Parental bonding and adult psychopathology: results from the US National Comorbidity Survey.

Science.gov (United States)

Enns, M W; Cox, B J; Clara, I

2002-08-01

Research using the parental bonding instrument (PBI) has suggested that lack of parental care and/or overprotection may be important risk factors for adult mental disorders. Much of this research, however, has relied on clinical populations with one or two disorders, or has used highly select community samples. The association between parenting experiences and the occurrence of 13 common mental disorders in adulthood was evaluated in the US National Comorbidity Survey (N = 5877). The effect of sociodemographic variables (age, education, income) was statistically controlled and the effects of six parenting variables (maternal and paternal care, overprotection and authoritarianism) were examined simultaneously. The effects in men and women were examined separately. Lack of care was the parenting variable most consistently associated with adult psychopathology. Parenting experiences with one's mother were more consistently associated with adult mental disorders. In general the impact of parenting was diagnostically non-specific. However, there appeared to be some unique effects for externalizing disorders (substance use disorders and antisocial personality disorder) in males; paternal overprotection and authoritarianism conferred a reduced risk of externalizing disorders in adult males. The overall impact of parenting as assessed by the PBI was modest, accounting for about 1 to 5 % of the variance in the occurrence of adult mental disorders. Parenting experiences, particularly lack of care, are potentially causally related in a non-specific manner to a wide variety of forms of adult psychopathology in both men and women. The overall magnitude of the effect is small but statistically significant in a nationally representative US sample.

Improving nursing students' assessment of fall risk in community-dwelling older adults.

Science.gov (United States)

Patton, Susan K

2016-12-09

Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

Food security among young adults with disabilities in the United States: Findings from the National Health Interview Survey.

Science.gov (United States)

Brucker, Debra L

2016-04-01

Prior research has suggested that young adults with disabilities face economic, health and social disadvantage. Food security, an area of disadvantage that can influence overall health, has not been fully explored for this population. To examine levels of food security between young adults with and without disabilities, controlling for individual characteristics. Logistic regression analysis of a nationally representative sample of young adults (age 18-25) (n = 32,795) with and without disabilities, using pooled data form the 2011-2013 National Health Interview Survey. Young adults with disabilities have significantly higher odds (OR: 2.58, p young adults without disabilities, even when controlling for individual characteristics. Odds of living in a household that is food insecure are particularly high (OR: 5.35, p young adults with high levels of psychological distress, controlling for other factors. Young adults with disabilities have increased odds of living in a household that is food insecure. This study has important policy and community program implications. Copyright © 2016 Elsevier Inc. All rights reserved.

[Metabolic syndrome in adults from 20 to 40 years old in a rural Mexican community].

Science.gov (United States)

Echavarría-Pinto, Mauro; Hernández-Lomelí, Adrián; Alcocer-Gamba, Marco Antonio; Morales-Flores, Héctor; Vázquez-Mellado, Alberto

2006-01-01

Metabolic syndrome is the main health problem in Mexico. Its two principal complications (ischemic cardiopathy and type-2 diabetes) are the two main causes of death in Mexico since 2000. To describe the prevalence of the metabolic syndrome in adults from 20 to 40 years old in a Mexican rural community (Senegal de Palomas, San Juan del Río, Querétaro) using the National Cholesterol Education Program (NCEP III) definition. A descriptive study with a random sample was carried out. We present a univariate analysis with a 95% confidence interval. 73 cases were studied. The prevalence of the metabolic syndrome was 45.2% slightly higher in men (48.4%) than in women (42.8%). The prevalence of hypertension was 27.3%. The prevalence of obesity was 26.1% using the definition of the WHO and this prevalence rises up to 49.4% using the definition of the Mexican Official Norm. 90.5% of women and 93.5% of men had low HDLc. The prevalence of metabolic syndrome in adults from 20 to 40 years old in this Mexican rural community is much higher than the national mean for the same age cohort. The results show the necessity to increase the research of our rural communities in order to identify the possible causes to this problem and to create therapeutic programs for patients with metabolic syndrome.

STRATEGIC PRIORITIES FOR INCREASING PHYSICAL ACTIVITY AMONG ADULTS AGE 50 AND OLDER: THE NATIONAL BLUEPRINT CONSENSUS CONFERENCE SUMMARY REPORT

Directory of Open Access Journals (Sweden)

Terry Bazzarre

2003-12-01

Full Text Available On May 1, 2001, a coalition of national organizations released a major planning document designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was developed with input from 46 organizations with expertise in health, medicine, social and behavioral sciences, epidemiology, gerontology/geriatrics, clinical science, public policy, marketing, medical systems, community organization, and environmental issues. The Blueprint notes that, despite a wealth of evidence about the benefits of physical activity for mid-life and older persons, there has been little success in convincing age 50+ Americans to adopt physically active lifestyles. The Blueprint identifies barriers in the areas of research, home and community programs, medical systems, public policy and advocacy, and marketing and communications. In addition to identifying barriers, the Blueprint proposes a number of concrete strategies that could be employed in order to overcome the barriers to physical activity in society at large. This report summarizes the outcome of the National Blueprint Consensus Conference that was held in October 2002. In this conference, representatives of more than 50 national organizations convened in Washington, D.C. with the goal of identifying high priority and high feasibility strategies which would advance the National Blueprint and which could be initiated within the next 12 to 24 months. Participants in the consensus conference were assigned to one of five breakout groups: home and community, marketing, medical systems, public policy, and research. Each breakout group was charged with identifying the three highest priority strategies within their area for effectively increasing physical activity levels in the mid-life and older adult population. In addition to the 15 strategies identified by the

National Adult Tobacco Survey (NATS)

Data.gov (United States)

U.S. Department of Health & Human Services — 2013-2014. The National Adult Tobacco Survey (NATS) was created to assess the prevalence of tobacco use, as well as the factors promoting and impeding tobacco use...

National Community Solar Platform

Energy Technology Data Exchange (ETDEWEB)

Rupert, Bart [Clean Energy Collective, Louisville, CO (United States)

2016-06-30

This project was created to provide a National Community Solar Platform (NCSP) portal known as Community Solar Hub, that is available to any entity or individual who wants to develop community solar. This has been done by providing a comprehensive portal to make CEC’s solutions, and other proven community solar solutions, externally available for everyone to access – making the process easy through proven platforms to protect subscribers, developers and utilities. The successful completion of this project provides these tools via a web platform and integration APIs, a wide spectrum of community solar projects included in the platform, multiple groups of customers (utilities, EPCs, and advocates) using the platform to develop community solar, and open access to anyone interested in community solar. CEC’s Incubator project includes web-based informational resources, integrated systems for project information and billing systems, and engagement with customers and users by community solar experts. The combined effort externalizes much of Clean Energy Collective’s industry-leading expertise, allowing third parties to develop community solar without duplicating expensive start-up efforts. The availability of this platform creates community solar projects that are cheaper to build and cheaper to participate in, furthering the goals of DOE’s SunShot Initiative. Final SF 425 Final SF 428 Final DOE F 2050.11 Final Report Narrative

50 CFR 600.345 - National Standard 8-Communities.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false National Standard 8-Communities. 600.345....345 National Standard 8—Communities. (a) Standard 8. Conservation and management measures shall... overfishing and rebuilding of overfished stocks), take into account the importance of fishery resources to...

Physical activity level and fall risk among community-dwelling older adults.

Science.gov (United States)

Low, Sok Teng; Balaraman, Thirumalaya

2017-07-01

[Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

Classification trees for identifying non-use of community-based long-term care services among older adults.

Science.gov (United States)

Penkunas, Michael James; Eom, Kirsten Yuna; Chan, Angelique Wei-Ming

2017-10-01

Home- and center-based long-term care (LTC) services allow older adults to remain in the community while simultaneously helping caregivers cope with the stresses associated with providing care. Despite these benefits, the uptake of community-based LTC services among older adults remains low. We analyzed data from a longitudinal study in Singapore to identify the characteristics of individuals with referrals to home-based LTC services or day rehabilitation services at the time of hospital discharge. Classification and regression tree analysis was employed to identify combinations of clinical and sociodemographic characteristics of patients and their caregivers for individuals who did not take up their referred services. Patients' level of limitation in activities of daily living (ADL) and caregivers' ethnicity and educational level were the most distinguishing characteristics for identifying older adults who failed to take up their referred home-based services. For day rehabilitation services, patients' level of ADL limitation, home size, age, and possession of a national medical savings account, as well as caregivers' education level, and gender were significant factors influencing service uptake. Identifying subgroups of patients with high rates of non-use can help clinicians target individuals who are need of community-based LTC services but unlikely to engage in formal treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Human Capital Development: Reforms for Adult and Community Education

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Choy, Sarojni; Haukka, Sandra

2007-01-01

The adult and community education (ACE) sector is consistently responsive to changing community needs and government priorities. It is this particular function that has drawn ACE into the lifelong learning debate as one model for sustaining communities. The responsiveness of ACE means that the sector and its programs continue to make valuable…

Feasibility of a community-based Functional Power Training program for older adults

Directory of Open Access Journals (Sweden)

Tan QLL

2018-02-01

Full Text Available Queenie Lin Ling Tan,1 Lilian Min Yen Chye,1 Daniella Hui Min Ng,1 Mei Sian Chong,1 Tze Pin Ng,1,2 Shiou Liang Wee1,3 1Frailty Research Program, Geriatric Education and Research Institute (GERI, Singapore; 2Department of Psychological Medicine, National University of Singapore, Singapore; 3Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore Purpose: Community-based programs can increase and sustain physical activity participation in older adults, even for those who are physically frail. We studied the feasibility and potential effect of a 12-week structured Functional Power Training (FPT program involving high velocities and low loads for older adults conducted in a common area of their housing estate.Patients and methods: The structured FPT program was conducted in collaboration with a health promotion social enterprise and a community service provider based in a public housing site. We recruited nine inactive residents as participants to the single, group-based, twice-weekly program. Attendance and adverse event(s were recorded throughout the program. The Short Physical Performance Battery, Timed Up and Go (TUG, and 30s Sit-to-Stand tests were used to assess functional outcomes pre- and postprogram. The FRAIL Scale was used to assess their frailty status, and a postprogram experience survey was conducted.Results: Eight subjects (aged 74±10 years completed the program with an average overall attendance of 90.3%, with at least five participants present for each session. Changes in functional outcomes showed a moderate-to-large effect with significant improvement in TUG (p<0.01. In addition, participants either reversed or maintained their frailty status (p<0.01. Overall, the program was perceived to be well structured, engaging, as well as providing physical and psychosocial benefits. No exercise-related adverse events occurred during the program, and participants were keen to recommend this program to others

Community Restructuring and Depressive Symptoms of Rural Mature and Elderly Adults: A Multilevel Analysis Based on a National Dataset in China.

Science.gov (United States)

Yang, Fan; Lou, Vivian W Q

2017-01-01

Community restructuring is an important predictor for residents' mental health. However, few studies have investigated how it affects the depressive symptoms of rural ageing population. Using cross-sectional data from China Health and Retirement Longitudinal Study (CHARLS), this study examined how community restructuring was associated with depressive symptoms of Chinese rural mature and older adults and what community-level factors mediated the association. We found that people in restructuring communities reported .75 unit lower depression score (p < .01); community restructuring is associated with more infrastructure, recreational amenities, and grassroots organization (p < .001) in the community; and the availability of infrastructure (p < .01) and grassroots organization (p < .05) had significant indirect effect on the association between community restructuring and depressive symptoms. World countries' urbanization policy shall not only focus on community physical environment, but also on the development of grassroots organizations that involve and connect local people.

Forging University-Community Collaboration: The Agency Perspective on National Service.

Science.gov (United States)

Tice, Carol H.

1994-01-01

With passage of the National and Community Service Trust Act of 1993, national service volunteers will be joining forces with community-based organizations to work with underserved populations, creating many challenges. The community agency perspective on some anticipated challenges, possible responses, and application of principles of good…

The development of national standards for adult educators in Namibia

Science.gov (United States)

Ellis, Justin; Richardson, Brent H.

2012-06-01

Since gaining independence from South Africa in 1990, Namibia has placed considerable emphasis on education, including adult learning. As a means of improving the quality of adult learning, the Namibian Ministry of Education commissioned the development of national standards in 2010 to express competency requirements for adult educators. Particular attention was paid to the views of adult learners who participated through thirty focus groups. The participatory process revealed that the work of an adult educator is more complex and demanding than had previously been appreciated. The required competencies were categorised under four headings: (1) Knowledge as an adult educator, (2) Practice as an adult educator, (3) Relationships as an adult educator and (4) Ethics and professionalism as an adult educator. The Namibia Qualifications Authority, acting under its legislative mandate of setting occupational standards for occupations, jobs, posts and positions, approved the national standards in 2011.

Using a SWOT analysis to inform healthy eating and physical activity strategies for a remote First Nations community in Canada.

Science.gov (United States)

Skinner, Kelly; Hanning, Rhona M; Sutherland, Celine; Edwards-Wheesk, Ruby; Tsuji, Leonard J S

2012-01-01

To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth. Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies. Remote, subarctic FN community of Fort Albany, Ontario, Canada. Adult (n  =  25) and youth (n  =  66, grades 6-11) community members. Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth. Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix. Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community. SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany.

The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010

Science.gov (United States)

2016-01-01

Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. PMID:27547452

The long arm of community: the influence of childhood community contexts across the early life course.

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Wickrama, K A S; Noh, Samuel

2010-08-01

This study examines the longitudinal effects of childhood community contexts on young adult outcomes. The study uses a sample of 14,000 adolescents (52% female) derived from the 1990 US Census and the National Longitudinal Study of Adolescent Health (Addhealth). The study examines whether community and family environments exert separate and/or joint long-term influences on young adult achievement and depression. We found both direct and indirect long-term influences of childhood community adversity on young adult educational attainment. The indirect influences of childhood community adversity operated through family and individual-level factors. The long-term influence of childhood community adversity on young adult depression was only indirect. Overall, community influences on young adult achievement outcomes were mediated by family context and by the adolescents' adjustments and transitions, including adolescent depression, school adjustment, and disruptive transitional events. The moderating effect of childhood community adversity suggests that the protective effects of family resources on young adult outcomes dissipate significantly in extremely adverse neighborhoods. The findings demonstrate the importance of integrating multiple theoretical perspectives for longitudinal research to capture pathways of community influence on adolescent developmental and young adulthood outcomes.

Implications of the Eighth Joint National Committee Guidelines for the Management of High Blood Pressure for Aging Adults: Atherosclerosis Risk in Communities Study.

Science.gov (United States)

Miedema, Michael D; Lopez, Faye L; Blaha, Michael J; Virani, Salim S; Coresh, Josef; Ballantyne, Christie M; Folsom, Aaron R

2015-09-01

The recent 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Eight Joint National Committee Panel may significantly affect the aging US population. We performed a cross-sectional analysis of black and white participants in Atherosclerosis Risk in Communities who participated in the fifth study visit (2011-2013). Sitting blood pressure was calculated from the average of 3 successive readings taken after a 5-minute rest. Currently, prescribed antihypertensive medications were recorded by reviewing medication containers brought to the visit. Blood pressure control was defined using both the Seventh and Eighth Joint National Committee thresholds. Of 6088 participants (mean age, 75.6 [range, 66-90] years, 58.4% women; 23.2% black), 54.9% had either diabetes mellitus or chronic kidney disease. The prevalence of hypertension according to Seventh Joint National Committee thresholds was 81.9%, and 62.8% of the entire sample were at blood pressure goal. Using the Eighth Joint National Committee thresholds, 79.4% were at blood pressure goal (16.6% were reclassified as at-goal). Reclassification was higher for individuals with diabetes mellitus or chronic kidney disease (20.6%) when compared with individuals without either condition (11.6%). The use of antihypertensive medications in our cohort was high, with 75.0% prescribed at least 1 antihypertensive medication and 46.7% on ≥2 antihypertensive agents. In conclusion, in a US cohort of aging white and black individuals, ≈1 in 6 individuals were reclassified as having blood pressure at goal by Eighth Joint National Committee guidelines. Despite these less aggressive goals, >20% remain uncontrolled by the new criteria. © 2015 American Heart Association, Inc.

Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults.

Science.gov (United States)

Nakakubo, Sho; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Lee, Sungchul; Hotta, Ryo; Bae, Seongryu; Suzuki, Takao; Shimada, Hiroyuki

2017-11-01

The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community-dwelling older adults. Cross-sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini-Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS). Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini-Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P performances than those in the inactive + GS and active + PS groups in the trail-making test, part B, and the symbol digit substitution test (P performances than in the active + GS in the trail-making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively). Inactivity and poor sleep quality were associated with poor cognitive performance among community-dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823-1828. © 2017 Japan Geriatrics Society.

