Dietary and fluid intakes of older adults in care homes requiring a texture modified diet. Proceedings of the 19th IAGG World Congress of Gerontology and Geriatrics, Paris: (5-7 July 2009).

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Effectiveness of nutritional and exercise interventions to improve body composition and muscle strength or function in sarcopenic obese older adults:A systematic review

Although sarcopenic obesity (SO) poses a major public health concern, a robust approach for\ud the optimization of body composition and strength/function in SO has not yet been\ud established. The purpose of this systematic review was to assess the effectiveness of\ud nutritional (focusing on energy and protein modulation) and exercise interventions, either\ud individually or combined, on body composition and strength/function in older adults with SO.\ud MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL and SPORTDiscus were\ud searched. Main inclusion criteria comprised sarcopenia as defined by the European Working\ud Group on Sarcopenia in Older People (EWGSOP) and obesity defined as % body fat .40%\ud (women) and .28% (men). Randomized controlled trials (RCTs), randomized controlled\ud crossover trials and controlled clinical trials with older adults (mean age .65 years) following\ud a nutritional regimen and/or an exercise training programwere considered. Out of 109 full text\ud articles identified, only two RCTs (61 participants) met the inclusion criteria. One study was a\ud nutritional intervention adding 15 g protein�Eday.1 (via cheese consumption) to the\ud participants' habitual diet. The second study was a high-speed circuit resistance training\ud intervention. Body composition did not change significantly in either of the studies. However,the exercise intervention improved significantly muscle strength and physical function.\ud Although this review was limited by the small number of eligible studies, it provides evidence\ud for the potential benefits of exercise and highlights the necessity for future research to develop\ud effective interventions including dietary and exercise regimens to combat sarcopenic obesity

Food in Hospitals: National catering and nutrient specification for food and fluid provision in hospitals in Scotland'. Edinburgh: The Scottish Government

EdinburghFood in Hospitals: National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland has been developed to support Scottish NHS Boards in implementing (1) the NHS QIS Clinical Standards for Food, Fluid and Nutritional Care in Hospitals specifically standards 3, 4 and 5 which aim to address the risks of malnutrition in hospital patients and (2) the delivery of a healthy balanced diet for patients who are considered to be 'nutritionally well'.sch_diepub810pu

Experiences in obtaining prescribable and non-prescribable gluten-free products of adults with coeliac disease in Lothian.

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Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman:a cross-sectional survey

Objectives: Physical activity is fundamental in diabetes management for good metabolic control. This study aimed to identify barriers to performing leisure time physical activity and explore differences based on gender, age, marital status, employment, education, income and perceived stages of change in physical activity in adults with type 2 diabetes in Oman.Design: Cross-sectional study using an Arabic version of the “Barriers to Being Active” 27 item questionnaire.Setting: Seventeen primary health centres randomly selected in Muscat.Participants: Individuals >18 years with type 2 diabetes, attending diabetes clinic for > 2 years and with no contraindications to performing physical activity.Primary and secondary outcome measures: Participants were asked to rate how far different factors influenced their physical activity, under the following categories: fear of injury, lack of time, social support, energy, willpower, skills, resources, religion and environment. On a scale of 0-9, barriers were considered important if scored ≥5.Results: A total of 305 questionnaires were collected. Most (96%) reported at least one barrier to performing leisure time physical activity. Lack of willpower (44.4%), lack of resources (30.5%) and lack of social support (29.2%) were the most frequently reported barriers. Using chi-square test, lack of willpower was significantly different in individuals with low vs high income (54.2% vs 40%, P=0.002) and in those reporting inactive vs active stages of change for physical activity (50.7% vs 34.7%, P=0.029), lack of resources was significantly different in those with low vs high income (40% vs 24.3%, P=0.004) and married vs unmarried (33.8% vs 18.5%, P=0.018). Lack of social support was significant in females vs males (35.4% vs 20.8%, P=0.005).Conclusions: The findings can inform the design on physical activity intervention studies by testing the impact of strategies which incorporate ways to address reported barriers including approaches that enhance self-efficacy and social support

Changes in Self-Efficacy and Social Support after an Intervention to Increase Physical Activity Among Adults with Type 2 Diabetes in Oman:A 12-month follow-up of the MOVEdiabetes trial

