Better than I deserve : evangelical Protestantism's effect on subjective social status.

Subjective social status (SSS), a measure of a person’s self-perceived social ranking compared to a reference group on socioeconomic variables (income, occupation, and education), is an effective indicator of a person’s overall health. To date, studies of SSS’ determinants have focused on psychosocial factors, as well as the role of neighborhood satisfaction and cultural identity. However, nearly one in four people report turning to their spiritual beliefs or ethical values to determine their SSS (MacArthur Network 2008). This study examines differences in SSS across religious group affiliation and religiosity and how those religious differences vary across racial groups. Findings from the Baylor Religion Survey (Wave 5) show that when the referent is more distal (i.e., “other Americans”) evangelical Protestants rank their SSS higher compared to all others, especially among white evangelicals. When the referent is more socially proximate (i.e., “your friends”), there is no statistical difference between evangelicals and others. This suggests that evangelical Protestantism is a determinant of SSS

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

Lenore Dedeyne,1 Mieke Deschodt,2–4 Sabine Verschueren,5 Jos Tournoy,1,3 Evelien Gielen1,3 1Department of Clinical and Experimental Medicine, 2Department of Public Health and Primary Care, KU Leuven – University of Leuven, Leuven, Belgium; 3Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; 4Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland; 5Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Heverlee, Belgium Background: Frailty is an aging syndrome caused by exceeding a threshold of decline across multiple organ systems leading to a decreased resistance to stressors. Treatment for frailty focuses on multi-domain interventions to target multiple affected functions in order to decrease the adverse outcomes of frailty. No systematic reviews on the effectiveness of multi-domain interventions exist in a well-defined frail population. Objectives: This systematic review aimed to determine the effect of multi-domain compared to mono-domain interventions on frailty status and score, cognition, muscle mass, strength and power, functional and social outcomes in (pre)frail elderly (≥65 years). It included interventions targeting two or more domains (physical exercise, nutritional, pharmacological, psychological, or social interventions) in participants defined as (pre)frail by an operationalized frailty definition. Methods: The databases PubMed, EMBASE, CINAHL, PEDro, CENTRAL, and the Cochrane Central register of Controlled Trials were searched from inception until September 14, 2016. Additional articles were searched by citation search, author search, and reference lists of relevant articles. The protocol for this review was registered on PROSPERO (CRD42016032905). Results: Twelve studies were included, reporting a large diversity of interventions in terms of content, duration, and follow-up period. Overall, multi-domain interventions tended to be more effective than mono-domain interventions on frailty status or score, muscle mass and strength, and physical functioning. Results were inconclusive for cognitive, functional, and social outcomes. Physical exercise seems to play an essential role in the multi-domain intervention, whereby additional interventions can lead to further improvement (eg, nutritional intervention). Conclusion: Evidence of beneficial effects of multi-domain compared to mono-domain interventions is limited but increasing. Additional studies are needed, focusing on a well-defined frail population and with specific attention to the design and the individual contribution of mono-domain interventions. This will contribute to the development of more effective interventions for frail elderly. Keywords: nutrition, supplement, exercise, cognition, hormone, social, vulnerable, older adult

Nutritional and physical exercise programs for older people: program format preferences and (dis)incentives to participate

Lenore Dedeyne,1 Louise Dewinter,1 Aniko Lovik,2 Sabine Verschueren,3 Jos Tournoy,1,4 Evelien Gielen1,4 1Department of Chronic Diseases, Metabolism and Ageing, KU Leuven – University of Leuven, Leuven, Belgium; 2L-BioStat, KU Leuven – University of Leuven, Leuven, Belgium; 3Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium; 4Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium Purpose: A growing number of studies in older people have been examining the beneficial effects of non-pharmacological interventions, such as physical exercise (PE) and nutritional supplementation, to target age-related syndromes such as sarcopenia and frailty. This study evaluated interpersonal, intrapersonal, and community (dis)incentives, concepts of motivation, and preferred program formats toward a PE or nutritional program in older people, with or without frailty or risk of sarcopenia. Methods: A questionnaire was developed and filled in by 115 community-dwelling older adults (≥65 years of age) after content (n=7 experts) and face validation (n=8 older adults). We assessed 1) the agreement with a statement (a statement with which ≥70% of the participants agree or strongly agree is considered as a common statement), 2) concepts of motivation by an exploratory factor analysis, and 3) program preferences by nonparametric Wilcoxon or Friedman’s analysis of variance and post hoc Wilcoxon signed-rank tests. Results: Intrapersonal motivators (eg, health benefits) were the most common motivators to participate in a PE or nutritional program. Identified concepts to participate in a PE intervention were intrinsic health beliefs, fear of falling or injuries, influence of significant others and environment, and (para)medical encouragement (Cronbach’s alpha: 0.75; 72% variance explained). Intrinsic health beliefs, influence of significant others and (para)medical encouragement were identified as concepts that motivate older people to participate in a nutritional intervention (Cronbach’s alpha: 0.77; 78% variance explained). No favorability of exercise location was identified; however, older people preferred protein supplement intake in a tablet form compared to liquid or powder form and in a pulsed timing compared with a spread intake. Conclusion: Program preferences of older people toward nutritional interventions need to be taken into account in future clinical trials and implementation programs, to increase recruitment and adherence to interventions. Keywords: physical activity, nutrition, incentives, sarcopenia, frailty, ol