On the border: young adults with LGBQ parents navigate LGBTQ communities.

Science.gov (United States)

Goldberg, Abbie E; Kinkler, Lori A; Richardson, Hannah B; Downing, Jordan B

2012-01-01

Little research has examined the perspectives of young adults with lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents, particularly in relation to their identification with the LGBTQ community. To address this gap, we conducted a qualitative study of 42 young adults (ages 18-29) who were raised by LGBQ parents. We found that participants often described their sense of belonging to the LGBTQ community as shifting over the life course. Some participants, particularly those whose parents had always been out, felt connected to the LGBTQ community as children. Of these, most maintained those connections over time. However, some increasingly deidentified with the LGBTQ community, which they sometimes attributed to their own heterosexual identification. Others, particularly those whose parents came out later in life, described a lack of connection to the LGBTQ community as children. Of these, most became increasingly identified with the community, which they often attributed to their own and their parents' increasing sense of comfort with their parents' sexuality. Heterosexual participants who sought out LGBTQ-oriented groups in young adulthood sometimes encountered resistance from these groups, whereby participants' reasons for wanting to become involved were not readily apparent or appreciated. Our findings highlight the need for practitioners to understand the complex and often changing role of the LGBTQ community in the lives of young adults with LGBQ parents. (c) 2012 APA, all rights reserved.

Program Spotlight: National Outreach Network's Community Health Educators

Science.gov (United States)

National Outreach Network of Community Health Educators located at Community Network Program Centers, Partnerships to Advance Cancer Health Equity, and NCI-designated cancer centers help patients and their families receive survivorship support.

Undernutrition and associated factors in a Portuguese older adult community

Directory of Open Access Journals (Sweden)

Ana Luísa Moreira dos Santos

2015-06-01

Full Text Available OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6; being institutionalized (OR=12.6; 95%CI=1.7-90.5; or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1 were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.

The Intersection of Black Lives Matter and Adult Education: One Community College Initiative

Science.gov (United States)

Miller, Brian; Schwartz, Joni

2016-01-01

This chapter is a call to action for adult educators to critically engage the Black Lives Matter Movement through pedagogy, community engagement and scholarly activism. It explores the intersection of the Black Lives Matter movement and adult education by highlighting the response of one community college initiative.

Senior Adult Sexuality in Age Segregated and Age Integrated Communities.

Science.gov (United States)

Weinstein, Stellye; Rosen, Efrem

1988-01-01

Middle-income older adults (N=314) responded to senior adult sexuality scale. Results showed that respondents who selected to reside in age-segregated leisure-type retirement communities exhibited significantly more sexual interest, sexual activities, and liberal sexual attitudes than did respondents residing in age-integrated mainstream…

Local Knowledge and Adult Learning in Environmental Adult Education: Community-Based Ecotourism in Southern Thailand

Science.gov (United States)

Walter, Pierre

2009-01-01

This paper examines how local knowledge is employed in environmental adult education in a community-based ecotourism project in an island community in southern Thailand. The study is based on field research and analysis of project websites, media reports and documents. Situated at the intersection of global tourism and a local Thai-Malay Muslim…

Spirituality, depression, living alone, and perceived health among Korean older adults in the community.

Science.gov (United States)

You, Kwang Soo; Lee, Hae-Ok; Fitzpatrick, Joyce J; Kim, Susie; Marui, Eiji; Lee, Jung Su; Cook, Paul

2009-08-01

Both theoretical and empirical studies have documented the protective effect of religiosity and spirituality on general health in older adults in community and hospital settings; however, no study has documented the relationship between spirituality and depression among older adults living alone in communities in Korea. We tested two hypotheses: Hypothesis 1: Korean older adults living alone would be more depressed and less healthy than older adults living with family, and Hypothesis 2: Individuals who are more religious and spiritual would report a lower level of depression and a higher level of general health even when other demographic and living status variables are controlled. A descriptive, comparative, and correlational design with a convenience sampling method was conducted among community-dwelling Korean older adults in Chounbook Providence, South Korea. This study included 152 men and women older than 65 years old. Hypothesis 1 was supported as Korean older adults living alone were significantly more depressed than were older adults living with family (Preligion with general health and depression.

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults

NARCIS (Netherlands)

van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-01-01

BACKGROUND/OBJECTIVES: Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling

Avoidable mortality among First Nations adults in Canada: A cohort analysis.

Science.gov (United States)

Park, Jungwee; Tjepkema, Michael; Goedhuis, Neil; Pennock, Jennifer

2015-08-01

Avoidable mortality is a measure of deaths that potentially could have been averted through effective prevention practices, public health policies, and/or provision of timely and adequate health care. This longitudinal analysis compares avoidable mortality among First Nations and non-Aboriginal adults. Data are from the 1991-to-2006 Canadian Census Mortality and Cancer Follow-up Study. A 15% sample of 1991 Census respondents aged 25 or older was linked to 16 years of mortality data. This study examines avoidable mortality among 61,220 First Nations and 2,510,285 non-Aboriginal people aged 25 to 74. During the 1991-to-2006 period, First Nations adults had more than twice the risk of dying from avoidable causes compared with non-Aboriginal adults. The age-standardized avoidable mortality rate (ASMR) per 100,000 person-years at risk for First Nations men was 679.2 versus 337.6 for non-Aboriginal men (rate ratio = 2.01). For women, ASMRs were lower, but the gap was wider. The ASMR for First Nations women was 453.2, compared with 183.5 for non-Aboriginal women (rate ratio = 2.47). Disparities were greater at younger ages. Diabetes, alcohol and drug use disorders, and unintentional injuries were the main contributors to excess avoidable deaths among First Nations adults. Education and income accounted for a substantial share of the disparities. The results highlight the gap in avoidable mortality between First Nations and non-Aboriginal adults due to specific causes of death and the association with socioeconomic factors.

Hydrocephalus in adults with community-acquired bacterial meningitis

NARCIS (Netherlands)

Soemirien Kasanmoentalib, E.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

2010-01-01

Objective: To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. Methods: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. Results: Hydrocephalus was diagnosed in 26 of 577

Adults' Orientation of Children--And Children's Initiative to Pitch In--To Everyday Adult Activities in a Tsotsil Maya Community.

Science.gov (United States)

Martínez-Pérez, Margarita

2015-01-01

This chapter examines how 2-year-old children attempt to actively participate in adult work in a Mayan community in Chiapas, Mexico, and how adults contribute and accommodate to the contributions. As children enter into activities and adults orient and reorient the activity to direct the children, teaching from expert to novice is generated by children's agency in co-participatory interactions. The chapter enriches the LOPI model by focusing on the structure of participation and communication, social and community organization, and the evaluation that occurs in the activity itself. © 2015 Elsevier Inc. All rights reserved.

Community Organizing for Healthier Communities: Environmental and Policy Outcomes of a National Initiative.

Science.gov (United States)

Subica, Andrew M; Grills, Cheryl T; Villanueva, Sandra; Douglas, Jason A

2016-12-01

Childhood obesity is disproportionately prevalent in communities of color, partially because of structural inequities in the social and built environment (e.g., poverty, food insecurity, pollution) that restrict healthy eating and active living. Community organizing is an underexamined, grassroots health promotion approach that empowers and mobilizes community residents to advocate for, and achieve, environmental and policy changes to rectify these structural inequities. This paper presents outcomes of the Robert Wood Johnson Foundation's Communities Creating Healthy Environments initiative: the first national program to apply community organizing to combat childhood obesity-causing structural inequities in communities of color. Twenty-one community-based organizations and tribal nations (grantees) conducted 3-year community organizing-based interventions primarily designed to increase children's healthy food and safe recreational access. Grantees' policy wins (environmental and policy changes resulting from grantee interventions) were measured from 2009 to 2014 using semi-structured interviews conducted quarterly and 6 months post-grant, and independently coded and reviewed in 2015 by researchers and expert community organizers. The 21 grantees achieved 72 policy wins (mean=3.43, SD=1.78) across six domains: two directly addressed childhood obesity by enhancing children's healthy food (37.50%) and recreational access (33.33%), whereas four indirectly addressed obesity by promoting access to quality health care (8.33%); clean environments (9.73%); affordable housing (8.33%); and discrimination- and crime-free neighborhoods (2.78%). These findings provide compelling evidence that community organizing-based interventions designed and led by community stakeholders can achieve diverse environmental and policy solutions to the structural inequities that foment childhood obesity in communities of color. Copyright © 2016 American Journal of Preventive Medicine. Published

National and state-specific health insurance disparities for adults in same-sex relationships.

Science.gov (United States)

Gonzales, Gilbert; Blewett, Lynn A

2014-02-01

We examined national and state-specific disparities in health insurance coverage, specifically employer-sponsored insurance (ESI) coverage, for adults in same-sex relationships. We used data from the American Community Survey to identify adults (aged 25-64 years) in same-sex relationships (n = 31,947), married opposite-sex relationships (n = 3,060,711), and unmarried opposite-sex relationships (n = 259,147). We estimated multinomial logistic regression models and state-specific relative differences in ESI coverage with predictive margins. Men and women in same-sex relationships were less likely to have ESI than were their married counterparts in opposite-sex relationships. We found ESI disparities among adults in same-sex relationships in every region, but we found the largest ESI gaps for men in the South and for women in the Midwest. ESI disparities were narrower in states that had extended legal same-sex marriage, civil unions, and broad domestic partnerships. Men and women in same-sex relationships experience disparities in health insurance coverage across the country, but residing in a state that recognizes legal same-sex marriage, civil unions, or broad domestic partnerships may improve access to ESI for same-sex spouses and domestic partners.

Emergency Department Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

Science.gov (United States)

Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J.

2016-01-01

Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization. PMID:28131350

Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study.

Science.gov (United States)

Tomita, Andrew; Burns, Jonathan K

2013-12-01

This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. Copyright © 2013 John Wiley & Sons, Ltd.

The influence of community well-being on mortality among Registered First Nations people.

Science.gov (United States)

Oliver, Lisa N; Penney, Chris; Peters, Paul A

2016-07-20

Living in a community with lower socioeconomic status is associated with higher mortality. However, few studies have examined associations between community socioeconomic characteristics and mortality among the First Nations population. The 1991-to-2006 Census Mortality and Cancer Cohort follow-up, which tracked a 15% sample of Canadians aged 25 or older, included 57,300 respondents who self-identified as Registered First Nations people or Indian band members. The Community Well-Being Index (CWB), a measure of the social and economic well-being of communities, consists of income, education, labour force participation, and housing components. A dichotomous variable was used to indicate residence in a community with a CWB score above or below the average for First Nations communities. Age-standardized mortality rates (ASMRs) were calculated for First Nations cohort members in communities with CWB scores above and below the First Nations average. Cox proportional hazards models examined the impact of CWB when controlling for individual characteristics. The ASMR for First Nations cohort members in communities with a below-average CWB was 1,057 per 100,000 person-years at risk, compared with 912 for those in communities with an above-average CWB score. For men, living in a community with below-average income and labour force participation CWB scores was associated with an increased hazard of death, even when individual socioeconomic characteristics were taken into account. Women in communities with below-average income scores had an increased hazard of death. First Nations people in communities with below-average CWB scores tended to have higher mortality rates. For some components of the CWB, effects remained even when individual socioeconomic characteristics were taken into account.

Identification of Important Community Living Skills for Adults with Mental Retardation.

Science.gov (United States)

Lovett, David L.; Harris, Mary B.

1987-01-01

Attempted to identify skills important for successful community living of adults with mental retardation. Individuals (N=73) who had significant contact with adults with mental retardation completed questionnaire on academic, leisure, personal, social, and vocational skills frequently taught to persons with mental handicaps. Subjects considered…

Community Participation Of Coastal Area On Management Of National Park, Karimunjawa Island

Science.gov (United States)

Wibowo, Bambang A.; Aditomo, Aryo B.; Prihantoko, Kukuh E.

2018-02-01

Karimunjawa island located in Jepara Regacy, Central Java has potential marine and fishing resources. Since 1998, this area has been selected as conservation for its natural resources. National park of Karimunjawa is managed by Balai Taman Nasional Karimunjawa (Karimunjawa National Park Beuroue). Some activities involved community have been done in order to get effective management. Community participation is an important component for success in coastal area management. The level of community/people awareness anual on natural resource conservation can increate sustainable resource. However, it is necesssary to provide tools in resource utilization for the community, so that their economic life can be secured. This study observe the level of community participation in the effort of Karimunjawa National Park management. Descriptive method and purposive random sampling were used to carry out the study parameters observed in this study include community participation related to level of knowladge and obedience on the rule of area zonation, an its impact to community. The result show that community knowledge was quite high (40%) with obedience (56%) on the rule of area zonation. Impact area zonation rule was less significant to community. The level of community participation to Karimunjawa National Park management was performed will low to medium level.

Multi-Barrier Protection of Drinking Water Systems in Ontario: A Comparison of First Nation and Non-First Nation Communities

Directory of Open Access Journals (Sweden)

Budhendra Singh

2012-11-01

Full Text Available In some way or another, all levels of government in Canada and First Nations share responsibility to implement multi-barrier protection of drinking water. The goal is to protect water from source to tap to minimize risk so that people have access to adequate and safe drinking water. The federal government has committed to assist First Nations achieve comparable levels of service standards available to non-First Nation communities. However, several recent reports on the status of drinking water services standards in First Nations indicate that people in these communities often experience greater health risks than those living off reserves. Using the federal drinking water risk evaluation guidelines, the capacities of First Nations and non-First Nations in Ontario to implement multi-barrier protection of their drinking water systems are compared. The Risk Level Evaluation Guidelines for Water and Wastewater Treatment in First Nation Communities rank drinking water systems as low, medium, or high risk based on information about source water, system design, system operation, reporting, and operator expertise. The risk evaluation scores for First Nations drinking water systems were obtained from Aboriginal Affairs and Northern Development Canada. A survey based on the federal Risk Level Evaluation Guidelines was sent to non-First Nation communities throughout Ontario with 54 communities responding. The capacity among First Nations was variable throughout the province, whereas all of the municipalities were in the low risk category, even small and northern non-First Nation community water systems. It is clear that the financial and technological capacity issues should be addressed regardless of the legislative and regulatory regime that is established. The current governance and management structure does not appear to be significantly reducing the gap in service standards despite financial investment. Exploring social or other underlying determinants

Community-level Adult Daily Smoking Prevalence Moderates the Association between Adolescents’ Cigarette Smoking and Perceived Smoking by Friends

Science.gov (United States)

Thrul, Johannes; Lipperman-Kreda, Sharon; Grube, Joel W.; Friend, Karen B.

2014-01-01

Few studies have investigated the complex interactions among the individual- and community-level social risk factors that underlie adolescents’ smoking behaviors. This study investigated whether community-level adult daily smoking prevalence is associated with adolescents’ smoking and whether it moderates the associations between perceived friends’ smoking approval and smoking behavior and adolescents’ own smoking. Self-reported data from 1,190 youths (50.3% female; 13–18 years old) in 50 midsized Californian cities were obtained through telephone interviews. Community characteristics were obtained from 2010 GeoLytics data. Community adult daily smoking prevalence was ascertained from telephone interviews with 8,918 adults conducted in the same 50 cities. Multilevel analyses, controlling for individual and city characteristics, were used to predict adolescents’ past 12-month smoking from perceived friends’ smoking approval and smoking behavior and from community adult daily smoking prevalence. Results showed that perceived friends’ smoking approval and behavior were associated positively with adolescents’ smoking, as was the community-level prevalence of adult daily smoking. Furthermore, the association between perceived friends’ smoking behavior and adolescents’ own smoking was moderated by the prevalence of adult daily smokers in the community. Specifically, the association was stronger in cities with higher prevalence of adult smokers. These results suggest that adult community norms that are more supportive of smoking may enhance the influence of friends’ smoking behavior. Therefore, interventions designed to prevent or reduce youths’ smoking should also focus on reducing smoking by adults. PMID:24241785

Community intervention to increase neighborhood social network among Japanese older adults.

