Long-Term Maintenance Strategies after Pulmonary Rehabilitation: Perspectives of People with Chronic Respiratory Diseases, Informal Carers, and Healthcare Professionals

Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6–12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare professionals (HCPs) were recruited from pulmonology appointments of two local hospitals, two primary care centres, and one community institutional practice and through snowballing technique. Focus groups were conducted using a semi-structured guide. Data were thematically analysed. Twenty-nine people with CRD (24% female, median 69 years), 5 informal carers (100% female, median 69 years), and 16 HCPs (75% female, median 36 years) were included. Three themes were identified: “Maintaining an independent and active lifestyle” which revealed common strategies adopted by people with “intrinsic motivation and professional and peer support” as key elements to maintain benefits, and that “access to information and partnerships with city councils’ physical activities” were necessary future steps to sustain active lifestyles. This study suggests that motivation, and professional and peer support are key elements to maintaining the benefits of PR in people with CRD, and that different physical activity options (independent or group activities) considering peoples’ preferences, should be available through partnerships with the community, namely city councils.

Cardiovascular Metrics Associated With Prevention of Aging-Related Parkinsonian Signs Following Exercise Intervention in Sedentary Older Rats

Preservation of motor capabilities is vital to maintaining independent daily living throughout a person's lifespan and may mitigate aging-related parkinsonism, a progressive and prevalent motor impairment. Physically active lifestyles can mitigate aging-related motor impairment. However, the metrics of physical activity necessary for mitigating parkinsonian signs are not established. Consistent moderate intensity (~10 m/min) treadmill exercise can reverse aging-related parkinsonian signs by 20 weeks in a 2-week on, 2-week off, regimen in previously sedentary advanced middle-aged rats. In this study, we initiated treadmill exercise in sedentary 18-month-old male rats to address two questions: (1) if a rest period not longer than 1-week off exercise, with 15 exercise sessions per month, could attenuate parkinsonian signs within 2 months after exercise initiation, and the associated impact on heart rate (HR) and mean arterial pressure (MAP) and (2) if continuation of this regimen, up to 20 weeks, will be associated with continual prevention of parkinsonian signs. The intensity and frequency of treadmill exercise attenuated aging-related parkinsonian signs by 8 weeks and were maintained till 23 months old. The exercise regimen increased HR by 25% above baseline and gradually reduced pre-intervention MAP. Together, these studies indicate that a practicable frequency and intensity of exercise reduces parkinsonian sign severity commensurate with a modest increase in HR after exercise. These cardiovascular changes provide a baseline of metrics, easily measured in humans, for predictive validity that practicable exercise intensity and schedule can be initiated in previously sedentary older adults to delay the onset of aging-related parkinsonian signs.

Rich and Balanced Experiences of Daily Emotions Are Associated With Activity Diversity Across Adulthood

We examined whether the diversity of daily activities (“activity diversity”) is associated with the diversity of daily emotions (“emodiversity”) and if the association differs by age. Two samples of adults from the Midlife in the United States Study provided activity and emotion data for eight days. Greater activity diversity was associated with greater positive and negative emodiversity in each sample. Age moderated the association between activity diversity and positive emodiversity in an older sample, such that association was stronger for younger adults than for older adults. Results from data combining the two samples revealed that the associations of activity diversity with positive or negative emodiversity were significant when age < 70, 71 years, respectively. Broad and even participation of daily activities may provide more opportunities to experience rich and balanced emotions in adulthood. The weaker associations in older age may suggest the need to promote active lifestyles in later life.

Switching up How You Get in Your Steps: Daily Activity Diversity and Cognitive Functioning

Active lifestyles are related to better cognitive health. More work is needed, however, to examine whether participating in a variety of daily activities (i.e., activity diversity) has unique importance beyond amount of activity. The current study examined associations between daily activity diversity and cognitive functioning among community-dwelling older adults (N = 313, ages 65-90). Participants completed a cognitive battery, then responded to ecological momentary assessments of their participation in 10 common activity types (e.g., exercise, chores, social visits, volunteering) every 3 hours for 5-6 days, and wore accelerometers to track daily step counts and duration of activity. Multiple regression models revealed that greater daily activity diversity related to higher overall cognitive functioning, executive functioning, memory, and crystallized intelligence. These associations remained significant after adjusting for step count and duration of activity. Findings suggest daily activity diversity has unique importance beyond sheer amount of activity for cognitive health in later adulthood.

Who Has Active Lifestyles? Personality and Activity Diversity in Adulthood

Broad and even participation across daily activities (“activity diversity”) has been found to be associated with better health. Less is known about who has greater activity diversity. We examined whether personality traits are associated with activity diversity in two independent samples of adults. Data came from the Midlife in the United States Study II and Refresher (n=2623, Mage=54yrs) and Daily Experiences and Well-being in Late Life Study (n=308, Mage=74yrs) who responded to daily activity questions. We constructed activity diversity scores in each sample using Shannon’s entropy. We focused on three personality traits — conscientiousness, extraversion, neuroticism — often associated with health. Higher extraversion was associated with greater activity diversity, replicated across the two samples. The associations were independent of conscientiousness and neuroticism (both were not significant), total activity time/frequency, age, gender, race, education, and self-rated health. Results suggest that future activity interventions may need to target those with lower extraversion.

