Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis

OBJECTIVES: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. METHODS: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged ≥65 years with a history of ≥3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. OUTCOME MEASURES INCLUDED: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. RESULTS: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward's triangle p<0.02). CONCLUSION: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women

A novel approach to reduce sedentary behaviour in care home residents: the GET READY study utilising service-learning and co-creation

The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff's level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment

Advocating for Justice: The role of U.S. policy & non-profit organizations in ending child sex trafficking

Child sex trafficking is a form of human trafficking pervasive throughout the world. Nearly one million children are used as modern day slaves in the sex trafficking industry at any given time (International Labour Organization, 2012). Traffickers use their positions of power and control to enslave their victim in horrific situations and use them for their personal financial gain, while buyers perpetuate the industry. Federal policies and non-profit organizations in the US work together to combat child sex trafficking, but the continued presence of supply and demand along with gaps left by ineffective laws, untrained law enforcement, and low community awareness allow the industry to continue. This paper uses a literature review to examine the history of child sex trafficking and to provide information about the victims, traffickers and buyers. It details the role of U.S. policies and non-profit organizations (NPOs) in addressing the needs of victims, prosecuting traffickers, and preventing further abuse. Information is provided on the shortcomings of certain U.S. policies and on how U.S. NPOs are addressing certain community needs. The research also includes a case study based on an interview with a staff member of Saving Innocence, a non-profit organization in California. Lastly, recommendations are made to increase training of law enforcement and service providers, to increase collaboration across sectors, to amend U.S. policies to better help victims, and to create a stronger focus on the demand for commercial sex with the intent of better addressing this crisis

Non-equilibrium dynamics in an interacting nanoparticle system

Non-equilibrium dynamics in an interacting Fe-C nanoparticle sample, exhibiting a low temperature spin glass like phase, has been studied by low frequency ac-susceptibility and magnetic relaxation experiments. The non-equilibrium behavior shows characteristic spin glass features, but some qualitative differences exist. The nature of these differences is discussed.Comment: 7 pages, 11 figure

Static chaos and scaling behaviour in the spin-glass phase

We discuss the problem of static chaos in spin glasses. In the case of magnetic field perturbations, we propose a scaling theory for the spin-glass phase. Using the mean-field approach we argue that some pure states are suppressed by the magnetic field and their free energy cost is determined by the finite-temperature fixed point exponents. In this framework, numerical results suggest that mean-field chaos exponents are probably exact in finite dimensions. If we use the droplet approach, numerical results suggest that the zero-temperature fixed point exponent $\theta$ is very close to $\frac{d-3}{2}$. In both approaches $d=3$ is the lower critical dimension in agreement with recent numerical simulations.Comment: 28 pages + 6 figures, LateX, figures uuencoded at the end of fil

Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.Funding Agencies|Swedish Research Council [2015-03481]; Strategic Research Programme in Care Sciences, Umea University; Karolinska Institute, Sweden; Umea University</p

Mean-field theory of temperature cycling experiments in spin-glasses

We study analytically the effect of temperature cyclings in mean-field spin-glasses. In accordance with real experiments, we obtain a strong reinitialization of the dynamics on decreasing the temperature combined with memory effects when the original high temperature is restored. The same calculation applied to mean-field models of structural glasses shows no such reinitialization, again in accordance with experiments. In this context, we derive some relations between experimentally accessible quantities and propose new experimental protocols. Finally, we briefly discuss the effect of field cyclings during isothermal aging.Comment: Some misprints corrected, references updated, final version to apper in PR

Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible

School-Based Consultation to Improve Concussion Recognition and Response

Many students who have sustained concussions return to school requiring academic adjustments while their brains heal. However, school personnel often are not trained to accommodate these students. This exploratory project examined the usefulness of school-based training paired with ongoing consultation and continued dissemination of information to improve both concussion recognition and response among school personnel. A case study design was employed in which a school district received training that was followed by ongoing consultation and continued dissemination of concussion resources. This study highlights the importance of involving school psychologists in concussion management programs