Fall Prevention Interventions for Community-Dwelling Older Adults

Primary Focus: Productive Aging Learning Objectives: At the conclusion of the session, the learner will be able to: 1. Recognize the impact of falls on community-dwelling older adults 2. Describe ways to include fall prevention interventions into current clinical practice 3. Discuss benefits of preventative interventions in regards to current healthcare trends Abstract: According to the Centers for Disease Control and Prevention (CDC), older adults (65+ years) are the largest growing population in the United States which comprises 14.5% of the total population (CDC, 2015). This population is estimated to almost double by 2030 to approximately 71 million Americans over the age of 65 (CDC, 2015). Unfortunately, research reports that 33% of home-dwelling older adults fall each year (Palvanen, 2014). After a fall, the older adult is two to three times more likely to experience additional falls. Ninety percent of older adults in the US want to remain living in their homes as long as possible (Farber, Shinkle, Lynott, Fox-Grage, & Harrell, 2011). This supports a vast need for fall prevention interventions to reduce the frequency of falls to allow the elderly to more safely age in place. Three databases, PubMed, CINAHL, and Ovid, were searched to address the question “What is the evidence for fall prevention interventions for decreasing the frequency of falls for community dwelling older adults?” Of the 1,957 preliminary results from the three databases, specific inclusion and exclusion criteria were applied to identify 14 articles to review critically. The inclusion criteria was English language, peer reviewed journals from 2011 to 2016, randomized controlled trials, fall prevention/intervention, older adults aged 65 year and older, community-dwelling, men and women, and outcomes directly linked to fall frequency or number of falls. The purpose of this presentation is to identify interventions for preventing falls in community-dwelling older adults. The findings of the critical review demonstrated that multi-component interventions are more effective in reducing the fall rate in older adults than physical exercise alone. Strong evidence supports perturbation training (inducing slips and trips) and stepping programs are statistically and clinically significant in reducing the frequency of falls in older adults. In this session, the audience will learn current effective fall prevention interventions for community-dwelling older adults. The findings will advance the field of occupational therapy by assisting to make the profession more widely recognized across the United States. The need for occupational therapy is relevant for increasing the safety and overall health of older adults while also minimizing the impact on the healthcare system. References: Centers for Disease Control and Prevention. (2015). Falls among older adults: An overview. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html Farber, N., Shinkle, D., Lynott, J., Fox-Grage, W., & Harrell, R. (2011). Aging in place: A state survey of livability policies and practices. Palvanen, M., Kannus, P., Piirtola, M., Niemi, S., Parkkari, J., & Järvinen, M. (2014). Effectiveness of the Chaos Falls Clinic in preventing falls and injuries of home-dwelling older adults: a randomised controlled trial. Injury,45(1), 265-271. Other: Level of material being presented: Introductory Target Audience: Mixed Audience for CREATE Day (Family members of older adults, OT’s, OTA’s, faculty, researchers, and healthcare professionals) Presentation: 46:2

Bruce Springsteen: Evolution of the American Dream

Bruce Springsteen is a man many people associate with the ideals of the “American Dream”. He comes from a poor, working-class family. He is currently an incredibly successful musician and he has been for some time now. However, he does not think this way and he has not for some time now. He has changed his opinions on the “American Dream” over time, coming from one end of the spectrum in thinking that the “American Dream” is real to the other end where he now thinks that it is a lie, and the promised land is not real

Electronic sculpting of ligand-GPCR subtype selectivity:the case of angiotensin II

GPCR subtypes possess distinct functional and pharmacological profiles, and thus development of subtype-selective ligands has immense therapeutic potential. This is especially the case for the angiotensin receptor subtypes AT1R and AT2R, where a functional negative control has been described and AT2R activation highlighted as an important cancer drug target. We describe a strategy to fine-tune ligand selectivity for the AT2R/AT1R subtypes through electronic control of ligand aromatic-prolyl interactions. Through this strategy an AT2R high affinity (<i>K</i>_i = 3 nM) agonist analogue that exerted 18,000-fold higher selectivity for AT2R versus AT1R was obtained. We show that this compound is a negative regulator of AT1R signaling since it is able to inhibit MCF-7 breast carcinoma cellular proliferation in the low nanomolar range

Sex-Based Effects of Branched-Chain Amino Acids on Strength Training Performance and Body Composition

