Multicomponent exercise program in older adults with lung cancer during adjuvant/palliative treatment: A secondary analysis of an intervention study

2021 ◽  
pp. 1-7
Author(s):  
N. Martínez-Velilla ◽  
M.L. Saez de Asteasu ◽  
R. Ramírez-Vélez ◽  
I.D. Rosero ◽  
A. Cedeño-Veloz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Older Adults ◽  
Emergency Department ◽  
Palliative Treatment ◽  
Secondary Analysis ◽  
Exercise Programme ◽  
Control Group ◽  
Post Intervention ◽  
Frailty Status ◽  
The Impact

Background: Lung cancer is the second most prevalent common cancer in the world and predominantly affects older adults. This study aimed to examine the impact of an exercise programme in the use of health resources in older adults and to assess their changes in frailty status. Design: This is a secondary analysis of a quasi-experimental study with a non-randomized control group. Setting: Oncogeriatrics Unit of the Complejo Hospitalario de Navarra, Spain. Participants: Newly diagnosed patients with NSCLC stage I–IV. Intervention: Multicomponent exercise programme that combined resistance, endurance, balance and flexibility exercises. Each session lasted 45–50 minutes, and the exercise protocol was performed twice a week over 10 weeks. Measurements: Mortality, readmissions and Visits to the Emergency Department. Change in frailty status according to Fried, VES-13 and G-8 scales. Results: 26 patients completed the 10-weeks intervention (IG). Mean age in the control group (CG) was 74.5 (3.6 SD) vs 79 (3 SD) in the IG, and 78,9% were male in the IG vs 71,4% in the CG. No major adverse events or health-related issues attributable to the testing or training sessions were noted. Significant between-group differences were obtained on visits to the emergency department during the year post-intervention (4 vs 1; p:0.034). No differences were found in mortality rate and readmissions, where an increasing trend was observed in the CG compared with the IG in the latter (2 vs 0; p 0.092). Fried scale was the unique indicator that seemed to be able to detect changes in frailty status after the intervention. Conclusions: A multicomponent exercise training programme seems to reduce the number of visits to the emergency department at one-year post-intervention in older adults with NSCLC during adjuvant therapy or palliative treatment, and is able to modify the frailty status when measured with the Fried scale.

scholarly journals Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric Emergency Department: A Pilot and Feasibility Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Leah I. Stein Duker ◽  
Anita R. Schmidt ◽  
Phung K. Pham ◽  
Sofronia M. Ringold ◽  
Alan L. Nager
Keyword(s):  
Emergency Department ◽  
State Anxiety ◽  
Low Cost ◽  
Pediatric Emergency ◽  
Control Group ◽  
Pediatric Emergency Department ◽  
Post Intervention ◽  
Paired Samples ◽  
Before And After ◽  
The Impact

Objectives: Anxiety and anticipatory stressors are commonly experienced by children visiting the Pediatric Emergency Department (PED), but little research exists that addresses the efficacy of interventions to decrease this stress. This one-sample pretest-postest pilot study gathered preliminary data on the feasibility and effectiveness of utilizing audiobooks to reduce fear and state anxiety in children in the PED.Methods: Participants were 131 children in kindergarten through 8th grade (M = 9.4 years, 54% female), triaged urgent or emergent, presenting to the PED. Participants self-reported fear (Children's Fear Scale) and state anxiety (modified State-Trait Anxiety Inventory for Children; mSTAIC) before and after listening to an age-appropriate audiobook (two options). Data regarding patient experience were also collected. Paired samples t-test was used to examine pre–post intervention changes in fear and state anxiety.Results: Significant, albeit small, improvements in fear and the mSTAIC states of nervous, calm, happy, and relaxed were found after use of the audiobook (Cohen's dz = 0.22–0.35). Small, yet significant correlations were found between child age/grade level and improvements in fear and in the mSTAIC states of scared and relaxed, suggesting that the audiobook was more beneficial for older participants. Over 60% of participants liked the audiobook content “a lot” as well as enjoyed listening to the audiobook “a lot.” Without prompting, 15% of participants requested to listen to an additional audiobook.Conclusions: Listening to an audiobook is feasible and could be effective in decreasing fear and state anxiety for children during a waiting period in the PED. The technology is low-cost, simple, and portable. The results of this study should be interpreted with prudence due to the lack of a control group and results that, although significant, were modest based on effect size conventions; future studies should explore the impact of audiobooks on patient stress with an expanded sample size and control group.