Objectives: This study aimed to describe changes in self-efficacy (SE) and social support (SS) 12 months after the MOVEdiabetes trial, an intervention designed to increase physical activity (PA) among adults with type 2 diabetes mellitus in Oman. Methods: The original MOVEdiabetes trial was conducted between April 2016 and June 2017 in Muscat, Oman. The intervention group (IG) received personalised PA consultations, pedometers and monthly messages using a web-based application, while the comparison group received usual care. Self-reported SE and SS from family and friends were assessed using validated psychosocial scales. Results: Of the 232 original participants in the trial, a total of 174 completed the 12 months follow-up study period (response rate: 75%). However, based on intention-to-treat analysis with several imputation procedures for missing data at 3 and/or 12 months, there was a significant increase in SE scores in the IG (+10.3, 95% confidence interval [CI]: 7.1–13.5; P <0.001); however, the correlation with PA levels was weak (+4.2, 95% CI: 2.7–5.7; P <0.001). Higher SE scores were noted in those without comorbidities (+12.2, 95% CI: 6.8–17.6; P <0.001) and with high income levels (+9.7, 95% CI: 5.2–14.2; P <0.001). Additionally, SS scores increased significantly among those in the IG who received support from friends (+2.3, 95% CI: 1.1–3.7; P <0.001), but not family (+1.2, 95% CI: −0.4–2.8; P = 0.110). The reliability of the scales was acceptable for SE and SS from family, but poor for SS from friends (Cronbach’s alpha coefficients = 0.82, 0.82 and 0.40, respectively). Conclusion: The PA intervention was associated with positive changes in SE and SS from friends. However, further tools for assessing psychosocial influences on PA are needed in Arab countries.   KEYWORDS Physical Activity; Type 2 Diabetes Mellitus; Self-Management; Health Behaviors; Social Support, Self-Efficacy; Primary Healthcare; Oman

Ethnicity and the Writing of Medieval Scottish history

Historians have long tended to define medieval Scottish society in terms of interactions between ethnic groups. This approach was developed over the course of the long nineteenth century, a formative period for the study of medieval Scotland. At that time, many scholars based their analysis upon scientific principles, long since debunked, which held that medieval 'peoples' could only be understood in terms of 'full ethnic packages'. This approach was combined with a positivist historical narrative that defined Germanic Anglo-Saxons and Normans as the harbingers of advances of Civilisation. While the prejudices of that era have largely faded away, the modern discipline still relies all too often on a dualistic ethnic framework. This is particularly evident in a structure of periodisation that draws a clear line between the 'Celtic' eleventh century and the 'Norman' twelfth. Furthermore, dualistic oppositions based on ethnicity continue, particularly in discussions of the law, kingship, lordship and religion

Health professionals’ perceptions about physical activity promotion in diabetes care within primary health care settings in Oman

Background: As part of formative work to inform an interventional design to increase physical activity (PA) in patients with type 2 diabetes in Oman, this qualitative study aimed to determine health professionals’ perception of barriers and opportunities, personnel responsibilities and plausible PA promotional approaches. Methods: Four focus group discussions were carried out with groups of health care professionals (family physicians, dieticians and health educators, managers and general practitioners). All discussions were audio recorded and transcribed. Responses were analysed using a thematic analysis. Results: Barriers to PA reported by participants (n = 29) were identified at three levels: health care system (e.g. deficient PA guidelines); individual (e.g. obstructive social norms) and community (e.g. lack of facilities). Participants felt that a multilevel approach is needed to address perceived barriers and to widen current opportunities. In the presence of various diabetes primary care providers, the potential for dieticians to include individualised PA consultations as part of their role was highlighted. Participants felt that consultations should be augmented by approaches within the community (volunteer support and/or appropriate facilities). However, despite lack of experience with technology supported approaches and motivational tools, the telephone application “WhatsApp” and use of pedometers were considered potentially suitable. The need for training in behaviour change techniques and clearly communicated intervention guidelines was emphasised. Conclusions: A multi-component approach including PA consultations, possibly led by trained dieticians, technological routes for providing support along with community mapping for resources appear to offer promising approaches for further PA intervention studies within diabetes primary health care