The European Silver Economy

The European Union is going through a period of profound transformation due to socio-economic and demographic changes. Europe's population is aging as a result of declining fertility and increasing life expectancy, and its share of the world's population continues to decline. The top 10 countries on the planet with the oldest populations include nine EU countries. Older citizens are increasingly shaping the economy, constituting a growing segment in many areas of consumption. The expansion of this age group is expected to lead to an increased demand in many sectors, and in the not-too-distant future will provide significant economic opportunities for European businesses. The so-called “silver economy” (or longevity economy) is a concept of responding to and adapting to the challenges determined by demographic shifts at the global, regional and country levels by inclusively supporting job growth and productivity in traditional and new sectors of the modern digital economy, acceptable to government, business and the entire population, and supposedly capable of becoming the engine of the future economy. Population aging, its density, and household size, in turn, have also had an impact on the spread of the COVID-19 pandemic, whose outbreak tested health and welfare systems as well as economic and social sustainability. This is why demographic processes need to be taken into account in the post-pandemic economic cycle, managing their long-term effects has many different aspects concerning health care, including care for the elderly, as well as government budgets. The integration of digital solutions, robotic technologies in these areas can significantly empower the elderly, promote independent and active lifestyles, and integrate into the labor market. Thus, it can be argued that the potential risks of the modern demographic transition are not inevitable, and the challenge is to find tools, opportunities and means to adapt the economy and society to it.

Predicting Physical Exercise Adherence in Fitness Apps Using a Deep Learning Approach

The use of mobile fitness apps has been on the rise for the last decade and especially during the worldwide SARS-CoV-2 pandemic, which led to the closure of gyms and to reduced outdoor mobility. Fitness apps constitute a promising means for promoting more active lifestyles, although their attrition rates are remarkable and adherence to their training plans remains a challenge for developers. The aim of this project was to design an automatic classification of users into adherent and non-adherent, based on their training behavior in the first three months of app usage, for which purpose we proposed an ensemble of regression models to predict their behaviour (adherence) in the fourth month. The study was conducted using data from a total of 246 Mammoth Hunters Fitness app users. Firstly, pre-processing and clustering steps were taken in order to prepare the data and to categorize users into similar groups, taking into account the first 90 days of workout sessions. Then, an ensemble approach for regression models was used to predict user training behaviour during the fourth month, which were trained with users belonging to the same cluster. This was used to reach a conclusion regarding their adherence status, via an approach that combined affinity propagation (AP) clustering algorithm, followed by the long short-term memory (LSTM), rendering the best results (87% accuracy and 85% F1_score). This study illustrates the suggested the capacity of the system to anticipate future adherence or non-adherence, potentially opening the door to fitness app creators to pursue advanced measures aimed at reducing app attrition.

Active Urban Dwelling: Variations Of Body And Space For Improved Well-Being

<div>Designed for efficiency and economy, the design of apartment housing in Toronto has become repetitive, often leading our lived environments to lack spatial variation and limit how we use, and move, in space. This impairs the well-being of our minds and bodies as we slip into the ‘automatic’ -- increasing the risks of declines in our cognitive functioning, physical abilities, and life span. This thesis proposes and tests a new conception of mid-rise urban dwelling that is based around active lifestyles through physical and social engagement. Various scales are considered: that of private dwelling, shared clusters of spaces, shared building sites, and context and site as it integrates with the city. Findings of this thesis highlight that urban living can promote well-being through the use of affordances, proximities, and public and private gradients which create interstitial spaces between housing and the city.</div>

Active Urban Dwelling: Variations Of Body And Space For Improved Well-Being

<div>Designed for efficiency and economy, the design of apartment housing in Toronto has become repetitive, often leading our lived environments to lack spatial variation and limit how we use, and move, in space. This impairs the well-being of our minds and bodies as we slip into the ‘automatic’ -- increasing the risks of declines in our cognitive functioning, physical abilities, and life span. This thesis proposes and tests a new conception of mid-rise urban dwelling that is based around active lifestyles through physical and social engagement. Various scales are considered: that of private dwelling, shared clusters of spaces, shared building sites, and context and site as it integrates with the city. Findings of this thesis highlight that urban living can promote well-being through the use of affordances, proximities, and public and private gradients which create interstitial spaces between housing and the city.</div>

New Considerations for a Totally Implantable Active Middle Ear Implant

Totally implantable active middle ear implants (AMEI) provide full-time hearing amplification to those with moderate to severe sensorineural hearing loss. While technology in conventional hearing aids (CHA) has advanced greatly, limitations remain for people with active lifestyles, limited vision or dexterity, and hearing aid fit issues. Furthermore, direct-drive properties of AMEI are thought to provide those with inefficient middle ear transfer functions a distinct advantage in delivering prescribed sound to the cochlea, ultimately improving speech understanding with less distortion. AMEI safety, stability, and efficacy outcomes are well documented and fitting strategies continue to improve. Recent studies show how simple aided speech testing can help predict whether a patient struggling with CHA may instead benefit from an AMEI. Totally implantable AMEI continue to be a viable option for patients who cannot or will not utilize traditional hearing aids.