Reducing emergency department visits among older adults

2019 ◽  
Vol 27 (1) ◽  
pp. 37-49
Author(s):  
Daniel Chen ◽  
Alex M. Torstrick ◽  
Robert Crupi ◽  
Joseph E. Schwartz ◽  
Ira Frankel ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Integrated Care ◽  
Low Income ◽  
Medical Center ◽  
Emergency Department Visits ◽  
Control Group ◽  
Content Type ◽  
Low Intensity ◽  
The Impact

Purpose There is mixed evidence regarding the efficacy of low-intensity integrated care interventions in reducing the use of emergency services and costs of care. The purpose of this paper is to examine the effects of a low-intensity intervention formulated for older adults and delivered in an urban medical center serving low-income individuals. Design/methodology/approach The intervention included an initial evaluation of stress, psychiatric symptomatology and health habits; potential referrals for lifestyle management and psychiatric treatment; and training for physicians about the impact of lifestyle change in older adults. Participants included older adults (at or above 50 years of age) seen as outpatients in an urban medical center serving a low-income community (n=945). Participants were entered into the intervention at any point during this two-year period. Mixed models analyses examined all visits for all enrolled individuals over a two-year period, comparing visits before the individual received the initial intervention evaluation to those received after this evaluation. Outcomes included total health care costs incurred, average cost per visit, and emergency department (ED) usage within the facility. Findings The intervention was associated with reduced likelihood of emergency department use and reduced costs per visit following the intervention. These effects were seen across all participants. Research limitations/implications Limitations of the study include the lack of control group. Practical implications This program is easy to disseminate and could improve the quality of care and costs. Originality/value This study is among the few available to document a decrease in medical costs, as well as decreased ED utilization following a low-intensity integrated care intervention.

scholarly journals The effect of a multicomponent exercise protocol (VIVIFRAIL©) on inflammatory profile and physical performance of older adults with different frailty status: study protocol for a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Petrella ◽  
Ivan Aprahamian ◽  
Ronei Luciano Mamoni ◽  
Carla Fernanda de Vasconcellos Romanini ◽  
Natália Almeida Lima ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Inflammatory Mediators ◽  
Gait Speed ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Frailty Status ◽  
Anti Inflammatory ◽  
Inflammatory Profile

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

scholarly journals Shingles Immunity and Health Functioning in the Elderly:Tai Chi Chihas a Behavioral Treatment

2004 ◽  
Vol 1 (3) ◽  
pp. 223-232 ◽  
Author(s):  
Michael Irwin ◽  
Jennifer Pike ◽  
Michael Oxman
Keyword(s):  
Older Adults ◽  
Behavioral Treatment ◽  
Tai Chi ◽  
Relaxation Response ◽  
Control Group ◽  
Varicella Zoster ◽  
Specific Immunity ◽  
Health Functioning ◽  
Increased Risk ◽  
The Impact

Both the incidence and severity of herpes zoster (HZ) or shingles increase markedly with increasing age in association with a decline in varicella zoster virus (VZV)-specific immunity. Considerable evidence shows that behavioral stressors, prevalent in older adults, correlate with impairments of cellular immunity. Moreover, the presence of depressive symptoms in older adults is associated with declines in VZV-responder cell frequency (VZV-RCF), an immunological marker of shingles risk. In this review, we discuss recent findings that administration of a relaxation response-based intervention,tai chi chih(TCC), results in improvements in health functioning and immunity to VZV in older adults as compared with a control group. TCC is a slow moving meditation consisting of 20 separate standardized movements which can be readily used in elderly and medically compromised individuals. TCC offers standardized training and practice schedules, lending an important advantage over prior relaxation response-based therapies. Focus on older adults at increased risk for HZ and assay of VZV-specific immunity have implications for understanding the impact of behavioral factors and a behavioral intervention on a clinically relevant end-point and on the response of the immune system to infectious pathogens.

