Long-term maintenance of increased exercise involvement following a self-management intervention for housebound older adults with arthritis

<p>Abstract</p> <p>Background</p> <p>Sustained maintenance of health behaviors is a determinant of successful symptom reduction strategies for older adults with arthritis. This study examined whether or not short-term improvements in exercise involvement were maintained 8 months following a home-based arthritis self-management intervention as well as the moderating role of individual characteristics in the maintenance of behavior change.</p> <p>Methods</p> <p>Of the 113 housebound older adult participants at pre-intervention, 97 completed the post-intervention interview, and 80 completed the 8-month post-intervention interview.</p> <p>Results</p> <p>Some post-intervention improvements in exercise involvement were maintained 8 months later. More specifically, weekly exercise frequency, particularly regarding walking frequency, and variety of exercise activities were still significantly greater in the experimental group than in the control group 8 months following the completion of the intervention. No moderating influences were observed for any of the individual characteristics.</p> <p>Conclusion</p> <p>We conclude that gains in exercise involvement achieved through a self-management intervention can be maintained 8 months following the intervention.</p

Behavior change following a self-management intervention for housebound older adults with arthritis: an experimental study

BACKGROUND: This study examined the impact of a home-based self-management intervention for housebound older adults with arthritis on the adoption of health behaviors. The moderating role of socio-demographic, psychological, and physical characteristics in the process of behavior change was also investigated. METHODS: Participants were 113 older adult women (n = 102) and men (n = 11) with osteoarthritis (OA) or rheumatoid arthritis (RA) who were randomly assigned to experimental (n = 68) or wait list control (n = 45) groups. Participants were interviewed using standardized questionnaires at baseline, pre-intervention, and post-intervention. RESULTS: Adjusted multilevel modeling analyses indicated that from pre to post intervention, experimental participants significantly increased their weekly frequency of exercise and relaxation activities. Socioeconomic status and depression played a moderating role in this change for exercise with larger effects occurring among more privileged, non-depressed participants. CONCLUSION: We conclude that a self-management intervention can successfully improve involvement in exercise and relaxation among housebound older adults with arthritis

Risk perception and risk-taking among skateboarders

International audienceSkateboarding is considered to be a high risk activity. Although many studies have identified risk factors associated with skateboarding injuries, few have provided detailed in-depth knowledge on participants' psychological dispositions towards risk behaviors. The aim of this study was to identify individual factors associated with risk perception and risk-taking among skateboarders. Telephone interviews were conducted with 158 skateboarders (mean age = 18.1 years) recruited in 11 Montreal skateparks. Age, self-efficacy, previous injuries, fear of being injured, sensation seeking and experience level were all included in two linear regression models that were run for risk perception and risk-taking. Age, experience level, sensation seeking, and risk perception are significant explanatory variables of risk-taking. Results show that sensation seeking was the only significant factor associated with risk perception. These results allow for a better understanding of the behavior of skateboarders, they highlight the importance of impulsive sensation seeking in risk perception as well as risk-taking. This study characterizes skateboarders who take risks and provides additional information on interventions for injury prevention

Asthma patients' self-reported behaviours toward inhaled corticosteroids

SummaryBackgroundPatient adherence to recommended use of ICS is questionable in asthma, with irregular use or interruptions occurring frequently. Factors explaining discontinuation of controller therapy could orientate interventions. The characteristics of patients with interruptions of inhaled corticosteroids (ICSs), intentional or accidental, were investigated.MethodsAsthma patients regularly prescribed ICS by GPs (Cegedim network) were included. Patients' characteristics and behaviours toward ICS (accidental/intentional interruptions, less frequent use of ICS and change in dosing) were identified from self-report questionnaires, and linked to data prescription database. Interrelations between declared behaviours toward ICS were studied with a Multiple Component Analysis (MCA) and the correlates of ICS interruptions were identified.ResultsDuring the past 3 months, 31.6% of 204 patients (mean age: 53.8 years, females: 59.3%) intentionally interrupted ICS when feeling better, 25.4% forgot ICS and 18.3% deliberately changed the doses. A quarter of patients considered constant use of respiratory medicines as unhealthy. MCA revealed that intentional, accidental interruptions and less frequent use of ICS were closely correlated. Risk of intentional interruption was increased when patients considered constant use of respiratory therapy to be unhealthy (OR=3.36, 95%CI=[1.47–7.66]). Conversely, risk was significantly lower when ICS was associated or combined with another controller (OR=0.24, 95%CI=[0.08–0.73]), compared to ICS in monotherapy. Less frequent interruptions were observed in patients older than 65 (OR=0.35, 95%CI=[0.13–0.89]).ConclusionsOur study suggests that discontinuation of use of controllers is associated with other inadequate behaviours or beliefs about inhaled controllers. Efforts should be targeted at patients' perceptions and behaviours toward controller therapy