Science.gov (United States)

Harada, Kazuhiro; Masumoto, Kouhei; Katagiri, Keiko; Fukuzawa, Ai; Chogahara, Makoto; Kondo, Narihiko; Okada, Shuichi

2018-03-01

Strengthening neighborhood social networks is important for promoting health among older adults. However, effective intervention strategies aimed at increasing older adults' social networks have not yet been established. The present study examined whether a university-led community intervention that provided communication opportunities could increase older Japanese adults' neighborhood social networks. The present study used a quasi-experimental design. Before the intervention, using postal mail, we carried out a baseline questionnaire survey that was sent to all people living in the Tsurukabuto community aged ≥60 years (n = 1769), of whom 1068 responded. For the community intervention, 18 event-based programs were provided over the course of 1 year at Kobe University. Academic staff at Kobe University organized all the programs. During the program, social interactions among participants were promoted. A follow-up survey was distributed to those who responded to the baseline survey, and 710 individuals answered the question about their participation in the intervention programs (138 respondents were participants, 572 were non-participants). The neighborhood social network was measured in both the baseline and follow-up surveys. Analysis of covariance showed that the changes in neighborhood social network among participants in the program was significantly higher than the changes among non-participants (P = 0.046) after adjusting for the baseline score of social network. The present study found that participants of the intervention expanded their neighborhood social network, but non-participants did not. This finding shows that community interventions using university resources could increase older adults' neighborhood social networks. Geriatr Gerontol Int 2018; 18: 462-469. © 2017 Japan Geriatrics Society.

Current Tobacco Use Among Adults in the United States: Findings From the National Adult Tobacco Survey

Science.gov (United States)

Dube, Shanta R.; Tynan, Michael A.

2012-01-01

Objectives. We assessed the prevalence and sociodemographic correlates of tobacco use among US adults. Methods. We used data from the 2009–2010 National Adult Tobacco Survey, a national landline and cell phone survey of adults aged 18 years and older, to estimate current use of any tobacco; cigarettes; cigars, cigarillos, or small cigars; chewing tobacco, snuff, or dip; water pipes; snus; and pipes. We stratified estimates by gender, age, race/ethnicity, education, income, sexual orientation, and US state. Results. National prevalence of current use was 25.2% for any tobacco; 19.5% for cigarettes; 6.6% for cigars, cigarillos, or small cigars; 3.4% for chewing tobacco, snuff, or dip; 1.5% for water pipes; 1.4% for snus; and 1.1% for pipes. Tobacco use was greatest among respondents who were male, younger, of non-Hispanic “other” race/ethnicity, less educated, less wealthy, and lesbian, gay, bisexual, or transgender. Prevalence ranged from 14.1% (Utah) to 37.4% (Kentucky). Conclusions. Tobacco use varies by geography and sociodemographic factors, but remains prevalent among US adults. Evidence-based prevention strategies are needed to decrease tobacco use and the health and economic burden of tobacco-related diseases. PMID:22994278

Community Involvement of Young Adults with Intellectual Disabilities: Their Experiences and Perspectives on Inclusion.

Science.gov (United States)

Hall, Sarah A

2017-09-01

Inclusion in the community is essential to enhancing a person's quality of life. Although people with intellectual disabilities have a desire to be more involved in activities, they experience barriers that limit their inclusion. The purpose of this study was to describe the community involvement of young adults with intellectual disability. I interviewed fourteen young adults with intellectual disability to explore their involvement in work, recreation and leisure activities. Four themes emerged from the data: vocational endeavours, leisure pursuits, social inclusion and supports. The contexts of their experiences either facilitated or hindered their community involvement. The community involvement of young adults with intellectual disability varies depending on the opportunities and supports available to them. Their inclusion in the community may be enhanced by additional transportation options, continuing education in vocational and social skills, personalized guidance from group members and environments that are welcoming to people with disabilities. © 2016 John Wiley & Sons Ltd.

Children and Adults with Attention-Deficit/Hyperactivity Disorder

Science.gov (United States)

... Renew CHADD Annual Conference Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), is a national nonprofit organization ... ADHD community. © 2017 by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). All Rights Reserved. Press Privacy ...

Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries Among Community-Dwelling Older Adults.

Science.gov (United States)

Taylor-Piliae, Ruth E; Peterson, Rachel; Mohler, Martha Jane

2017-09-01

Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life. For community-dwelling older adults, effective fall prevention has the potential to reduce serious fall-related injuries, emergency room visits, hospitalizations, institutionalization, and functional decline. Copyright © 2017 Elsevier Inc. All rights reserved.

A Survey on the Education and Training of Adult and Community Educators for the Workplace.

Science.gov (United States)

Cooper, Tom; And Others

1995-01-01

Interviews with 26 adult/community educators, business/industry training officers, and employees in occupations requiring high education levels revealed the following preferences for an adult/community education specialization: course content based on learner needs, flexibility in courses delivery, recognition of prior learner, and formal…

Perception of Quality of Life for Adults with Hearing Impairment in the LGBT Community

Science.gov (United States)

Kelly-Campbell, Rebecca J.; Atcherson, Samuel R.

2012-01-01

The purpose of the this study was to examine the perception of both generic and disease-specific quality of life (QoL) in adults with hearing impairment who are members of the lesbian, gay, bisexual, and transgender (LGBT) community. Eighty-three adults who self-identified as having hearing impairment and as being members of the LGBT community and…

Macronutrient intake and inadequacies of community-dwelling older adults, a systematic review

NARCIS (Netherlands)

Borg, ter S.J.; Verlaan, S.; Mijnarends, D.; Schols, J.M.G.A.; Groot, de C.P.G.M.; Luiking, Y.C.

2015-01-01

Background: Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. Summary: This systematic review provides a comprehensive overview of the energy

Predictors of chewing ability among community-residing older adults in Korea.

Science.gov (United States)

Park, Kyongok; Hong, Gwi-Ryung Son

2017-01-01

Decreased chewing ability in older adults can lead to poor nutritional and physical conditions, and eventually death. The present study examined the relationships between chewing ability and related characteristics (e.g. health promotion habits, health status and functional status), and identified predictors of chewing ability in community-residing older adults. Among the total of 11 542 participants in the 2011 National Survey on Older Adults in Korea, data from 10 543 participants were used for analysis. Chewing ability was evaluated using a self-report of chewing ability. Exercise ability was assessed by objective exercise ability and perceived exercise ability in both the upper and lower extremities. Depression and cognitive functions were measured using the Geriatric Depression Scale-Short Form and the Mini-Mental State Examination, respectively. A total of 56.9% of participants had poor chewing abilities. After adjusting for age and sex, logistic regression analysis showed that depression (OR 1.76, 95% CI 1.60-1.92), cognitive impairment (OR 1.28, 95% CI 1.17-1.40), objective exercise ability (OR 1.24, 95% CI 1.11-1.41), regular exercise habits (OR 1.23, 95% CI 1.13-1.34), medical check-up history (OR 1.17, 95% CI 1.05-1.32), number of chronic diseases (OR 1.12, 95% CI 1.09-1.15) and perceived exercise ability in the lower extremities (OR 1.08, 95% CI 1.05-1.10) were significant predictors of chewing ability. Chewing ability in older adults should be improved in consideration of mental and general health condition. Geriatr Gerontol Int 2017; 17: 78-84. © 2015 Japan Geriatrics Society.

Accounting for Change: Adult and Community Education Organisations and the GST.

Science.gov (United States)

Gelade, Sue; Harris, Roger; Mason, Deb

A study examined impact of the adult and community education (ACE) Amendment to the Goods and Services Tax (GST) on Australian adult and continuing education (ACE) providers. Telephone interviews were held with representatives of 232 ACE organizations. Most were small businesses; almost half had less than $100,000 annual revenue; two-thirds had…

On the Border: Young Adults with LGBQ Parents Navigate LGBTQ Communities

Science.gov (United States)

Goldberg, Abbie E.; Kinkler, Lori A.; Richardson, Hannah B.; Downing, Jordan B.

2012-01-01

Little research has examined the perspectives of young adults with lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents, particularly in relation to their identification with the LGBTQ community. To address this gap, we conducted a qualitative study of 42 young adults (ages 18-29) who were raised by LGBQ parents. We found that…

Facilitating Wellness in Urban-Dwelling, Low-Income Older Adults Through Community Mobility: A Mixed-Methods Study.

Science.gov (United States)

Mulry, Claire M; Papetti, Christina; De Martinis, Julian; Ravinsky, Mark

Community participation is integral to wellness. This study examined the outcomes of Let's Go, a program designed to facilitate community participation of urban-dwelling, low-income older adults. Fifty-two older adults participated in a mixed-methods, single-group pretest-posttest study. The Impact on Participation and Autonomy Questionnaire, participant surveys, and semistructured interviews were used to evaluate self-reported participation in community-based occupations, confidence, isolation, frequency of community trips, autonomy outdoors, and satisfaction with social life and relationships. Significant improvement was found in participation, confidence, frequency of community trips, autonomy outdoors, and satisfaction with social life and relationships at 4 wk and 6 mo. Qualitative themes were decreased isolation, importance of peer and community support, increased knowledge of mobility options, and a shift from fear to confidence. Community mobility programming can facilitate the participation of marginalized older adults in community-based occupations. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland

DEFF Research Database (Denmark)

Stickley, Andrew; Santini, Ziggi Ivan; Koyanagi, Ai

2017-01-01

Background Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Methods Data were analyzed from 6...... community-dwelling adults but this association is largely explained by comorbid mental health problems, in particular, depression.......Background Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Methods Data were analyzed from...... 6903 community-dwelling adults aged ≥ 50 collected in the first wave of The Irish Longitudinal Study on Ageing (TILDA) in 2009–11. Information was obtained on the self-reported occurrence (yes/no) and severity (frequency/activity limitations) of UI in the past 12 months. Loneliness was measured using...

Factors associated with cane use among community dwelling older adults.

Science.gov (United States)

Aminzadeh, F; Edwards, N

2000-01-01

Guided by the Theory of Planned Behavior (TPB), this study examined factors associated with cane use among community dwelling older adults. Data were collected in a cross-sectional survey of a convenience sample of 106 community residing older adults in Ottawa, Canada. Using a stepwise discriminant analysis, subjective norms, attitudes, and age surfaced as the key variables associated with cane use in this sample. The discriminant function accounted for 67% of the variance in cane use and correctly classified 91% of cases (Wilks's lambda = 0.33, lambda2 = 110.12, df = 3, p cane use behaviors of older persons and have important implications for the design of theory-based fall prevention interventions to enhance the acceptance and effective use of mobility aids.

Supporting National User Communities at NERSC and NCAR

Energy Technology Data Exchange (ETDEWEB)

Killeen, Timothy L.; Simon, Horst D.

2006-05-16

The National Energy Research Scientific Computing Center(NERSC) and the National Center for Atmospheric Research (NCAR) are twocomputing centers that have traditionally supported large national usercommunities. Both centers have developed responsive approaches to supportthese user communities and their changing needs, providing end-to-endcomputing solutions. In this report we provide a short overview of thestrategies used at our centers in supporting our scientific users, withan emphasis on some examples of effective programs and futureneeds.

Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation.

Science.gov (United States)

Bobitt, Julie; Schwingel, Andiara

2017-01-01

While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.

Outdoor activities and depressive symptoms in displaced older adults following natural disaster: community cohesion as mediator and moderator.

Science.gov (United States)

Chao, Shiau-Fang

2016-09-01

This investigation examined whether community cohesion mediates or moderates the relationship between outdoor activities and depressive symptoms in older adults displaced by Typhoon Morakot in Taiwan. This cross-sectional study included 292 adults aged 65 years or older who were relocated to permanent houses after Typhoon Morakot damaged their homes on 8th August 2009. Multiple regression analysis was applied to test the role of community cohesion on the association between outdoor activities and depressive symptoms. The sample of displaced older adults displayed higher prevalence of depressive symptoms than the average for community dwelling older people in Taiwan. Community cohesion fully mediated the relationship between outdoor activities and depressive symptoms. Community cohesion also moderated the relationship between outdoor activities and depressive symptoms. Community cohesion occupies a key role on the link between outdoor activities and depressive symptoms. Participation in outdoor activities was associated positively with community cohesion, while high community cohesion was related negatively to depressive symptoms. Additionally, the benefit of outdoor activities to fewer depressive symptoms only manifested in older adults with high community cohesion. Programs and services should be designed to enhance community cohesion in order to maximize the benefit of outdoor activities to the mental health of displaced older adults after natural disasters.

Whole grain intakes in Irish adults: findings from the National Adults Nutrition Survey (NANS).

Science.gov (United States)

O'Donovan, Clare B; Devlin, Niamh F; Buffini, Maria; Walton, Janette; Flynn, Albert; Gibney, Michael J; Nugent, Anne P; McNulty, Breige A

2018-01-20

Observational studies link high whole grain intakes to reduced risk of many chronic diseases. This study quantified whole grain intakes in the Irish adult population and examined the major contributing sources. It also investigated potential dietary strategies to improve whole grain intakes. Whole grain intakes were calculated in a nationally representative sample of 1500 Irish adults using data from the most recent national food survey, the National Adult Nutrition Survey (NANS). Food consumption was assessed, at brand level where possible, using a 4-day semi-weighed food diary with whole grain content estimated from labels on a dry matter basis. Mean daily whole grain intakes were 27.8 ± 29.4 g/day, with only 19% of the population meeting the quantity-specific recommendation of 48 g per day. Wheat was the highest contributor to whole grain intake at 66%, followed by oats at 26%. High whole grain intakes were associated with higher dietary intakes of fibre, magnesium, potassium, phosphorus, and a higher alternative Mediterranean Diet Score. Whole grain foods were most frequently eaten at breakfast time. Regression analysis revealed that consumption of an additional 10 g of whole grain containing 'ready-to-eat breakfast cereals', 'rice or pastas', or 'breads' each day would increase intake of whole grains by an extra 5, 3.5, and 2.7 g, respectively. This study reveals low intakes of whole grains in Irish adults. Recommending cereals, breads, and grains with higher whole grain content as part of public health campaigns could improve whole grain intakes.

Documentation of daily sit-to-stands performed by community-dwelling adults.

Science.gov (United States)

Bohannon, Richard W; Barreca, Susan R; Shove, Megan E; Lambert, Cynthia; Masters, Lisa M; Sigouin, Christopher S

2008-01-01

No information exists about how many sit-to-stands (STSs) are performed daily by community-dwelling adults. We, therefore, examined the feasibility of using a tally counter to document daily STSs, documented the number of daily STSs performed, and determined if the number of STSs was influenced by demographic or health variables. Ninety-eight community-dwelling adults (19-84 years) agreed to participate. After providing demographic and health information, subjects used a tally counter to document the number of STSs performed daily for 7 consecutive days. All but two subjects judged their counter-documented STS number to be accurate. Excluding data from these and two other subjects, the mean number of STSs for subjects was 42.8 to 49.3, depending on the day. The number was significantly higher on weekdays than weekends. No demographic or health variable was significantly related to the number of STSs in univariate or multivariate analysis. In conclusion, this study suggests that a tally counter may be a practical aid to documenting STS activity. The STS repetitions recorded by the counter in this study provide an estimate of the number of STSs that community-dwelling adults perform daily.

Association between chronic musculoskeletal pain and executive function in community-dwelling older adults.

Science.gov (United States)

Murata, S; Sawa, R; Nakatsu, N; Saito, T; Sugimoto, T; Nakamura, R; Misu, S; Ueda, Y; Ono, R

2017-11-01

We examined the association of chronic musculoskeletal pain with executive function in community-dwelling older adults. This cross-sectional study recruited 234 community-dwelling older adults in Japan (mean age: 72.7, women: 62.8%). Chronic musculoskeletal pain was defined as having moderate or more severe pain lasting ≥ 3 months. Executive function was assessed using the Digit Symbol Substitution Test (DSST), Trail Making Test (TMT) parts A and B, Letter Verbal Fluency Test (LVFT) and Category Verbal Fluency Test (CVFT). Prevalence of chronic musculoskeletal pain was 19% (n = 44). In the univariate analysis, the DSST and CVFT scores were significantly lower in the chronic musculoskeletal pain group than in the control group (DSST: chronic musculoskeletal pain group vs. control group, 40.2 vs. 45.4, respectively, p dwelling older adults. The association of chronic musculoskeletal pain with executive function requires further investigation. Our results suggest an association between moderate-severe chronic musculoskeletal pain and impairments of semantic fluency and processing speed in community-dwelling older adults. © 2017 European Pain Federation - EFIC®.