scholarly journals Using Sensor Graphs for Monitoring the Effect on the Performance of the OTAGO Exercise Program in Older Adults

Sensors ◽  
2022 ◽  
Vol 22 (2) ◽  
pp. 493
Author(s):  
Björn Friedrich ◽  
Carolin Lübbe ◽  
Enno-Edzard Steen ◽  
Jürgen Martin Bauer ◽  
Andreas Hein
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Exercise Program ◽  
Exercise Programme ◽  
Control Group ◽  
Motion Sensors ◽  
Surrogate Variable ◽  
Physical Sensor ◽  
The Difference ◽  
Positive Effect

The OTAGO exercise programme is effective in decreasing the risk for falls of older adults. This research investigated if there is an indication that the OTAGO exercise programme has a positive effect on the capacity and as well as on the performance in mobility. We used the data of the 10-months observational OTAGO pilot study with 15 (m = 1, f = 14) (pre-)frail participants aged 84.60 y (SD: 5.57 y). Motion sensors were installed in the flats of the participants and used to monitor their activity as a surrogate variable for performance. We derived a weighted directed multigraph from the physical sensor network, subtracted the weights of one day from a baseline, and used the difference in percent to quantify the change in performance. Least squares was used to compute the overall progress of the intervention (n = 9) and the control group (n = 6). In accordance with previous studies, we found indication for a positive effect of the OTAGO program on the capacity in both groups. Moreover, we found indication that the OTAGO program reduces the decline in performance of older adults in daily living. However, it is too early to conclude causalities from our findings because the data was collected during a pilot study.

scholarly journals Geriatric Emergency Department Innovations: The Impact of Transitional Care Nurses on 30‐day Readmissions for Older Adults

2019 ◽  
Vol 27 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Scott M. Dresden ◽  
Ula Hwang ◽  
Melissa M. Garrido ◽  
Jeremy Sze ◽  
Raymond Kang ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Transitional Care ◽  
The Impact

scholarly journals Impact of Decreased Night Work on Workers’ Musculoskeletal Symptoms: A Quasi-Experimental Intervention Study

2020 ◽  
Vol 17 (23) ◽  
pp. 9092
Author(s):  
Hye-Eun Lee ◽  
Min Choi ◽  
Hyoung-Ryoul Kim ◽  
Ichiro Kawachi
Keyword(s):  
Musculoskeletal Pain ◽  
Night Shift ◽  
Night Work ◽  
Musculoskeletal Symptoms ◽  
Control Group ◽  
Body Parts ◽  
Difference In Difference ◽  
Post Intervention ◽  
Shift Workers ◽  
The Impact

A possible association between night shift work and musculoskeletal disorder has been suggested. This study aimed to evaluate the impact of decreased night work on musculoskeletal pain. Difference-in-difference estimation was used to compare changes in musculoskeletal pain between shift workers (N = 122) and non-shift workers (N = 170) in a manufacturing company before and after the introduction of a new shift system eliminating overnight work. Musculoskeletal pain was measured by a questionnaire asking if workers had symptoms in specific body parts, including the neck, shoulder, arm/elbow, wrist/hand, back, and leg/foot, over the past year. Generalized estimating equation models were used to estimate changes in pre- versus post-intervention musculoskeletal pain rates between the treated and control group. In the difference-in-difference (DID) models, prevalence of musculoskeletal pain for shoulder (−10.3%), arm (−12.9%), all sites combined (−9.2%), and upper extremity combined (−14.8%) showed significant decreases from pre- to post-intervention among the treated group (shift workers) compared to the control group (non-shift workers) after controlling for age and weekly working hours. Decreasing night work was related to improvement in musculoskeletal pain in shift workers.

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