Impact of a Multifaceted Community-Based Falls Prevention Program on Balance-Related Psychologic Factors

Objective: To©assess©the©impact©of©a©multifaceted©falls prevention© program© including© exercise© and© educational© components© on© perceived© balance© and© balance© confidence© among community-dwelling© seniors. Design: Quasi-experimental© design. Setting: Community-based© organizations. Participants: Two©hundred©community-dwelling©adults aged© 60© years© and© over© recruited© by© community-based© organizations. Intervention: A© 12-week© multifaceted© falls© prevention© program© including© 3© components© (a© 1-hour© group© exercise© class held© twice© a© week,© a© 30-minute© home© exercise© module© to© be performed© at© least© once© a© week,© a© 30-minute© educational© class held© once© a© week). Main Outcome Measures: Perceived© balance© and© balance confidence. Results: Multivariate© analysis© showed© that© the© program© was successful©in©increasing©perceived©balance©in©experimental participants.© However,© balance© confidence© was© not© improved by© program© participation. Conclusions: A© multifaceted© community-based© falls© prevention© program© that© was© successful© in© improving© balance© performance© among© community-dwelling© seniors© also© had© a© positive impact© on© perceived© balance.© However,© the© program© did© not improve© participants&apos;© balance© confidence.© These© results© suggest© that© balance© confidence© has© determinants© other© than© balance© and© that© new© components© and/or© modifications© of© existing components© of© the© program© are© required© to© achieve© maximal benefits©for©seniors©in©terms©of©physical©and©psychologic outcomes

Etude des facteurs de risque de la sévérité et de la survenue des traumatismes liés aux aires et appareils de jeu

The main objective of this research is to identify risk factors for severe playground injuries among children aged 1 to 14 years who visited the emergency room of a paediatric hospital in Montreal, during the summer of 1991. Secondary objectives are to study determinants of the occurrence of playground injuries, to estimate injury rates adjusted for exposure, and to do recommendations for prevention. To document circumstances of each injury, telephone interviews were completed with parents of children and a response rate of 90% was obtained.The objectives of this research required different study designs. The principal objective was achieved through a case-control study. In this study, logistic regressions were performed to study risk factors of serious (AIS3, n = 88) and moderate injuries (AIS2, n = 203), using minor injuries (AIS1, n = 348) as the reference category. One of our secondary objectives was to analyze risk factors for injury occurrence. For this, two additional case-control studies were performed. In the first study, cases related to playgrounds (n = 639) were compared with control children who had visited the emergency room for another type of injury (n = 1064). In the second study, characteristics of playgrounds where an injury occurred were compared with playgrounds with no injuries. Finally, qualitative analyses were conducted to describe the scenarios of the injury incidents. To prevent future incidents, the Canadian Standards on Children's Playspaces and Equipment were reviewed to identify playground elements associated with injuries.As they become older, boys tend to sustain more severe injuries than girls. Children who use playgrounds less frequently are at lower risk of being injured, however, when they are injured, the injuries are more severe. Approximately 75% of all playground injuries resulted from a fall. Injuries from falls are more severe than other types of injuries. Public playgrounds account for 71% of injuries and home playgrounds for 21%. Injuries sustained at public playgrounds are more severe than injuries at home, except among children aged 1 to 4. The rate of injury is higher on modules (combination of several types of equipment including swings, climbers and slides) and swings than on slides and climbers. However, injuries on slides are more severe. The odds of serious injuries are 2.1 times greater for a fall on grass compared to one on sand (CI: 1.08; 3.96). The height of the equipment also appears to be a risk factor for incidence and severity of injury. For all hospitals in Montreal during 1991, the average rate of emergency room visits for playground injuries among children aged 1 to 14 years is 397 per 100,000 children for the period May to September. Injury rates are higher for children under 10 years old and among boys.In conclusion, the findings regarding playground surfaces are the most important, and suggest that, under equipment, grass should be replaced by sand. This recommendation applies to both public and home playgrounds. Prevention programs should focus on ensuring that playgrounds are in compliance with Canadian Safety Standards and should include both public and home playgrounds