Effectiveness of a community-based multifaceted fall-prevention intervention in active and independent older Chinese adults

OpenAIRE

Xia, Q H; Jiang, Y; Niu, C J; Tang, C X; Xia, Z L

2009-01-01

Objective: To evaluate the effectiveness of an 18-month multifaceted intervention designed to reduce the incidence of falls in community-living older adults in China. Methods: A population-based community trial evaluated by before-and-after cross-sectional surveys. Four residential communities were randomised to either a multifaceted intervention or a control condition. Baseline information was collected from a sample of older adults in each community. A 1-year annual fall rate was calculated...

Adults Need Immunizations, Too!

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Andrew Kroger from CDC’s National Center for Immunization and Respiratory Diseases discusses simple, safe, and effective ways adults can help protect themselves, their family, and their community from serious and deadly diseases.

Perspectives on past and present waste disposal practices: a community-based participatory research project in three Saskatchewan first nations communities.

Science.gov (United States)

Zagozewski, Rebecca; Judd-Henrey, Ian; Nilson, Suzie; Bharadwaj, Lalita

2011-04-28

The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities.

Adults Need Immunizations, Too!

Centers for Disease Control (CDC) Podcasts

2012-03-19

In this podcast, Dr. Andrew Kroger from CDC’s National Center for Immunization and Respiratory Diseases discusses simple, safe, and effective ways adults can help protect themselves, their family, and their community from serious and deadly diseases.  Created: 3/19/2012 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 3/19/2012.

Developing Accessible Cyberinfrastructure-Enabled Knowledge Communities in the National Disability Community: Theory, Practice, and Policy

Science.gov (United States)

Myhill, William N.; Cogburn, Derrick L.; Samant, Deepti

2008-01-01

Since publication of the Atkins Commission report 2003, the national scientific community has placed significant emphasis on developing cyberinfrastructure-enabled knowledge communities, which are designed to facilitate enhanced efficiency and collaboration in geographically distributed networks of researchers. This article suggests that the new…

National labs working with local communities

Energy Technology Data Exchange (ETDEWEB)

Cavallo, J.D. [Argonne National Lab., IL (United States). Existing Buildings Efficiency Research Program

1996-10-01

In mid September Argonne National Laboratory celebrated its fiftieth anniversary with an open house in which more than 20,000 people toured the site and viewed some 100 demonstrations, exhibits and presentations of the scientific and engineering programs currently being pursued at Argonne. During the course of the open house it became obvious that to even long time residents of the Chicago area the activities of ANL were unknown or unclear. Part of this lack of knowledge about the scientific and engineering research occurring at DOE national laboratories is the remoteness of most research programs from the everyday lives of citizens. It is both the discussions that are remote as well as a remoteness of impacts on ordinary lives that often leads people to miss the exciting research activity occurring nearby. However, at least one research program at Argonne is structured to be purposefully different. The Existing Buildings Efficiency Research (EBER) program pursues its scientific work in concert with architects, engineers, and community developers as they attempt to provide high quality energy efficient, high performance buildings at reasonable cost. Instead of conducting experiments inside the barbed wire fences of secure facilities, technical assistance for the inclusion of DOE tools, techniques, and technologies is offered at the construction site within the community and research results are drawn back as projects are monitored for the performance of the energy conservation measures. In this report several projects at ANL are briefly discussed to give a sense of the possibilities for the laboratory and broader scientific community to work one-on-one with community-based organizations and the agencies that directly serve the needs of low-income neighborhoods.

Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults

Science.gov (United States)

Fargo, Jamison D.; Munley, Ellen A.; Byrne, Thomas H.; Montgomery, Ann Elizabeth; Culhane, Dennis P.

2013-01-01

Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations. PMID:24148057

Community-level characteristics associated with variation in rates of homelessness among families and single adults.

Science.gov (United States)

Fargo, Jamison D; Munley, Ellen A; Byrne, Thomas H; Montgomery, Ann Elizabeth; Culhane, Dennis P

2013-12-01

We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey.

Science.gov (United States)

Ryu, Mikyung; Jo, Jaeseong; Lee, Yunhwan; Chung, Yoon-Sok; Kim, Kwang-Min; Baek, Weon-Chil

2013-11-01

this study examined the association of physical activity with sarcopenia and sarcopenic obesity among the community-dwelling Korean elderly. subjects consisted of 2,264 aged 65 years or older in the 2008-09 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as 2 SD below the mean of the appendicular skeletal muscle/weight for healthy young adults. Obesity was defined as waist circumference ≥ 90 cm for men and ≥ 85 cm for women. Levels of physical activity were classified using the metabolic equivalent task method. the prevalence of sarcopenia was 12.1% in men and 11.9% in women. Among those with sarcopenia, obesity was prevalent in 68.3% of men and 65.0% of women. Adjusting for all covariates, compared with those with low physical activity, men who engaged in moderate and high activity were 38% and 74%, respectively, less likely to have sarcopenia (Ptrend women, the relationship between physical activity and sarcopenia was not significant. For sarcopenic obesity, men participating in moderate [odds ratio (OR) = 0.47; 95% confidence interval (CI) 0.26-0.87] and high (OR = 0.27; 95% CI: 0.12-0.60) physical activity, compared with low activity, had significantly lower risk (Ptrend = 0.001). In women, high physical activity was associated with a lower risk of sarcopenic obesity (OR = 0.43; 95% CI: 0.22-0.86). physical activity is associated with a reduced risk of sarcopenia and sarcopenic obesity in older Korean adults. There were gender differences in the relationship, with stronger associations observed in men than in women.

The Long Arm of Community: The Influence of Childhood Community Contexts across the Early Life Course

Science.gov (United States)

Wickrama, K. A. S.; Noh, Samuel

2010-01-01

This study examines the longitudinal effects of childhood community contexts on young adult outcomes. The study uses a sample of 14,000 adolescents (52% female) derived from the 1990 US Census and the National Longitudinal Study of Adolescent Health (Addhealth). The study examines whether community and family environments exert separate and/or…

Effects of a community disability prevention program for frail older adults at 48-month follow up.

Science.gov (United States)

Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutumimoto, Kota; Yoshida, Daisuke; Suzuki, Takao

2017-12-01

The present prospective study was carried out to determine whether participation in community-based intervention studies exerted a positive impact on disability prevention in older adults with physical frailty. A total of 514 community-dwelling older adults (aged ≥65 years) with physical frailty who had undergone baseline assessment and participated in community-based intervention studies (participants) or did not (non-participants) were included in the present study. Non-participants were selected through propensity score matching, to balance potential covariates at baseline. Disability incidence was followed up at 48 months as a main outcome. Demographic data (age, sex and medical history), global cognitive function, grip strength, walking speed, and blood test results including serum albumin and brain-derived neurotrophic factor at baseline were included as covariates. Disability incidence rates differed significantly between participants (11.3%) and non-participants (19.8%) of community-based intervention studies during the 48-month follow-up period (P = 0.007). Participation in community-based intervention studies (hazard ratio 0.55, 95% confidence interval 0.35-0.88) was significantly associated with the incidence of disability in older adults with physical frailty. Participation in community-based intervention studies could reduce the incidence of disability in older adults with physical frailty. Thus, strategies designed to increase the number of participants in community-based intervention programs should be considered in community-based approaches for the prevention of disability in older adults with physical frailty. Geriatr Gerontol Int 2017; 17: 2347-2353. © 2017 Japan Geriatrics Society.

Psychological effects of exercise on community-dwelling older adults

Directory of Open Access Journals (Sweden)

Tada A

2018-02-01

Full Text Available Akio Tada Faculty of Health Science, Hyogo University, Kakogawa, Hyogo, Japan Background: In recent years, there have been an increasing number of older adults who suffer from mental disorders globally.Objective: The objective of this study was to examine the effect of an intervention that consisted of an exercise program to improve the mental health of community-dwelling older adults.Participants and methods: The recruited participants of this study were community-dwelling older adults aged ≥60 years who participated in a comprehensive health promotion program in Kakogawa, Japan. Participants in the intervention group received an exercise program that was developed for older adults using Thera-Band. To measure participants’ mental health status, a Japanese version of the short form of the Profile of Mood States (POMS-SF was used. Stress markers were measured, such as salivary cortisol, alpha-amylase, and sIgA levels. All participants provided salivary samples and completed psychological questionnaires at baseline and 6-month follow-up.Results: No significant differences were observed between the intervention and control groups with respect to POMS-SF score and salivary biomarker profile at baseline. After the intervention, the intervention group showed a significant decrease in the POMS-SF “fatigue” score and cortisol level. No significant changes were observed in the control group.Conclusion: Simultaneous changes in feelings of fatigue and cortisol levels were observed among subjects who had received the intervention of regular exercise. Further research is needed to investigate the effectiveness of exercise intervention in improving mental health among older adults. Keywords: intervention, exercise, psychological status, stress, cortisol

Nutrition Education and Support Program for Community-Dwelling Adults with Intellectual Disabilities

Science.gov (United States)

Humphries, Kathleen; Traci, Meg Ann; Seekins, Tom

2008-01-01

To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre--post-test design. Adults (N = 32) with intellectual or developmental…

Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial.

Science.gov (United States)

Van Dorn, Richard A; Desmarais, Sarah L; Rade, Candalyn B; Burris, Elizabeth N; Cuddeback, Gary S; Johnson, Kiersten L; Tueller, Stephen J; Comfort, Megan L; Mueser, Kim T

2017-08-04

Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among this vulnerable and high-risk population. This paper describes a study that will develop research and communication protocols and adapt two evidence-based treatments, dual-diagnosis motivational interviewing (DDMI) and integrated group therapy (IGT), for delivery to adults with CODs across a jail-to-community treatment continuum. Adaptations to DDMI and IGT were guided by the Risk-Need-Responsivity model and the National Institute of Corrections' implementation competencies; the development of the implementation framework and communication protocols were guided by the Evidence-Based Interagency Implementation Model for community corrections and the Inter-organizational Relationship model, respectively. Implementation and evaluation of the protocols and adapted interventions will occur via an open trial and a pilot randomized trial. The clinical intervention consists of two in-jail DDMI sessions and 12 in-community IGT sessions. Twelve adults with CODs and four clinicians will participate in the open trial to evaluate the acceptability and feasibility of, and fidelity to, the interventions and research and communication protocols. The pilot controlled trial will be conducted with 60 inmates who will be randomized to either DDMI-IGT or treatment as usual. A baseline assessment will be conducted in jail, and four community-based assessments will be conducted during a 6-month follow-up period. Implementation, clinical, public health, and treatment preference outcomes will be evaluated

First Nations Women in Northern Ontario: Health, Social, and Community Priorities

Directory of Open Access Journals (Sweden)

Christine Simard

2011-05-01

Full Text Available This article reports on data from women dwelling in First Nations communities regarding (1 baseline statistics about women’s circumstances, needs, interests, and opportunities for community engagement, and 2 information about women’s present status, experience, interest, and other questions of social, economic,and health status. Two hundred twenty-six women from 35 First Nations communities completed the survey. This paper focuses on the main findings from the survey, which fall into 4 thematic areas. Theme 1 consists of demographic information as provided by participants. Theme 2 consists of social information such as housingand education. Theme 3 includes information about participants’ top community health concerns. Theme 4 examines participants’ community involvement. Use of the survey in directing women's social policy isdiscussed.

Perspectives on past and Present Waste Disposal Practices: A community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

Directory of Open Access Journals (Sweden)

Rebecca Zagozewski

2011-01-01

Full Text Available The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities.

FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

Directory of Open Access Journals (Sweden)

Michaela Dingová

2017-03-01

Full Text Available Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged from data analysis: development of the fear of falling, feared consequences of falling, activities curtailment, fall prevention behavior and meaning of social support in daily life. The fear of falling was described as a negative experience, directly linked to fall consequences such as physical injury, incapacitation, loss of autonomy, fear of dependence and experience of humiliating conditions. To maintain a certain level of independence in daily life, the participants chose to avoid falls by activity curtailment, organizing their lives more carefully and getting support from others. Conclusion: All participants identified that they had discovered their fear of falling after experiencing falls. The fear of falling was associated with feared consequences of a potential fall and had an impact on their daily life. The participant also mentioned other contributors to their fear of falling, including ill health and aging. Keywords: Fear of falling, older adults, perceived consequences of falls, daily life.

Technical Report and Data File User's Manual: For the 2003 National Assessment of Adult Literacy. NCES 2009-476

Science.gov (United States)

Baldi, Stephane, Ed.; Kutner, Mark; Greenberg, Elizabeth; Jin, Ying; Baer, Justin; Moore, Elizabeth; Dunleavy, Eric; Berlin, Martha; Mohadjer, Leyla; Binzer, Greg; Krenzke, Thomas; Hogan, Jacqueline; Amsbary, Michelle; Forsyth, Barbara; Clark, Lyn; Annis, Terri; Bernstein, Jared; White, Sheida

2009-01-01

The 2003 National Assessment of Adult Literacy (NAAL) assessed the English literacy skills of a nationally representative sample of more than 19,000 U.S. adults (age 16 and older) residing in households and correctional institutions. NAAL is the first national assessment of adult literacy since the 1992 National Adult Literacy Survey (NALS). The…

Hospitalization, Depression and Dementia in Community-Dwelling Older Americans: Findings from the National Health and Aging Trends Study

Science.gov (United States)

Davydow, Dimitry S.; Zivin, Kara; Langa, Kenneth M.

2014-01-01

Objective To estimate the prevalence of both dementia and depression among community-dwelling older Americans, and to determine if hospitalization is independently associated with dementia or depression in this population. Method This cross-sectional study utilized data from a nationally representative, population-based sample of 7,197 community-dwelling adults ≥ 65 years old interviewed in 2011 as part of the National Health and Aging Trends Study. Information on hospitalizations was obtained from self or proxy-report. Possible and probable dementia was assessed according to a validated algorithm. Depressive symptoms were assessed with the Patient Health Questionnaire-2. Results An estimated 3.1 million community-dwelling older Americans may have dementia, and approximately 5.3 million may have substantial depressive symptoms. After adjusting for demographic and social characteristics, medical diagnoses, smoking history, serious falls, and pain symptoms, being hospitalized in the previous year was independently associated with greater odds of probable dementia (odds ratio [OR]: 1.42, 95% confidence interval[95%CI]: 1.16, 1.73) and substantial depressive symptoms (OR: 1.60, 95%CI: 1.29, 1.99). Conclusions Dementia and depression are common in community-dwelling older Americans, and hospitalization is associated with these conditions. Additional research increasing understanding of the bi-directional relationship between hospitalizations, dementia, and depression, along with targeted interventions to reduce hospitalizations, are needed. PMID:24388630

Evaluation of predictive factors influencing community reintegration in adult patients with stroke

Directory of Open Access Journals (Sweden)

Olajide Ayinla Olawale

2018-01-01

Full Text Available Objectives: Patients with stroke are faced with gait, balance, and fall difficulties which could impact on their community reintegration. In Nigeria, community reintegration after stroke has been understudied. The objective of this study was to evaluate the predictors of community reintegration in adult patients with stroke. Materials and Methods: Participants were 91 adult patients with stroke. Gait variables, balance self-efficacy, community balance/mobility, and fall self-efficacy were assessed using Rivermead Mobility Index, Activities-specific Balance Confidence Scale, Community Balance and Mobility Scale, and Falls Efficacy Scale-International respectively. Reintegration to Normal Living Index was used to assess satisfaction with community reintegration. Pearson Product-Moment Correlation Coefficient was used to determine the relationship between community reintegration and gait spatiotemporal variables, balance performance, and risk of fall. Multiple regression analysis was used to determine predictors of community reintegration (P ≤ 0.05. Results: There was significant positive relationship between community reintegration and cadence (r = 0.250, P = 0.017, functional mobility (r = 0.503, P = 0.001, balance self-efficacy (r = 0.608, P = 0.001, community balance/mobility (r = 0.586, P = 0.001, and duration of stroke (r = 0.220, P = 0.036. Stride time (r = −0.282, P = 0.073 and fall self-efficacy (r = 0.566, P = 0.001 were negatively correlated with community reintegration. Duration of stroke, balance self-efficacy, community balance/mobility, and fall self-efficacy (52.7% of the variance were the significant predictors of community reintegration. Conclusion: Community reintegration is influenced by cadence, functional mobility, balance self-efficacy, community balance/mobility, and duration of stroke. Hence, improving balance and mobility during rehabilitation is important in enhancing community reintegration in patients with stroke.

The Health Literacy and ESL study: a community-based intervention for Spanish-speaking adults.

Science.gov (United States)

Soto Mas, Francisco; Ji, Ming; Fuentes, Brenda O; Tinajero, Josefina

2015-04-01

Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits.

