care should be centered on the population’s health needs, which requires actions at other levels of clinical and health responsibility. Brazilian nursing has achieved important advancements since the implementation of policies intended to reorganize work. There is, however, a need to shift work processes from being focused on individual procedures to being focused on patients so that an enlarged clinic is the ethical-political imperative guiding the organization of services and professional intervention.Objetivo: identificar e categorizar as práticas exercidas pelos enfermeiros junto às Unidades Básicas e às Equipes de Saúde da Família, à luz das atribuições previstas pelos marcos legais e programáticos da profissão e do Sistema Único de Saúde. Método: realizou-se uma revisão da literatura com o método scoping review, nas bases LILACS, IBECS, BDENF, CINAHL e MEDLINE, e nas bibliotecas Cochrane e SciELO. Incluíram-se artigos de pesquisa original, produzidos com enfermeiros, sobre as práticas de enfermagem no contexto dos cuidados de saúde primários. Resultados: a revisão abrangeu trinta estudos publicados entre 2005 e 2014. Da análise, resultaram três categorias: práticas no serviço, práticas na comunidade e práticas de gestão e formação. Conclusão: os desafios dos enfermeiros são complexos, posto que o cuidado deve estar centrado nas necessidades de saúde da população, o que remete à ação para outros níveis de responsabilidade clínica e sanitária. A enfermagem brasileira mostra importantes avanços desde a implantação das políticas de reorganização do trabalho. Necessita, entretanto, avançar no que se refere ao deslocamento dos processos de trabalho, focados em procedimentos individuais, para um processo mais voltado aos usuários, onde a clínica ampliada seja o imperativo ético-político da organização dos serviços e da intervenção profissional.Objetivo: identificar y categorizar las prácticas ejercidas por los enfermeros en las Unidades Básicas y los Equipos de Salud de la Familia, desde el punto de vista de las atribuciones previstas por los marcos legales y programáticos de la profesión y del Sistema Único de la Salud. Método: se realizó una revisión de la literatura con el método scoping review, en las bases LILACS, IBECS, BDENF, CINAHL y MEDLINE, y en las bibliotecas Cochrane y SciELO. Se incluyeron artículos de investigación original, producidos con enfermeros, sobre las prácticas de enfermería en el contexto de los cuidados de salud primarios. Resultados: la revisión abarcó treinta estudios publicados entre 2005 y 2014. Del análisis, resultaron tres categorías: prácticas en el servicio; prácticas en la comunidad; y, prácticas de administración y formación. Conclusión: los desafíos de los enfermeros son complejos, ya que el cuidado debe estar centrado en las necesidades de salud de la población, lo que conduce a la acción para otros niveles de responsabilidad clínica y sanitaria. La enfermería brasileña muestra importantes avances a partir de la implantación de las políticas de reorganización del trabajo. Necesita, entre tanto, avanzar en lo que se refiere al desplazamiento de los procesos de trabajo, enfocados en procedimientos individuales, para un proceso más dirigido a los usuarios, en donde la clínica ampliada sea el imperativo ético político de la organización de los servicios y de la intervención profesional.info:eu-repo/semantics/publishedVersio