Background: Branched-chain amino acids (BCAAs) are widely studied for their effects on muscle recovery and performance. Aims: This study examined the effects of BCAA supplementation on anthropometric data, physical performance, delayed onset muscle soreness (DOMS), and fatigue in recreational weightlifters. Methods: The trial involved 100 participants (50 men and 50 women), randomized into BCAA and placebo groups. Subjects in the BCAA group took five daily capsules of 500 mg L-leucine, 250 mg L-isoleucine, and 250 mg L-valine for six months. A two-way ANOVA was used to analyze the main and interaction effects of sex and treatment. Results: Notable findings include significant improvements in muscle recovery, as indicated by reduced DOMS, particularly in women who showed a decrement of 18.1 +/- 9.4 mm compared to 0.8 +/- 1.2 mm in the placebo group of a horizontal 100 mm line. Fatigue perception was also significantly lower in the BCAA group, with women reporting a greater decrease (2.6 +/- 1.5 scores) compared to the placebo group (0.6 +/- 0.7 scores). Strength gains were prominent, especially in men, with a 10% increase in bench press maximum observed in the BCAA group. The interaction between sex and treatment was significant, suggesting sex-specific responses to BCAA supplementation. Conclusions: These results underscore the effectiveness of BCAA supplementation in enhancing muscle recovery, reducing fatigue, and improving strength. This study also highlights sex-specific responses, with women benefiting more in terms of DOMS and fatigue reduction, while men experienced greater strength gains, suggesting a need for tailored supplementation strategies

Effects on Children’s Physical and Mental Well-Being of a Physical-Activity-Based School Intervention Program: A Randomized Study

This study aimed to evaluate the effectiveness of physically active breaks of a total duration of 10 min a day, introduced during curricular lessons, together with a 10 min physical activity intervention during the daily school recess period on obesity prevention, fitness, cognitive function, and psychological well-being in school-aged children. A sample of 310 children (139 boys vs. 171 girls), aged between 8 and 10 years (9.82 ± 0.51), was selected. Our strategy was implemented over a 6-month period and the participants were randomly assigned to either the intervention group (n = 157) or the non-intervention (control) group (n =153). In the intervention group, a significant decrease (p < 0.05) in body mass index, waist circumference, waist–height ratio, and relative body fat mass was achieved after the intervention (T1) compared to the values measured before intervention (T0); in the control group, no differences emerged between T0 and T1 for any of the parameters considered. We found a significant increase in the intervention group in standing long jump, Ruffier, and sit and reach test scores (p < 0.001 for all). At T0, cognitive test scores did not differ between the girls and boys or between the intervention and control groups; instead at T1, significant differences were observed in the two groups regarding the total number of responses and the concentration performance scores (p < 0.001). Consistently, in the intervention group, well-being levels significantly increased between T0 and T1 (p < 0.001). Finally, the intervention had significant effects on the children regardless of gender. We may therefore conclude that schools should create more opportunities for teachers and students to introduce intervention strategies to promote regular PA during school recess

Validazione di un modello probabilistico degli span complessi basato sulla Theory of Constructive Operators

In attesa di "ABSTRACT

The Effects of Exergames on Physical Fitness, Body Composition and Enjoyment in Children: A Six-Month Intervention Study

Background/Objectives: Physical inactivity in children can lead to decreased physical fitness and reduced enjoyment of physical activity. This study aimed to evaluate the impact of exergaming on physical fitness, body composition and perceived enjoyment in elementary school children. Methods: Sixty-four male students (mean age 9.5 years) were randomly assigned to an exergaming group (EG, n = 32), engaging in Kinect Adventures three times a week for six months, or a control group (CG, n = 32), which continued standard physical education. Assessments were conducted pre- and post-intervention, including anthropometric measures, physical fitness tests (standing long jump, countermovement jump, sit-and-reach, 20-m sprint), aerobic fitness (20-m shuttle run), and perceived enjoyment measured with the PACES scale. Results: The EG demonstrated significant reductions in body weight, BMI, and relative fat mass compared to the CG (p < 0.01). Improvements in physical fitness were evident in EG, with increases in standing long jump distance (+12.8%; p < 0.0001), countermovement jump height (+65%, p < 0.0001), and flexibility (+75%; p < 0.0001). Aerobic fitness improved significantly in EG (+87.8m) compared to CG. Perceived enjoyment was notably higher in EG, especially at week three, compared to CG (69.3 +/- 5.8 vs. 44.2 +/- 11.6; p < 0.0001). Conclusions: Exergaming offers benefits for physical fitness and body composition in children, while also enhancing enjoyment. Incorporating exergames into physical education programs could be an effective strategy for addressing childhood obesity, improving physical skills, and increasing student enjoyment, encouraging long-term physical activity adherence

Bevacizumab specifically decreases elevated levels of circulating KIT+CD11b+ cells and IL-10 in metastatic breast cancer patients.