The Health Literacy and ESL Study: A Community-Based Intervention for Spanish-Speaking Adults

Science.gov (United States)

MAS, FRANCISCO SOTO; JI, MING; FUENTES, BRENDA O.; TINAJERO, JOSEFINA

2015-01-01

Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits. PMID:25602615

Community College Economics Instruction: Results from a National Science Foundation Project

Science.gov (United States)

Maier, Mark; Chi, W. Edward

2016-01-01

The principal investigator of a National Science Foundation project, "Economics at Community Colleges," surveyed community college economics faculty and organized workshops, webinars, and regional meetings to address community college faculty isolation from new ideas in economics and economics instruction. Survey results, combined with…

Creating a "culture of research" in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program.

Science.gov (United States)

Dimond, Eileen P; St Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

2015-06-01

The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute's Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important component yet often challenging to

Contextual Influences and Campaign Awareness Among Young Adults: Evidence from the National truth® Campaign.

Science.gov (United States)

Vallone, Donna M; Ilakkuvan, Vinu; Xiao, Haijun; Cantrell, Jennifer; Rath, Jessica; Hair, Elizabeth

2015-01-01

Mass media campaigns have been found to shape the public's knowledge, attitudes, beliefs, and behavior around tobacco. This study examines the influence of contextual factors with respect to awareness of the national truth® campaign, a mass media, branded tobacco use prevention campaign, among a sample of young adults (n = 2,804) aged 24-34 years old; these respondents were within the age range for both the primary and secondary targets of the campaign during the period (2000-2007) when the campaign was airing television advertising at consistently high levels. Mulitvariable models reveal lower educational attainment and Hispanic ethnicity as significant contextual factors predictive of lower campaign awareness, controlling for media use. In contrast, gender, state tobacco control policy, sensation-seeking, current smoking status, and community-level SES variables were not significantly associated with campaign awareness. Further research is needed to identify the mechanisms through which public education campaigns operate, particularly among disadvantaged communities.

Performance on physical function tests and the risk of fractures and admissions: Findings from a national health screening of 557,648 community-dwelling older adults.

Science.gov (United States)

Chun, So Hyun; Cho, Belong; Yang, Hyung-Kook; Ahn, Eunmi; Han, Min Kyu; Oh, Bumjo; Shin, Dong Wook; Son, Ki Young

Falls and fractures in older adults are often preventable, yet remain major health concerns as comprehensive physical function assessment may not be readily available. This study investigated whether simple timed up and go test (TUG) and unipedal stance test (UST) are effective in identifying people with an increased risk of fractures, femoral fractures, or admissions due to femoral fractures. Community-dwelling Korean older adults aged 66 years participated in the Korean National Screening Program for the Transitional Ages (n=557,648) between 2007 and 2010. Overall fractures, femoral fractures, and admissions due to femoral fracture during this period were outcome measures. The outcome measures were overall fractures, femoral fractures, and admissions due to femoral fracture after the health screening. The associations between inferior physical function test results and outcome measures were evaluated. A total of 523,502 subjects were followed-up for a mean period of 1.42 years, which resulted in 12,965 subjects with any fractures. Fracture data were retrieved from medical claims record. Subjects who performed poorly on one or both of the two physical function tests experienced higher number of overall fractures (aHR 1.21, 95% CI: 1.16-1.26), femoral fractures (aHR 1.80, 95% CI: 1.59-2.17), and admissions due to femoral fractures (aHR 1.85, 95% CI: 1.55-2.22) as compared to subjects with normal results on both tests. Combining TUG and UST was not superior to performing UST alone in predicting the increased risk of overall fractures (p=0.347), femoral fractures (p=0.402) or admissions due to femoral fractures (p=0.774). Poor performance on physical performance tests is associated with a higher risk of overall fractures, femoral fractures and admissions due to femoral fractures. The TUG and UST can be used to identify community-dwelling older individuals who are more vulnerable to fractures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

2012 National Park visitor spending effects: economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine; Huber, Christopher C.; Koontz, Lynne

2014-01-01

The National Park Service (NPS) manages the nation's most iconic destinations that attract millions of visitors from across the nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.

Living in an older adult community: a pharmacy student's experience.

Science.gov (United States)

Anastasia, Emily; Estus, Erica

2013-12-01

Interacting with older adults is a daily practice for pharmacists. It is important to understand how medications affect their wellbeing, but there are many other factors that affect quality of life. To truly understand some of the challenges facing older adults, Emily Anastasia, a sixth-year pharmacy student at the University of Rhode Island, moved into South Bay Retirement Living, a senior living community, for an eight-day immersion experience as a special project within one of her advanced pharmacy practice experience rotations. During her stay, she did not attend classes nor leave the facility unless on the South Bay bus with the other assisted living residents. She lived with a 92-year-old roommate, developed close friendships with many of the residents, and kept a detailed journal of her experience. The purpose of this reflection is to share her experience and recognize lifestyle as well as social and physical environment as factors in understanding the aging process. Immersing a pharmacy student within an assisted living community provides a unique opportunity to observe and appreciate characteristics of older adults that cannot be learned within a classroom setting.

Variables explaining health-related quality of life in community-dwelling older adults.

Science.gov (United States)

Sartor-Glittenberg, Cecelia; Lehmann, Sara; Okada, Mari; Rosen, Danielle; Brewer, Kathryn; Bay, R Curtis

2014-01-01

Although health-related quality of life (HRQL) has been linked to numerous factors in older adults, limited or conflicting studies have investigated variables explaining HRQL in healthy, community-dwelling older adults. The purpose of this study was to determine whether physical activity, gait speed, balance, strength, endurance, and flexibility were associated with HRQL in healthy, community-dwelling older adults. Participants of this cross-sectional, correlational research design study included residents of a senior living community, aged 60 years and older who were independent in at least unlimited household ambulation. These residents participated in tests of physical activity, gait speed, balance, strength, endurance, flexibility, and HRQL (Medical Outcomes Study Short-Form Health Survey, SF-36). The physical (PCS) and mental (MCS) component summary scores of the SF-36 were calculated. Data were collected on 84 participants (mean [SD] age = 78.6 (5.9) years, 54.8% women). Significant correlations were found between the PCS and fast gait speed (FGS) (r = 0.43; p Fullerton Advanced Balance Scale (r = 0.44; p balance, and lower body strength were associated with the PCS of the SF-36; however, FGS was the only variable that uniquely contributed to the variance in the PCS. Body mass index was associated with the MCS; however, only balance uniquely contributed to the variance in the MCS. Physical activity was not associated with the PCS or MCS. The results of this study support the assessment of FGS in community-dwelling older adults to gain insight into physical health status. Interventions directed toward FGS, balance, and BMI may contribute to optimum HRQL in this population.

Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.

Science.gov (United States)

Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha

2016-02-01

The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults. © The Author(s) 2014.

Brief report: Aggressive challenging behaviour in adults with intellectual disability following community resettlement.

Science.gov (United States)

Bhaumik, S; Watson, J M; Devapriam, J; Raju, L B; Tin, N N; Kiani, R; Talbott, L; Parker, R; Moore, L; Majumdar, S K; Ganghadaran, S K; Dixon, K; Das Gupta, A; Barrett, M; Tyrer, F

2009-03-01

Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long-term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging behaviour and psychotropic drug use in adults with ID following resettlement using a person-centred approach. The Modified Overt Aggression Scale was administered to carers of 49 adults with ID prior to discharge from a long-stay hospital and 6 months and 1 year after community resettlement. All areas of aggressive challenging behaviour reduced significantly between baseline and 6 months following resettlement (P < 0.001). This reduction remained (but did not decrease further) at 1-year follow-up. Further work is needed to evaluate the role of environmental setting on aggressive challenging behaviour in adults with ID.

From Amateur to Framauteur: Art Development of Adolescents and Young Adults within an Interest-Based Community

Science.gov (United States)

Manifold, Marjorie Cohee

2012-01-01

In this article, the art developmental progression of adolescents and young adults within the cultural context of an interest-based community is described; the role of narrative and sociocultural community to the art development of adolescents and young adults is highlighted. Artistic development begins in response to an aesthetic phenomenon, is…

Older Adults: Community College Students of the 1990s.

Science.gov (United States)

Craig, Ford M.

1990-01-01

Provides a literature review on community college services to older adults, focusing on studies of this population's needs (e.g., personal business and financial information, employment needs, physical fitness training, and maintaining self-esteem and a sense of the purpose and meaning in life) and courses and services that colleges offer. (DMM)

Community conservation adjacent to Ruaha National Park, Tanzania

Science.gov (United States)

Sue Stolberger

2007-01-01

In the areas adjacent to Ruaha National Park where rural communities exist, much more work and education is required to enable them to benefit directly and indirectly from tourism and managing their own natural resources.

Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008?2013 Korean Community Health Survey

OpenAIRE

Hong, Ickpyo; Simpson, Annie N.; Logan, Sarah; Woo, Hee-Soon

2016-01-01

Objective To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. Methods We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Results Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 10...

Community-acquired acute kidney injury in adults in Africa.

Science.gov (United States)

Adu, Dwomoa; Okyere, Perditer; Boima, Vincent; Matekole, Michael; Osafo, Charlotte

We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa. A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015. The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired. Most patients with AKI are young with a weighted mean age of 41.3 standard deviation (SD) 9.3 years, and a male to female ratio of 1.2 : 1.0. Medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 - 27% of cases and surgical causes in 2 - 24% of cases. In the reported studies, between 17 and 94% of patients who needed dialysis received this. The mortality of AKI in adults in Africa ranged from 11.5 to 43.5%. Most reported cases of AKI in Africa originate in the community. The low incidence of hospital-acquired AKI is likely to be due to under ascertainment. Most patients with AKI in Africa are young and have a single precipitating cause. Prominent among these are infection, pregnancy complications and nephrotoxins. Early treatment can improve clinical outcomes.

Conversations on telemental health: listening to remote and rural First Nations communities.

Science.gov (United States)

Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

2011-01-01

Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

Science.gov (United States)

van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-10-01

Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Beyond Traditional Art Education: Transformative Lifelong Learning in Community-Based Settings with Older Adults

Science.gov (United States)

Lawton, Pamela Harris; La Porte, Angela M.

2013-01-01

Quality community-based art education programs for older adults over the age of 50 should exploit the broad range of interests and cognitive abilities of participants by utilizing adult education theory, brain research, and the best practices of adult art education programs. We consider a developing paradigm on the cognitive abilities of the…

Do Community Characteristics Relate to Young Adult College Students' Credit Card Debt? The Hypothesized Role of Collective Institutional Efficacy.

Science.gov (United States)

Friedline, Terri; West, Stacia; Rosell, Nehemiah; Serido, Joyce; Shim, Soyeon

2017-03-01

This study examines the extent of emergent, outstanding credit card debt among young adult college students and investigates whether any associations existed between this credit card debt and the characteristics of the communities in which these students grew up or lived. Using data (N = 748) from a longitudinal survey and merging community characteristics measured at the zip code level, we confirmed that a community's unemployment rate, average total debt, average credit score, and number of bank branch offices were associated with a young adult college student's acquisition and accumulation of credit card debt. For example, a community's higher unemployment rate and lower number of bank branches were associated with a young adult college student's greater accumulated debt. Community characteristics had the strongest associations with credit card debt, especially after controlling for individual characteristics (i.e., a young adult college student's race and financial independence) and familial characteristics (i.e., their parents' income and parents' discussions of financial matters while growing up at home). The findings may help to understand the unique roles that communities play in shaping children and young adults' financial capability, and how communities can be better capacitated to support the financial goals of their residents. © Society for Community Research and Action 2017.

A measure of fall risk behaviors and perceptions among community-dwelling older adults.

Science.gov (United States)

Yuen, Hon Keung; Carter, Rickey E

2006-01-01

Relatively little is known about the interaction between behavioral and environmental circumstances associated with falls among community-dwelling older adults. This study is designed to develop an instrument that measures community-dwelling older adults' participation in and perceptions of fall risk behaviors. Eighty-seven community-dwelling older adults aged 60 or above (mean +/- SD = 76 +/- 7.9), who had experienced at least one fall in the past 12 months, completed a questionnaire dealing with frequency of their participation in fall risk behaviors, their perceptions of these behaviors, and their fall history. Data were subjected to exploratory factor analysis. A 20-item instrument consisting of three constructs was presented as the Fall Risk Behaviors and Perceptions Scale (FRB&PS). Two of the three constructs of the instrument were de-stabilizers and non-supports, both of which measure participation in fall risk behaviors; the third was perceptions of fall risk behaviors. Internal consistency coefficient of the FRB&PS is 0.733 with a root mean square error of approximation (RMSEA) score of 0.075, which indicates an adequate model fit. Results from the stepwise regression analyses indicated that adults aged 75 and above (the old-old) participated less frequently in fall risk activities (p = 0.025), and had more knowledge about fall risks as measured by a higher perception score (p = 0.025) than those aged 60 to 75 (the young-old). Older men tended to participate more frequently in fall risk activities (p = 0.020) than older women; in addition, those older adults who are more mobile (p = 0.002) also participated more frequently in fall risk behaviors than those who are less mobile. Preliminary findings indicate that the pilot FRB&PS is a reliable and valid instrument to measure community-dwelling older adults' participation in and perceptions of fall risk behaviors. Additional psychometric validation of the FRB&PS on predicting the likelihood of falls is

Direct Marketing Promotion and Electronic Cigarette Use Among US Adults, National Adult Tobacco Survey, 2013–2014

OpenAIRE

Dai, Hongying; Hao, Jianqiang

2017-01-01

Introduction The use of electronic cigarettes (e-cigarettes) among US adults has increased since 2007. The objective of this study was to investigate the prevalence of direct marketing promotion of e-cigarettes and its association with e-cigarette use among US adults. Methods We used using data from the 2013–2014 National Adult Tobacco Survey (NATS) to estimate prevalence of e-cigarette promotions received by mail or email. Multinomial logistic regression was used to examine the associations ...

Perspectives on past and Present Waste Disposal Practices: A community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

OpenAIRE

Rebecca Zagozewski; Ian Judd-Henrey; Suzie Nilson; Lalita Bharadwaj

2011-01-01

The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatche...

Perspectives on Past and Present Waste Disposal Practices: A Community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

OpenAIRE

Rebecca Zagozewski; Ian Judd-Henrey; Suzie Nilson; Lalita Bharadwaj

2011-01-01

The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatche...

Association between statin use and physical function among community-dwelling older Japanese adults.

Science.gov (United States)

Kawai, Hisashi; Ihara, Kazushige; Kera, Takeshi; Hirano, Hirohiko; Fujiwara, Yoshinori; Tanaka, Masashi; Kojima, Motonaga; Obuchi, Shuichi

2018-04-01

Statin-associated muscle symptoms (SAMS) are the muscle-related side-effects of statins, but the association between statin use and physical function among community-dwelling older adults is unclear. The objective of the present study was to examine the association between statin use and physical function among community-dwelling older Japanese adults by considering the risk factors of statin-associated muscle symptoms. The participants were 1022 community-dwelling older adults aged 65-88 years, who participated in comprehensive health checkups from 2013 to 2015. Statin use in the participants (381 men and 559 women) was verified by using data from their medicine notebooks. The differences between statin use (users and non-users) and physical functions (grip strength, knee extension torque, normal and maximum gait speed, Timed Up & Go test, one-legged stance, quadriceps muscle thickness and echo intensity) were analyzed using the t-test. Multiple regression analyses were also carried out to examine the association between statin use and physical function. A total of 93 men (24.4%) and 154 women (27.5%) were statin users. Grip strength, normal gait speed and one-legged stance declined significantly in statin users compared with the non-users. In multiple regression analysis while controlling for the risk factors of statin-associated muscle symptoms, including age, sex, body mass index and number of medicines, no independent association, between statin use and the reduction of physical functions, was observed. Statin use was not associated with the decline of physical function in community-dwelling older Japanese adults. Geriatr Gerontol Int 2018; 18: 623-630. © 2017 Japan Geriatrics Society.

The Aspen Prize for Community College Excellence

Science.gov (United States)

Perlstein, Linda

2011-01-01

The nation's community colleges share a common and vital purpose: preparing students--young and working adults--for jobs and continued academic study. Today, over 7 million community college students strive to attain a degree that will expand their opportunity, whether they aim to graduate directly into the workforce or continue on to seek a…

Identifying and Assessing Community-Based Social Behavior of Adolescents and Young Adults with EBD.

