Interventions targeting social isolation in older people: a systematic review

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. METHODS: Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. RESULTS: Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. CONCLUSIONS: More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.National Institute for Health Researc

Business models for timber frame industry enterprises in multi dwelling house construction in Finland and Sweden

The recent productivity improvement in multi dwelling construction processes has opened for substituting on site construction with industrial processes. Increased prefabrication of components and systems have resulted in the development of industrial construction timber enterprises (house component and other woodworking industry enterprises) but also sawmills and their upgrading activities (pre cutting, planing and other upgrading) to gradually adopt new intra firm value creation activities including planning and assembling services. The prior major business model, processes cost minimizing for standard timber products, has been transferred towards client oriented tailor made solutions and services. The major contractors and other construction system integrators have been reluctant to introduce the upflow enterprises in value chains and to participate in the development of new industrialization with improved component and product offerings for multi dwelling house construction. This paper discusses the value creation positioning and coverage in the business model formation among the timber element production industry enterprises. The business models are based on the vision formation and implementation strategy with using, maintaining or selling construction enterprises as clients integrating multi dwelling house construction processes. Research task here is to extend a business model taxonomy for the three major industrial product offering types for timber construction products (components, elements and modules) by including further client types and market conditions in the multi dwelling construction Multi dwelling construction constitute annual house construction majority in both countries with aggregate volumes of the same magnitude. The core task is to discuss the future options to develop the business models that fit with the objectives of the major construction producers and real estate developers