Whether bevacizumab exerts its anti-tumor properties through systemic effects beyond local inhibition of angiogenesis and how these effects can be monitored in patients, remain largely elusive. To address these questions, we investigated bone marrow-derived cells and cytokines in the peripheral blood of metastatic breast cancer patients undergoing therapy with bevacizumab. Circulating endothelial cells (CEC), circulating endothelial progenitor (CEP) and circulating CD11b+ cells in metastatic breast cancer patients before and during therapy with paclitaxel alone (n = 11) or in combination with bevacizumab (n = 10) were characterized using flow cytometry, real time PCR and RNASeq. Circulating factors were measured by ELISA. Aged-matched healthy donors were used as baseline controls (n = 12). Breast cancer patients had elevated frequencies of CEC, CEP, TIE2+CD11b+ and KIT+CD11b+ cell subsets. CEC decreased during therapy, irrespective of bevacizumab, while TIE2+CD11b+ remained unchanged. KIT+CD11b+ cells decreased in response to paclitaxel with bevacizumab, but not paclitaxel alone. Cancer patients expressed higher mRNA levels of the M2 polarization markers CD163, ARG1 and IL-10 in CD11b+ cells and increased levels of the M2 cytokines IL-10 and CCL20 in plasma. M1 activation markers and cytokines were low or equally expressed in cancer patients compared to healthy donors. Chemotherapy with paclitaxel and bevacizumab, but not with paclitaxel alone, significantly decreased IL-10 mRNA in CD11b+ cells and IL-10 protein in plasma. This pilot study provides evidence of systemic immunomodulatory effects of bevacizumab and identified circulating KIT+CD11b+ cells and IL-10 as candidate biomarkers of bevacizumab activity in metastatic breast cancer patients

Immunolocalization of the AT-1R Ang II Receptor in Human Kidney Cancer

This study aimed to evaluate AT1-R expression in normal and cancerous human kidneys, how these expressions are modified, and AT1-R functionality. AT-1R mRNA expression, determined by real-time PCR, was detected in all samples. AT-1R mRNA increased in well-differentiated cancer (G1, p < 0.01) and decreased 2.9-fold in undifferentiated cancer (G4, p < 0.001) compared with normal kidney tissues. Immunocytochemistry analysis showed that the AT-1R was expressed in the normal tubular epithelium. The glomerulus was also immunoreactive, and as expected, the smooth muscle cells of the vessel walls also expressed the receptor. A total of 35 out of 42 tumors were AT-1R positive, with the cell tumors showing varying numbers of immunoreactive cells, which were stained in a diffuse cytoplasmic and membranous pattern. Computer-assisted counting of the stained tumor cells showed that the number of AT-1R-positive cells increased in the well-differentiated cancers. The functionality of AT-1R was assessed in primary cultures of kidney epithelial cells obtained from three G3 kidney cancer tissues and corresponding histologically proven non-malignant tissue adjacent to the tumor. Indeed, Ang II stimulated, in a dose-dependent manner, the 24 h proliferation of normal kidney cells and cancer cells in the primary culture and phosphorylated extracellular regulated kinases 1 and 2. In conclusion, Ang II may be involved in the growth or function of neoplastic kidney tissue

Referees' physical performance over a soccer season

Background: An important role of soccer referees is to apply the rules of the game by observing the match closely. Thus, referees have to undertake training to keep up with play and attain an optimal position when making critical decisions. We analyzed the variation of the soccer referee physical performance during official championship. Methods: The referees were classified into three groups according to ages (16–20 years; 21–29 years; 30–45 years) and physical fitness variations were studied at the start (T0), at the middle (T1) and at the end of the competitive season (T2). In each period, Yo–Yo intermittent recovery test level 1 (YYIRT1) and 40 m sprint test were performed and VO2max assessed. Finally, the referees’s rating (i.e. the mean of numerically quantification of the performances received during the season) was also evaluated. Results: The mean distance covered by the referees during the YYIRT1 test increased significantly from T0 to T1 and T2, and from T1 to T2, in all age groups, with a higher effect observed for group 16–20 years in all testing periods. This group significantly improved YYIR1 performance and VO2max at T1and T2. Referee ages correlated with differences (Δ) in running speed test (40 m sprint test), of YYIRT1 and VO2max. Finally, the referees’ rating, based upon training, experience, performance and fitness assigned by qualified officials, ranged from 8.20 to 8.65. A positive correlation was found between the excellent rating and younger age (p = 0.015 by Chi-square test χ = 8.6). Conclusions: The young referees performed better physical performances than adult referees and obtained better assessments by qualified officials