Science.gov (United States)

Bullis, Michael; And Others

1994-01-01

A battery of three measures for assessing the community-based social behavior of adolescents and young adults with emotional and behavioral disorders is described. The measures, in male and female forms, are "Test of Community-Based Social Skill Knowledge,""Scale of Community-Based Social Skill Performance," and "Behaviors That Are Undesirable for…

Image acts and visual communities: everyday nationalism in contemporary Turkey

NARCIS (Netherlands)

Kuryel, A.

2015-01-01

In the dissertation entitled "Image Acts and Visual Communities: Contemporary Nationalism in Turkey", I investigate the image politics of nationalist practices in everyday life by focusing on contemporary Turkey and tracking the way images of the nation travel through a variety of fields. I depart

2017 National Park visitor spending effects : Economic contributions to local communities, states, and the Nation

Science.gov (United States)

Cullinane Thomas, Catherine M.; Koontz, Lynne; Cornachione, Egan

2018-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2017, the National Park System received an estimated 331 million recreation visits. Visitors to National Parks spent an estimated \\$18.2 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 306 thousand jobs, \\$11.9 billion in labor income, \\$20.3 billion in value added, and \\$35.8 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.5 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with \\$3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

2016 National Park visitor spending effects: Economic contributions to local communities, states, and the Nation

Science.gov (United States)

Cullinane Thomas, Catherine; Koontz, Lynne

2017-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2016, the National Park System received an estimated 330,971,689 recreation visits. Visitors to National Parks spent an estimated $18.4 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 318 thousand jobs, $12.0 billion in labor income, $19.9 billion in value added, and $34.9 billion in economic output. The lodging sector saw the highest direct contributions with $5.7 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with $3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

Adult and Community Education in Complex Societies: Reconsidering Critical Perspectives

Science.gov (United States)

Wildemeersch, Danny

2014-01-01

In this contribution, I explore how critical pedagogical perspectives can inspire adult and community education practices. The central argument is that today, in contrast with the heydays of emancipatory practices and theories, the classical critical approaches need reconsideration. The paper explores how these approaches sometimes have a…

The Effects of a 12-Week Walking Program on Community-Dwelling Older Adults

Science.gov (United States)

Cheng, Shun-Ping; Tsai, Tzu-I; Lii, Yun-Kung; Yu, Shu; Chou, Chen-Liang; Chen, I-Ju

2009-01-01

Walking is a popular and easily accessible form of physical activity. However, walking instruction for older adults is based on the evidence gathered from younger populations. This study evaluated walking conditions, strength, balance, and subjective health status after a 12-week walking-training program in community-dwelling adults greater than…

Chronic Disease Risk Typologies among Young Adults in Community College.

Science.gov (United States)

Jeffries, Jayne K; Lytle, Leslie; Sotres-Alvarez, Daniela; Golden, Shelley; Aiello, Allison E; Linnan, Laura

2018-03-01

To address chronic disease risk holistically from a behavioral perspective, insights are needed to refine understanding of the covariance of key health behaviors. This study aims to identify distinct typologies of young adults based on 4 modifiable risk factors of chronic disease using a latent class analysis approach, and to describe patterns of class membership based on demographic characteristics, living arrangements, and weight. Overall, 441 young adults aged 18-35 attending community colleges in the Minnesota Twin Cities area completed a baseline questionnaire for the Choosing Healthy Options in College Environments and Settings study, a RCT. Behavioral items were used to create indicators for latent classes, and individuals were classified using maximum-probability assignment. Three latent classes were identified: 'active, binge-drinkers with a healthy dietary intake' (13.1%); 'non-active, moderate-smokers and non-drinkers with poor dietary intake' (38.2%); 'moderately active, non-smokers and non-drinkers with moderately healthy dietary intake' (48.7%). Classes exhibited unique demographic and weight-related profiles. This study may contribute to the literature on health behaviors among young adults and provides evidence that there are weight and age differences among subgroups. Understanding how behaviors cluster is important for identifying groups for targeted interventions in community colleges.

Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

Science.gov (United States)

Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-03-06

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

Validation of the Community Integration Questionnaire in the adult burn injury population.

Science.gov (United States)

Gerrard, Paul; Kazis, Lewis E; Ryan, Colleen M; Shie, Vivian L; Holavanahalli, Radha; Lee, Austin; Jette, Alan; Fauerbach, James A; Esselman, Peter; Herndon, David; Schneider, Jeffrey C

2015-11-01

With improved survival, long-term effects of burn injuries on quality of life, particularly community integration, are important outcomes. This study aims to assess the Community Integration Questionnaire's psychometric properties in the adult burn population. Data were obtained from a multicenter longitudinal data set of burn survivors. The psychometric properties of the Community Integration Questionnaire (n = 492) were examined. The questionnaire items were evaluated for clinical and substantive relevance; validation procedures were conducted on different samples of the population; construct validity was assessed using exploratory factor analysis; internal consistency reliability was examined using Cronbach's α statistics; and item response theory was applied to the final models. The CIQ-15 was reduced by two questions to form the CIQ-13, with a two-factor structure, interpreted as self/family care and social integration. Item response theory testing suggests that Factor 2 captures a wider range of community integration levels. Cronbach's α was 0.80 for Factor 1, 0.77 for Factor 2, and 0.79 for the test as a whole. The CIQ-13 demonstrates validity and reliability in the adult burn survivor population addressing issues of self/family care and social integration. This instrument is useful in future research of community reintegration outcomes in the burn population.

Social risk factors for falls among rural Nigerian community-dwelling older adults.

Science.gov (United States)

Maruf, Fatai Adesina; Muonwe, Chidile; Odetunde, Marufat

2016-06-01

Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults. The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded. Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85). The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

Experiences of Adult Students in Multi-Generational Community College Classrooms

Science.gov (United States)

Clemente, Kathleen Ann

2010-01-01

This qualitative study is a basic interpretative inquiry studying the experiences of fourteen adult students 45 years of age or older in a multi-generational community college classroom. The study is informed by social constructivism, social constructionism and andragogy. It focused on how students viewed their experiences in the…

Fear of falling and its predictors among community-living older adults in Korea.

Science.gov (United States)

Oh, Eunmi; Hong, Gwi-Ryung Son; Lee, Seonhye; Han, Soojeong

2017-04-01

To explore the prevalence and predicting factors of fear of falling (FOF) among community-living older adults in Korea. Secondary data analysis of the 2011 Korean National Elderly Living Conditions and Welfare Desire Survey was used. Logistic regression analysis was conducted to examine the predictors of FOF. In total, 75.6% of older adults with normal cognition have FOF. Factors associated with an increased risk of FOF in older adults are previous experience with falling (OR = 3.734, 95% CI = 2.996-4.655), limitations in the performance of exercise involving lower extremities (OR = 2.428, 95% CI = 2.063-2.858), being female (OR = 2.335, 95% CI = 2.023-2.694), having more than three chronic diseases (OR = 1.994, 95% CI = 1.625-2.446), limitations in instrumental activities of daily living (IADLs) (OR = 1.745, 95% CI = 1.230-2.477), limitations in the performance of exercise involving upper extremities (OR = 1.646, 95% CI = 1.357-1.997), living without a spouse (OR = 1.626, 95% CI = 1.357-1.948), having poor self-rated health (OR = 1.571, 95% CI = 1.356-1.821), limitations in muscle strength (OR = 1.455, 95% CI = 1.150-1.841), age (≥75 years) (OR = 1.320, 95% CI = 1.150-1.516), lower levels of education (0-6 years) (OR = 1.231, 95% CI = 1.075-1.409), and life satisfaction (OR = 1.104, 95% CI = 1.065-1.114). A multidimensional construct of general characteristics, physical, and psychosocial variables act as risk factors for FOF. Preventive intervention should be developed to decrease the FOF among Korean older adults.

Youth and Adult Perspectives on Violence Prevention Strategies: A Community-Based Participatory Study

Science.gov (United States)

Dodington, James; Mollen, Cynthia; Woodlock, Joseph; Hausman, Alice; Richmond, Therese S.; Fein, Joel A.

2012-01-01

This project explores the beliefs and perspectives of urban adults and youth regarding community violence prevention strategies and identifies points of overlap and differences of opinion that can contribute to the development of successful youth violence prevention programs. We coded transcript data from adults and 10-16-year-old youth from the…

Responsible Adult Culture (RAC): Cognitive and Behavioral Changes at a Community-Based Correctional Facility

Science.gov (United States)

Devlin, Renee S.; Gibbs, John C.

2010-01-01

This article examined cognitive and behavioral changes among participants in Responsible Adult Culture (RAC), a cognitive-behavioral (especially, cognitive restructuring) treatment program in use at the Franklin County Community-Based Correctional Facility (CBCF). Participants were adult felony offenders (approximately three-fourths male). A…

Associations Between Resilience, Community Belonging, and Social Participation Among Community-Dwelling Older Adults: Results From the Eastern Townships Population Health Survey.

Science.gov (United States)

Levasseur, Mélanie; Roy, Mathieu; Michallet, Bernard; St-Hilaire, France; Maltais, Danielle; Généreux, Mélissa

2017-12-01

To examine the associations between resilience, community belonging, and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. Community. A sample (N=4541) of women (n=2485) and men (n=2056) aged ≥60 years was randomly selected according to area. Most participants had community belonging, and resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in 8 community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to the local community. Social participation and sense of belonging questions came from Statistics Canada surveys. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale, capturing the ability to cope with adversity. Controlling for age, education, and psychological distress, greater resilience and community belonging were associated with greater social participation among women (R 2 =.13; Pcommunity belonging and social participation varied as a function of resilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (Pcommunity belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Cognitive health benefits of strengthening exercise for community-dwelling older adults.

Science.gov (United States)

Anderson-Hanley, Cay; Nimon, Joseph P; Westen, Sarah C

2010-11-01

While aerobic exercise has been linked to improved performance on cognitive tasks of executive functioning among older adults, not all older adults can avail themselves of such exercise due to physical limitations. In this study, community-dwelling older adults were evaluated on tasks of executive functioning before and after a month-long strengthening, nonaerobic exercise program. A total of 16 participants who engaged in such exercise showed significantly improved scores on Digits Backward and Stroop C tasks when compared to 16 participants who were on an exercise waiting list. Positive benefits of strengthening exercise on cognition are supported. Additional research is needed to clarify the generalizability of these findings.

A post hoc assessment of duration of protection in CAPiTA (Community Acquired Pneumonia immunization Trial in Adults)

NARCIS (Netherlands)

Patterson, Scott; Webber, Chris; Patton, Michael; Drews, Wayne; Huijts, Susanne M.; Bolkenbaas, Marieke; Gruber, William C.; Scott, Daniel A.; Bonten, Marc J M

2016-01-01

Background: The Community Acquired Pneumonia immunization Trial in Adults (CAPiTA) was conducted to evaluate 13-valent pneumococcal conjugate vaccine (PCV13) for the prevention of vaccine-type community-acquired pneumonia (VT-CAP) and vaccine-type invasive pneumococcal disease (VT-IPD) in adults

Community fisheries in eastern South Dakota: Angler demographics, use, and factors influencing satisfaction

Science.gov (United States)

Greiner, Michael J.; Lucchesi, David O.; Chipps, Steven R.; Gigliotti, Larry M.

2016-01-01

We surveyed anglers on five community fishing lakes near Brookings, South Dakota to assess angler use and satisfaction. The community lakes attracted younger anglers when compared to statewide and national averages. Overall, satisfaction was generally high (74%) among anglers fishing community lakes. Logistic regression analysis showed that harvest rate, anglers targeting trout, familiarity with the lake, adults fishing with children, and fishing during open water periods were significantly related to angler satisfaction. Angler parties consisting of adults fishing with children were 1.7 times more likely to respond as “satisfied” compared with adults-only angler groups. Fishing opportunities provided by community lakes can enhance participation by younger anglers while simultaneously providing family-oriented recreation (i.e., adults fishing with children) that enhances trip satisfaction.

Participation in Types of Physical Activities Among US Adults--National Health and Nutrition Examination Survey 1999-2006.

Science.gov (United States)

Dai, Shifan; Carroll, Dianna D; Watson, Kathleen B; Paul, Prabasaj; Carlson, Susan A; Fulton, Janet E

2015-06-01

Information on specific types of physical activities in which US adults participate is important for community and program development to promote physical activity. Prevalence of participation and average time spent for 33 leisure-time aerobic activities and 10 activity categories were calculated using self-reported data from 22,545 participants aged ≥ 18 years in the National Health and Nutrition Examination Survey 1999-2006. Overall, 38% of US adults reported no leisure-time physical activities, and 43% reported 1 or 2 activities in the past 30 days. Walking was the most frequently reported activity for both men (29%) and women (38%). Among walkers, the average time spent walking was 198 minutes/week for men and 152 minutes/week for women. The most reported activities for men after walking were bicycling and yard work, and for women were aerobics and dance. For most activity categories, participation was lower among adults aged ≥ 65 years than among younger adults, and among Mexican Americans and non-Hispanic blacks than among non-Hispanic whites. Participation in most categories increased with increasing educational attainment. Participation in physical activity differs by types of activities and demographic characteristics. Physical activity promotion programs should take these differences into account when developing intervention strategies.

2015 National Park visitor spending effects: Economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine M.; Koontz, Lynne

2016-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.In 2015, the National Park System received over 307.2 million recreation visits. NPS visitors spent \\$16.9 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 295 thousand jobs, \\$11.1 billion in labor income, \\$18.4 billion in value added, and \\$32.0 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.2 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bar sector, with \\$3.4 billion in economic output directly contributed to local gateway economies nationally.Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at http://go.nps.gov/vse.

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease.

Science.gov (United States)

Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

2017-04-10

Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005-2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05-1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07-1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84-1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26-3.48). Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. © 2017 Canadian Medical Association or its licensors.

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

Science.gov (United States)

Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

2017-12-01

Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly

Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia.

Science.gov (United States)

Kader Maideen, Siti Fatimah; Sidik, Sherina Mohd; Rampal, Lekhraj; Mukhtar, Firdaus

2014-01-01

Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor. A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires. A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity. The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.

Youth-Adult Partnership and Youth Civic Development: Cross-National Analyses for Scholars and Field Professionals

Science.gov (United States)

Zeldin, Shepherd; Gauley, Josset; Krauss, Steven Eric; Kornbluh, Mariah; Collura, Jessica

2017-01-01

Across the world, community-based youth organizations are engaging youth as partners with adults to promote youth civic development. A sample of 528 youth from the United States, Portugal, and Malaysia were surveyed to explore associations between youth-adult partnership (youth voice in decision making; supportive adult relationships) and two key…

Living alone and fall risk factors in community-dwelling middle age and older adults.

Science.gov (United States)

Elliott, Sharon; Painter, Jane; Hudson, Suzanne

2009-08-01

As part of a larger study on fall-related risk factors, this study investigated the relationship between living alone status and fall-related variables among community-dwelling adults who lived in a rural county in eastern North Carolina. A convenience sample of 666 community-dwelling adults ages 50 and over participated in this 4-year study and completed a fall questionnaire. Significant findings were found in relation to living alone status and experiencing a fall, who they informed about their fall, injuries, safety equipment, ambulatory devices, and personal emergency response system usage. Three hundred thirty-eight participants stated they lived alone, compared to 300 who lived with others. The percentage reporting a fall was appreciably larger for those living alone (52%) than for those living with others (48%) in both genders in all age groups except for the 61-70 year old adults where the percentage was less. Findings from this research enhance knowledge about the prevalence and contributing fall-related factors in adults who live alone compared to those who live with others. Insights gained from this research will assist community and public health leaders and health care professionals in developing more efficacious intervention strategies to prevent or reduce falls, and associated psychological and physical consequences.

First Nations Communities and Tobacco Taxation: A Commentary

Science.gov (United States)

Samji, Hasina; Wardman, Dennis

2009-01-01

Taxation of tobacco is a widely used strategy that promotes smoking cessation among adults and reduces cigarette consumption among continuing smokers. First Nations (FN) populations' tobacco use is estimated to be 2-3 times that of other Canadians and, in part, a reflection that tobacco products purchased on reserve by FN people are tax exempt.…

Drug-related problems among community-dwelling older adults in mainland China.