Quels apports des services écosystémiques pour l’aide à la décision en entreprise ?

International audienceLa gestion actuelle des eaux usées industrielles présente des problématiques diverses, malgré les précautions prises par l’Europe à travers de nombreux textes règlementaires. L’atteinte des objectifs de qualité des masses d’eau fixés à l’horizon 2015 devra passer par une réelle appropriation des enjeux par l’ensemble des acteurs afin de mettre en place des filières de traitement adaptées à chaque cas. Dans le cadre conceptuel actuel d’écologie industrielle où les déchets deviennent produits, nous nous sommes donc penchés sur les possibilités d’utilisation des principes de gestion de la qualité prescrits par l’ISO 9000 à la gestion des effluents industriels, avec comme clients potentiels des industries (réutilisation), des stations d’épurations communales, mais également les écosystèmes récepteurs. La prise en compte d’écosystèmes comme clients pose néanmoins des questions délicates telles que l’évaluation de leurs besoins. La complexité de cette évaluation nous a poussé à considérer le territoire du point de vue des services écosystémiques (c’est-à-dire les services rendus par les écosystèmes qui contribuent au bien être de l’Homme) afin d’identifier des cibles humaines aptes à exprimer leurs besoins afin d’en tirer des exigences vis-à-vis du milieu. Ces exigences sont ensuite converties, en fonction de données locales et règlementaires, en exigences qualitatives vis-à-vis des rejets. Cette démarche a été matérialisée sous la forme d’un outil destiné aux industriels ou tout autre acteur sans compétence particulière dans le domaine de l’eau. L’apport de ce travail est donc l’analyse des enjeux environnementaux locaux via les services écosystémiques pour contribuer au cahier des charges des filières de traitement d’effluents aqueux industriels par l’élaboration de seuils de rejet

Quels apports des services écosystémiques pour l’aide à la décision en entreprise ?

International audienceLa gestion actuelle des eaux usées industrielles présente des problématiques diverses, malgré les précautions prises par l’Europe à travers de nombreux textes règlementaires. L’atteinte des objectifs de qualité des masses d’eau fixés à l’horizon 2015 devra passer par une réelle appropriation des enjeux par l’ensemble des acteurs afin de mettre en place des filières de traitement adaptées à chaque cas. Dans le cadre conceptuel actuel d’écologie industrielle où les déchets deviennent produits, nous nous sommes donc penchés sur les possibilités d’utilisation des principes de gestion de la qualité prescrits par l’ISO 9000 à la gestion des effluents industriels, avec comme clients potentiels des industries (réutilisation), des stations d’épurations communales, mais également les écosystèmes récepteurs. La prise en compte d’écosystèmes comme clients pose néanmoins des questions délicates telles que l’évaluation de leurs besoins. La complexité de cette évaluation nous a poussé à considérer le territoire du point de vue des services écosystémiques (c’est-à-dire les services rendus par les écosystèmes qui contribuent au bien être de l’Homme) afin d’identifier des cibles humaines aptes à exprimer leurs besoins afin d’en tirer des exigences vis-à-vis du milieu. Ces exigences sont ensuite converties, en fonction de données locales et règlementaires, en exigences qualitatives vis-à-vis des rejets. Cette démarche a été matérialisée sous la forme d’un outil destiné aux industriels ou tout autre acteur sans compétence particulière dans le domaine de l’eau. L’apport de ce travail est donc l’analyse des enjeux environnementaux locaux via les services écosystémiques pour contribuer au cahier des charges des filières de traitement d’effluents aqueux industriels par l’élaboration de seuils de rejet