Science.gov (United States)

Yang, Jiadan; Meng, Long; Liu, Yu; Lv, Liping; Sun, Shusen; Long, Rui; Shan, Xuefeng; Song, Jie; Qiu, Feng

2018-04-01

Background Little is known about the extent of drug-related problems (DRPs) in community-dwelling older adult patients with chronic diseases in mainland China. Setting A medication therapy review service at a community health center in Chongqing, China. Objective To identify and categorize DRPs along with pharmacists' recommendations in addressing the DRPs identified. Method The study was conducted between May 2015 and July 2016. A total of 102 community-dwelling older adults were included. MTR was carried out by clinical pharmacists. DRPs and pharmacotherapy recommendations were recorded and analyzed. Main outcome measure The number of drug-related problems and main problem categories. Results The average age of patients was 69.4 years. Patients took an average of 6.3 medications. A total of 489 DRPs were identified (mean of 4.8 per patient). The most common category was under-treated (27.8%) followed by over- or under-dose (18.8%) and monitoring (17.8%). The number of medications taken was the significant associated factor for DRPs. Pharmacists made 526 recommendations to address the DRPs (mean of 1.1 recommendations per DRP). Primary care providers accepted 68.1% of these recommendations, and implemented 60.9% of them. Conclusion The prevalence of DRPs among studied patient population was high. Pharmacists may play a vital role in addressing the DRPs and optimize pharmacotherapy through MTR service located in community health centers.

Needing smart home technologies: the perspectives of older adults in continuing care retirement communities.

Science.gov (United States)

Courtney, Karen L; Demiris, George; Rantz, Marilyn; Skubic, Marjorie

2008-01-01

At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs), which range from independent apartments to assisted living and skilled-nursing facilities. With predictions of a large increase in the segment of the population aged 65 and older, a subsequent increase in demand on CCRCs can be anticipated. With these expectations, researchers have begun exploring the use of smart home information-based technologies in these care facilities to enhance resident quality of life and safety, but little evaluation research exists on older adults' acceptance and use of these technologies. This study investigated the factors that influence the willingness of older adults living in independent and assisted living CCRCs to adopt smart home technology. Participants (n = 14) were recruited from community-dwelling older adults, aged 65 or older, living in one of two mid-western US CCRC facilities (independent living and assisted living type facilities). This study used a qualitative, descriptive approach, guided by principles of grounded theory research. Data saturation (or when no new themes or issues emerged from group sessions) occurred after four focus groups (n = 11 unique respondents) and was confirmed through additional individual interviews (n = 3). The findings from this study indicate that although privacy can be a barrier for older adults' adoption of smart home technology their own perception of their need for the technology can override their privacy concerns. Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.

The emotional impact of national music on young and older adults differing in posttraumatic stress disorder symptoms.

Science.gov (United States)

Bensimon, Moshe; Bodner, Ehud; Shrira, Amit

2017-10-01

In spite of previous evidence regarding the function of national songs as a contextual stimulus, their effect on the emotional state of older adults living with different levels of posttraumatic stress disorder (PTSD) symptoms has not be been examined. Following the 2014 Israel-Gaza conflict, we examined the emotional effects of listening to happy national songs (songs of Independence Day) and sad national songs (Memorial Day songs) on young (N = 144, mean age = 29.4) and older adults (N = 132, mean age = 68.5). Respondents were exposed to happy or sad national songs, and completed measures of exposure to missile attacks, related PTSD symptoms, and positive and negative emotions. Sad national songs were related to higher negative affect among young adults who were lower on PTSD symptoms, but not among their older counterparts. In contrast, sad national songs were related to higher negative affect among older adults who were higher on PTSD symptoms, but not among their young counterparts. These findings support the strength and vulnerability model, as they demonstrate that relative to young adults, older adults are generally more capable to withstand negative stimuli, yet are more sensitive to negative stimuli when they suffer from chronic vulnerability, as in the case of higher level of PTSD symptoms.

Drinking water management: health risk perceptions and choices in First Nations and non-First Nations communities in Canada.

Science.gov (United States)

Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

2014-05-30

The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000-2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009-2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience.

Drinking Water Management: Health Risk Perceptions and Choices in First Nations and Non-First Nations Communities in Canada

Science.gov (United States)

Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

2014-01-01

The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000–2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009–2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience. PMID:24886757

Life-Space Assessment questionnaire: Novel measurement properties for Brazilian community-dwelling older adults.

Science.gov (United States)

Simões, Maria do Socorro Mp; Garcia, Isabel Ff; Costa, Lucíola da Cm; Lunardi, Adriana C

2018-05-01

The Life-Space Assessment (LSA) assesses mobility from the spaces that older adults go, and how often and how independent they move. Despite its increased use, LSA measurement properties remain unclear. The aim of the present study was to analyze the content validity, reliability, construct validity and interpretability of the LSA for Brazilian community-dwelling older adults. In this clinimetric study we analyzed the measurement properties (content validity, reliability, construct validity and interpretability) of the LSA administered to 80 Brazilian community-dwelling older adults. Reliability was analyzed by Cronbach's alpha (internal consistency), intraclass correlation coefficients and 95% confidence interval (reproducibility), and standard error of measurement (measurement error). Construct validity was analyzed by Pearson's correlations between the LSA and accelerometry (time in inactivity and moderate-to-vigorous activities), and interpretability was analyzed by determination of the minimal detectable change, and floor and ceiling effects. The LSA met the criteria for content validity. The Cronbach's alpha was 0.92, intraclass correlation coefficient was 0.97 (95% confidence interval 0.95-0.98) and standard error of measurement was 4.12. The LSA showed convergence with accelerometry (negative correlation with time in inactivity and positive correlation with time in moderate to vigorous activities), the minimal detectable change was 0.36 and we observed no floor or ceiling effects. The LSA showed adequate reliability, validity and interpretability for life-space mobility assessment of Brazilian community-dwelling older adults. Geriatr Gerontol Int 2018; 18: 783-789. © 2018 Japan Geriatrics Society.

Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

Science.gov (United States)

Bandayrel, Kristofer; Wong, Sharon

2011-01-01

Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

Science.gov (United States)

Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

2015-01-01

Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

Perceptions, attitudes and beliefs of adults in a Nigerian community ...

African Journals Online (AJOL)

Perceptions, attitudes and beliefs of adults in a Nigerian community about cleft lip and palate. ... Attempted abortion and smoking by the mother during pregnancy were perceived to cause CLP by 36.3% and 33.3% respectively while an “Act of God” was believed to be the aetiology by 23%. A small percentage (17%) ...

Extracorporeal Membrane Oxygenation for Adult Community-Acquired Pneumonia: Outcomes and Predictors of Mortality.

Science.gov (United States)

Ramanathan, Kollengode; Tan, Chuen Seng; Rycus, Peter; MacLaren, Graeme

2017-05-01

Extracorporeal membrane oxygenation is a rescue therapy used to support severe cardiorespiratory failure. Data on outcomes from severe community-acquired pneumonia in adults receiving rescue extracorporeal membrane oxygenation are mainly confined to single-center experiences or specific pathogens. We examined data from the Extracorporeal Life Support Organisation registry to identify risk factors for poor outcomes in adult patients with community-acquired pneumonia. Retrospective data analysis. Extracorporeal Life Support Organization Registry database. We collected deidentified data on adult patients (> 18 yr) receiving extracorporeal membrane oxygenation for community-acquired pneumonia between 2002 and 2012. Patients with incomplete data or brain death were excluded. The primary outcome measure was in-hospital mortality. Other measurements included demographic information, pre-extracorporeal membrane oxygenation mechanical ventilation and biochemical variables, inotrope requirements, extracorporeal membrane oxygenation mode, duration, and complications. Initial univariate analysis assessed potential associations between survival and various pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation factors. Variables with p values of less than 0.1 were considered for logistic regression analysis to identify predictors of mortality. None. One thousand fifty-five patients, who satisfied inclusion criteria, were included in the final analysis. There was an increase in the number of patients cannulated per annum over the 10-year period studied. Univariate analysis identified pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation variables associated with high mortality. Further multiple regression analysis identified certain pre-extracorporeal membrane oxygenation factors as predictors of mortality, including duration of mechanical ventilation prior to extracorporeal membrane oxygenation, lower arterial pressure, fungal

Nonimaging clinical assessment of impaired swallowing in community-dwelling older adults in Taiwan.

Science.gov (United States)

Chen, Miao-Yen; Lin, Li-Chan

2012-12-01

Impaired swallowing is common in elderly patients as well as those with neurological disorders and degenerative diseases. Convenient and accurate assessments should be available to community-dwelling older adults to diagnose and provide early management and care of swallowing difficulties, an important factor of influence on elderly life quality. This study used convenient nonimaging methods to assess swallowing functions in community-dwelling older adults and estimated the prevalence of swallowing difficulties. The study adopted a survey method and recruited 216 community-dwelling older adults over 65 years old in northern Taiwan. Researchers used tools including a swallowing test, questionnaire, water test, peripheral arterial pulse oximeter, and laryngeal S-EMG to assess participant swallowing functions and the prevalence of impaired swallowing. We found a 9.5% prevalence of impaired swallowing based on swallow questionnaire and water test results. Age correlated negatively with swallowing speed. A one-way ANOVA showed a significant difference in swallowing speed among the four age groups (F = 6.478, p < .00). A post hoc Scheffe comparison showed significant differences in swallowing time between the 60- to 69- and 70- to 79-year-old groups and 60- to 69- and 80- to 89-year-old groups. Multiple regression of impaired swallowing on various independent variables showed a significant standardized coefficient of 0.163 for age (t = 2.328, p = .021). Logistic regression showed a significant Wals test value for age (p = .007). The Kappa value was 0.307 for agreement analysis between impaired swallowing and SaO(2) value reduction of more than 2%. Swallowing function deteriorates with age. Results of this study provide an assessment of the prevalence of impaired swallowing in community-dwelling older adults in Taiwan. Results can help guide clinical nurses to enhance their objective assessment of impaired swallowing to improve patient quality of life.

A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

Science.gov (United States)

Dalleck, Lance C; Van Guilder, Gary P; Richardson, Tara B; Bredle, Donald L; Janot, Jeffrey M

2014-01-01

Background Lower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness. Methods and results Metabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (Pmetabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; Pexercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease. PMID:25120373

Journey to Healthy Aging: Impact of Community Based Education Programs on Knowledge and Health Behavior in Older Adults

Science.gov (United States)

McLarry, Sue

2007-01-01

The objective of this study was to determine if community based health education programs increased knowledge and health behavior in older adults. The study was a pretest-posttest design with a convenience sample of 111 independent community dwelling older adults. Participants received two disease prevention education presentations: type 2…

Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

OpenAIRE

Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

2015-01-01

[Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ? 4.1?years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older...

A Community Art Therapy Group for Adults with Chronic Pain

Science.gov (United States)

O'Neill, Aimee; Moss, Hilary

2015-01-01

This paper describes a community art therapy group for people living with chronic pain. Nine adults were offered 12 weekly group art therapy sessions that included art therapy activities such as guided imagery focusing on body scans followed by art responses and artistic expressions of the pain experience. This pilot group art therapy program is…

Wiisokotaatiwin: development and evaluation of a community-based palliative care program in Naotkamegwanning First Nation.

Science.gov (United States)

Nadin, Shevaun; Crow, Maxine; Prince, Holly; Kelley, Mary Lou

2018-04-01

Approximately 474 000 Indigenous people live in 617 First Nations communities across Canada; 125 of those communities are located in Ontario, primarily in rural and remote areas. Common rural health challenges, including for palliative care, involve quality and access. The need for culturally relevant palliative care programs in First Nations communities is urgent because the population is aging with a high burden of chronic and terminal disease. Because local palliative care is lacking, most First Nations people now leave their culture, family and community to receive care in distant hospitals or long-term care homes. Due to jurisdictional issues, a policy gap exists where neither federal nor provincial governments takes responsibility for funding palliative care in First Nations communities. Further, no Canadian program models existed for how different levels of government can collaborate to fund and deliver palliative care in First Nations communities. This article describes an innovative, community-based palliative care program (Wiisokotaatiwin) developed in rural Naotkamegwanning, and presents the results of a process evaluation of its pilot implementation. The evaluation aimed to (i) document the program's pilot implementation, (ii) assess progress toward intended program outcomes and (iii) assess the perceived value of the program. The Wiisokotaatiwin Program was developed and implemented over 5 years using participatory action research (http://www.eolfn.lakeheadu.ca). A mixed-method evaluation approach was adopted. Descriptive data were extracted from program documents (eg client registration forms). Client tracking forms documented service provision data for a 4-month sample period. Quantitative and qualitative data were collected through client and family member questionnaires (n=7) and healthcare provider questionnaires (n=22). A focus group was conducted with the program leadership team responsible for program development. Quantitative data were

Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan

OpenAIRE

Chang, Hsiao-Ting; Chen, Hsi-Chung; Chou, Pesus

2016-01-01

Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ? 65 years. The measurements inc...

78 FR 5430 - Extension of Approval Period for Certain Tests Used in the National Reporting System for Adult...

Science.gov (United States)

2013-01-25

... DEPARTMENT OF EDUCATION Extension of Approval Period for Certain Tests Used in the National Reporting System for Adult Education AGENCY: Office of Vocational and Adult Education, Department of... National Reporting System for Adult Education (NRS regulations) (73 FR 2306). The NRS regulations...

Outcomes related to nutrition screening in community living older adults: A systematic literature review.

Science.gov (United States)

Hamirudin, Aliza Haslinda; Charlton, Karen; Walton, Karen

2016-01-01

Nutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening. A systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines. Fifty-four articles were eligible to be included in the review and malnutrition risk varied from 0% to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the' nutritional status of older adults. Timely nutrition screening of older adults living in the community, if followed up with appropriate intervention and monitoring improves the nutritional status of older adults. This indicates that nutrition intervention should be considered a priority following nutrition screening for malnourished and at risk older adults. Further evaluation of outcomes of nutrition screening and associated interventions, using structured pathways of care, is warranted. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sexual orientation and health among U.S. adults: national health interview survey, 2013.

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Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S

2014-07-15

To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Volunteers' Experiences Delivering a Community-University Chronic Disease Health Awareness Program for South Asian Older Adults.

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Ford-Jones, Polly; Daly, Tamara

2017-12-01

Volunteers and voluntary organizations can connect preventative health care programs to communities and may play an important role in addressing the health needs of older adults. Despite this, tensions may exist in the structures that drive volunteers and voluntary organizations representing immigrant communities to provide unpaid labour to augment and supplement health care services. Furthermore, organizational challenges may exist for community agencies relying on volunteers to sustain a health screening and education program. The intervention program was led by one voluntary agency specifically for South Asian communities in partnership with the university and five local organizations. This paper draws on volunteer surveys (n = 22) and key informant interviews (n = 12) to detail volunteer experiences providing this intervention. Volunteers were university students and other community volunteers. A total of 810 adults participated in the intervention within the Greater Toronto Area, Ontario, Canada between October 2014 and June 2016. We found that volunteers often used their experience as a 'stepping stone' position to other education or work. They also gained from the knowledge and used it to educate themselves and their family members and friends. This paper provides a critical reflection on the role of volunteers in a preventative and educational healthcare intervention program for older adults from the South Asian community. Tensions exist when relying on volunteer labour for the implementation of preventative community health care programming and must be explored to ensure program sustainability as well as equity within the health care system.

Obesity Prevention in Older Adults.

Science.gov (United States)

Volpe, Stella Lucia; Sukumar, Deeptha; Milliron, Brandy-Joe

2016-06-01

The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.

Aging in Community: Developing a More Holistic Approach to Enhance Older Adults' Well-Being.

Science.gov (United States)

Davitt, Joan K; Madigan, Elizabeth A; Rantz, Marilyn; Skemp, Lisa

2016-01-01

Public health advances have contributed to increased longevity; however, individuals are more likely to live longer with multiple chronic conditions. The existing health care system primarily focuses on treating disease rather than addressing well-being as a holistic construct that includes physical, social, and environmental components. The current commentary emphasizes the importance of supporting healthy active aging and aging in community. The barriers to aging in community and the state of the intervention science in response to this problem are discussed, and recommendations for future research are provided. Active aging is more than managing illness or care transitions-it promotes engagement, participation, dignity, self-fulfillment, self-determination, and support for older adults. To support aging in community and healthy active aging, a paradigm shift is needed in how the well-being of older adults is thought about and supported. Copyright 2016, SLACK Incorporated.

Reach and effectiveness of an integrated community-based intervention on physical activity and healthy eating of older adults in a socioeconomically disadvantaged community

NARCIS (Netherlands)

Luten, Karla A; Reijneveld, Sijmen A; Dijkstra, Arie; de Winter, Andrea F

2016-01-01

The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled

Options for a National Framework for Benefit Distribution and Their Relation to Community-Based and National REDD+ Monitoring

Directory of Open Access Journals (Sweden)

Margaret Skutsch

2014-07-01

Full Text Available Monitoring is a central element in the implementation of national REDD+ and may be essential in providing the data needed to support benefit distribution. We discuss the options for benefit sharing systems in terms of technical feasibility and political acceptability in respect of equity considerations, and the kind of data that would be needed for the different options. We contrast output-based distribution systems, in which rewards are distributed according to performance measured in terms of carbon impacts, with input-based systems in which performance is measured in term of compliance with prescribed REDD+ activities. Output-based systems, which would require regular community carbon inventories to produce Tier 3 data locally, face various challenges particularly for the case of assessing avoided deforestation, and they may not be perceived as equitable. Input-based systems would require data on activities undertaken rather than change in stocks; this information could come from community-acquired data. We also consider how community monitored data could support national forest monitoring systems and the further development of national REDD+.

Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.

Science.gov (United States)

Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi

2018-01-01

To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

Adult Education and Community Development

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Ana Krajnc

1996-12-01

Full Text Available Community education means a new way of connecting knowledge with what people create. It increases the applicability of knowledge and con­ nects education with the direct needs of people. There are quite few things one can do by him/her­ self. Mainly one is dependent on the things he/she can create together with others. In non-democratic societies people get used to being given solutions from above, which is why they can wait for some­ one else (especially institutions to solve their problems while they remain passive. Socio-economic and political changes require from the people in Slovenia to redefine their attitude to the environment and life in general and to assume an active role. Community education means learning in groups of interested people in order to reach a certain goal or find a solution to a certain problem, e. g. establishing a local museum, publishing a tourist guide, constructing a bypass to decrease the traffic in town, erecting a monument, protecting green areas, introducing new forms of child care, solving problems of the disabled, unemployment and income maintenance, etc. People leam in order to be able to work. There are two goals which are always present: product and knowledge. People leam parallelly with the phases of work in order to achieve certain goal. It is typical of community education that it was developed in order to meet the needs of local people explicitly. It is therefore of great importance for adult educators facilitating problem-solving based on knowledge to get to know the real needs of people first. Generallack of knowledge is manifested in functional illiteracy. As long as people are unable to communicate orally or by writing with the others, their activities are blocked and they cannot help themselves. They can only live a dependent life, based on help expected from others, which nowadays is not possible any more. Each individual has to be responsible for his/her own survival. In the present

Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence.

Science.gov (United States)

Marshall, S; Bauer, J; Capra, S; Isenring, E

2013-01-01

Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand. To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years). Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012. Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097). Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.

Occurrence and impact of xerostomia among dentate adult New Zealanders: findings from a national survey.

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Benn, A M L; Broadbent, J M; Thomson, W M

2015-09-01

We investigated the prevalence, associations and impact of xerostomia in a nationally representative sample of dentate adult community-dwelling New Zealanders aged 18 years and over. The data were collected from a representative sample of 2209 adults, as part of the 2009 New Zealand Oral Health Survey (NZOHS). Data were collected using face-to-face interviews, dental examinations and the short-form Oral Health Impact Profile (OHIP-14). Data analysis used appropriate weighting for all procedures to account for the complex survey design. The overall prevalence estimate for xerostomia was 13.1% (95% CI 11.7, 14.7), and it was more common among females. Those in the 75+  and 25-34 age groups were more likely (odds ratios of 6.5 and 4.0, respectively) to have xerostomia. After controlling for sociodemographic characteristics and clinical oral disease, the mean OHIP-14 score among xerostomics was 50% higher than among those who did not have the condition. These data indicate that xerostomia is a common condition which can affect quality of life among people of all ages. © 2015 Australian Dental Association.

The contribution of community and family contexts to African American young adults' romantic relationship health: a prospective analysis.

Science.gov (United States)

Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu

2013-06-01

Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.

Falls prevention education between older adults and healthcare providers during transition from hospital to community-living

OpenAIRE

Lee, Den-Ching Angel

2017-01-01

Background: Falls are a problem for older adults. In particular, older hospitalised adults and those recently discharged from hospital have been shown to be at an increased risk of falls compared to older adults living in the community. Falls impact negatively on the physical and psychosocial well-being of older adults. They increase the burden of care for their family, caregivers and the healthcare system. However, many falls in older adults are preventable. Cochrane reviews demonstrated man...

Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008-2013 Korean Community Health Survey.

Science.gov (United States)

Hong, Ickpyo; Simpson, Annie N; Logan, Sarah; Woo, Hee-Soon

2016-08-01

To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (pfall accidents decreased from 38.12% to 23.16% (pfall accidents than males (pfall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04-2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83-3.10). The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults.

Planning for Serious Illness amongst Community-Dwelling Older Adults

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Donna Goodridge

2013-01-01

Full Text Available Older adults have long been encouraged to maintain their autonomy by expressing their wishes for health care before they become too ill to meaningfully participate in decision making. This study explored the manner in which community-dwelling adults aged 55 and older plan for serious illness. An online survey was conducted within the province of Saskatchewan, Canada, with 283 adults ranging in age from 55 to 88 years. Planning for future medical care was important for the majority (78.4% of respondents, although only 25.4% possessed a written advance care plan and 41.5% had designated a substitute decision maker. Sixty percent of respondents reported conversations about their treatment wishes; nearly half had discussed unacceptable states of health. Associations between key predictor variables and planning behaviors (discussions about treatment wishes or unacceptable states of health; designation of a substitute decision maker; preparation of a written advance care plan were assessed using binary logistic regression. After controlling for all predictor variables, self-reported knowledge about advance care planning was the key variable significantly associated with all four planning behaviors. The efforts of nurses to educate older adults regarding the process of advance care planning can play an important role in enhancing autonomy.

Recruitment of racial/ethnic minority older adults through community sites for focus group discussions.

Science.gov (United States)

Northridge, Mary E; Shedlin, Michele; Schrimshaw, Eric W; Estrada, Ivette; De La Cruz, Leydis; Peralta, Rogelina; Birdsall, Stacia; Metcalf, Sara S; Chakraborty, Bibhas; Kunzel, Carol

2017-06-09

Despite a body of evidence on racial/ethnic minority enrollment and retention in research, literature specifically focused on recruiting racially/ethnically diverse older adults for social science studies is limited. There is a need for more rigorous research on methodological issues and the efficacy of recruitment methods. Cultural obstacles to recruitment of racial/ethnic minority older adults include language barriers, lack of cultural sensitivity of target communities on the part of researchers, and culturally inappropriate assessment tools. Guided by the Consolidated Framework for Implementation Research (CFIR), this study critically appraised the recruitment of racial/ethnic minority older adults for focus groups. The initial approach involved using the physical and social infrastructure of the ElderSmile network, a community-based initiative to promote oral and general health and conduct health screenings in places where older adults gather, to recruit racial/ethnic minority adults for a social science component of an interdisciplinary initiative. The process involved planning a recruitment strategy, engaging the individuals involved in its implementation (opinion leaders in senior centers, program staff as implementation leaders, senior community-based colleagues as champions, and motivated center directors as change agents), executing the recruitment plan, and reflecting on the process of implementation. While the recruitment phase of the study was delayed by 6 months to allow for ongoing recruitment and filling of focus group slots, the flexibility of the recruitment plan, the expertise of the research team members, the perseverance of the recruitment staff, and the cultivation of change agents ultimately resulted in meeting the study targets for enrollment in terms of both numbers of focus group discussions (n = 24) and numbers of participants (n = 194). This study adds to the literature in two important ways. First, we leveraged the social and

Recruitment of racial/ethnic minority older adults through community sites for focus group discussions

Directory of Open Access Journals (Sweden)

Mary E. Northridge

2017-06-01

Full Text Available Abstract Background Despite a body of evidence on racial/ethnic minority enrollment and retention in research, literature specifically focused on recruiting racially/ethnically diverse older adults for social science studies is limited. There is a need for more rigorous research on methodological issues and the efficacy of recruitment methods. Cultural obstacles to recruitment of racial/ethnic minority older adults include language barriers, lack of cultural sensitivity of target communities on the part of researchers, and culturally inappropriate assessment tools. Methods Guided by the Consolidated Framework for Implementation Research (CFIR, this study critically appraised the recruitment of racial/ethnic minority older adults for focus groups. The initial approach involved using the physical and social infrastructure of the ElderSmile network, a community-based initiative to promote oral and general health and conduct health screenings in places where older adults gather, to recruit racial/ethnic minority adults for a social science component of an interdisciplinary initiative. The process involved planning a recruitment strategy, engaging the individuals involved in its implementation (opinion leaders in senior centers, program staff as implementation leaders, senior community-based colleagues as champions, and motivated center directors as change agents, executing the recruitment plan, and reflecting on the process of implementation. Results While the recruitment phase of the study was delayed by 6 months to allow for ongoing recruitment and filling of focus group slots, the flexibility of the recruitment plan, the expertise of the research team members, the perseverance of the recruitment staff, and the cultivation of change agents ultimately resulted in meeting the study targets for enrollment in terms of both numbers of focus group discussions (n = 24 and numbers of participants (n = 194. Conclusions This study adds to the

A Randomized Trial of a Multifaceted Intervention to Reduce Falls among Community-Dwelling Adults

Science.gov (United States)

Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.

2010-01-01

Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…

Exploring factors associated with sexual activity in community-dwelling older adults.

Science.gov (United States)

Killinger, Kim A; Boura, Judith A; Diokno, Ananias C

2014-01-01

Sexuality is an important, yet often overlooked, aspect of successful aging. The current article explores potential relationships between sexual activity in older adults and marital status, health, mobility, urinary incontinence, and caffeine and alcohol use, as well as sexual desire and erectile function in women and men, respectively. A survey was mailed to community-dwelling older adults 60 and older. Of 242 respondents (79% ages 60 to 74, 53% male), 159 (65.7%) were sexually active. A higher proportion of sexually active adults were married (p = 0.0005), had better health (p = 0.0003), and drank alcohol (p = 0.007). A lower proportion of sexually active adults had urinary incontinence (p = 0.006). Similar proportions of men and women were sexually active (62.8% and 68.2%, respectively; p = 0.38). Sexually active women had better sexual desire scores (p Sexually active men had better mobility (p = 0.012) and erectile function (p sexually active men had incontinence (p sexual health in older adults. Copyright 2014, SLACK Incorporated.

A Qualitative Study Exploring Community Yoga Practice in Adults with Rheumatoid Arthritis.

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Greysen, Heather M; Greysen, S Ryan; Lee, Kathryn A; Hong, Oi Saeng; Katz, Patricia; Leutwyler, Heather

2017-06-01

Yoga may improve physical function and reduce disease symptoms in adults with rheumatoid arthritis (RA). However, little is known about how patients with RA are practicing yoga in the community. The objective of this qualitative study was to explore community yoga practice characteristics and thoughts about yoga practice for adults with RA. Participants completed a semi-structured telephone interview with open-ended questions. Thematic analysis was used to analyze interview transcripts. A convenience sample of 17 adults with rheumatologist-diagnosed RA who had participated in yoga within the past year were asked about the decision to start, continue, and stop yoga; the perceived benefits of yoga; components of yoga sessions; and general thoughts about yoga as it relates to RA. Although eight different styles of yoga were practiced, commonalities in yoga class components (such as stretching, strengthening, deep breathing, meditation, and positive messaging from the instructor) reveal examples of preferred types of yoga for patients with RA. Three main themes emerged, each with multiple subthemes: (1) motivators (physical fitness, influence of others, reduced price), (2) barriers (cost, symptom burden, class difficulty), and (3) benefits of yoga practice (mind-body, a tool for coping, pride/achievement, social, and "yoga meets you where you are"). In this study, patients with RA described how yoga practice helped improve physical and psychosocial symptoms related to their disease. Yoga practice, a dynamic exercise, encompassing many different styles, can provide many benefits for adults with RA; however, yoga may not be beneficial for every adult with RA.

Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample.

Science.gov (United States)

Collishaw, Stephan; Pickles, Andrew; Messer, Julie; Rutter, Michael; Shearer, Christina; Maughan, Barbara

2007-03-01

Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse. Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style. Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.

Role of Colleges in Adult Education--Adjustments

Science.gov (United States)

Mathias, Irene

1978-01-01

If colleges are to be relevant to the needs of India, they must plan and implement programs of direct benefit to the community and thus contribute to the nation's resolve to extend adult education programs within the next five years to combat illiteracy. (LBH)

Strengthening the role of Community Health Representatives in the Navajo Nation

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Caroline King

2017-04-01

Full Text Available Abstract Background Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. Methods The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. Results CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. Conclusions These findings suggest that CHRs have experienced

Evaluating the Impacts of Professional Development: A Mixed Method Study of Adult Education Learning Communities

Science.gov (United States)

Dilworth, Jessica S.

2010-01-01

Adult education programs providing classes to students preparing for high school equivalency and learning English that demonstrate characteristics of learning organizations may be better able to thrive when confronted with less-than-ideal circumstances. Many of these programs organize adult educators into learning communities as the context for…

Community Building as an Instructional Goal in Japanese Adult Basic Education

Science.gov (United States)

Jacobson, Erik

2009-01-01

This paper presents the results of a multisite case study of adult basic education in Japan. A key finding of the study is that as part of community building within classrooms, students, teachers, and administrators prioritize human relations and expressions of empathy rather than academic skill development. In contrast to Japanese educational…

Aggressive Challenging Behaviour in Adults with Intellectual Disability Following Community Resettlement

Science.gov (United States)

Bhaumik, S.; Watson, J. M.; Devapriam, J.; Raju, L. B.; Tin, N. N.; Kiani, R.; Talbott, L.; Parker, R.; Moore, L.; Majumdar, S. K.; Ganghadaran, S. K.; Dixon, K.; Gupta, A. Das; Barrett, M.; Tyrer, F.

2009-01-01

Background: Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long-term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging…

Statin Use and Decline in Gait Speed in Community-Dwelling Older Adults

DEFF Research Database (Denmark)

Lo-Ciganic, W. H.; Perera, S.; Gray, S. L.

2015-01-01

ObjectivesTo examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults. DesignLongitudinal cohort study. SettingHealth, Aging and Body Composition (Health ABC) Study. ParticipantsTwo thousand five participants aged 70-79 at baseli...

Transcending jurisdictions: developing partnerships for health in Manitoba First Nation communities.

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Eni, Rachel; Phillips-Beck, Wanda

2011-09-01

The article describes national, regional and community-level activities that contributed to the Manitoba First Nation partnership in maternal and child health programming. The activities reveal a potential for health change that is possible through working together across jurisdictional boundaries. Although we are only in the early phases of program implementation, the Manitoba First Nation Strengthening Families Maternal Child Health Program already suggests considerable successes and measurable outcomes. The article encourages development of further partnerships in the promotion of First Nation health and wellness programming.

High School Community Service as a Predictor of Adult Voting and Volunteering

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Hart, Daniel; Donnelly, Thomas M.; Youniss, James; Atkins, Robert

2007-01-01

The influences of high school community service participation, extracurricular involvement, and civic knowledge on voting and volunteering in early adulthood were examined using the National Educational Longitudinal Study. The major finding in this study is that both voluntary and school-required community service in high school were strong…

Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

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Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

2016-07-08

Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

Piloting the older adult financial exploitation measure in adult safeguarding services.

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Phelan, A; Fealy, G; Downes, C

Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

Community integration after severe traumatic brain injury in adults.

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Truelle, Jean-Luc; Fayol, Patrick; Montreuil, Michèle; Chevignard, Mathilde

2010-12-01

Despite being the main cause of death and disability in young adults, traumatic brain injury (TBI) is a rather neglected epidemic. Community integration of persons with TBI was, until recently, insufficiently informed by clinical research. To bridge the gap between rehabilitation and community re-entry, the first task is to assess the person, using TBI-specific outcome measures. The second task is to provide re-entry programs, the effectiveness of which is assessed by those measures, using well designed studies. There are very few such studies. However, there are some effective comprehensive programs and others which are specifically targeted dealing mainly with return to work, behavior, and family issues. The complex psychological and environmental components of the disability require individualized and often long-term care. For persons with severe TBI trying to achieve the best possible community integration a new semiology is required, not just limited to medical care, but also involving social and psychological care that is tailored to the needs of each individual and family, living within his/her environment. Currently, only a minority benefit from well validated programs.

The effectiveness of Pilates on balance and falls in community dwelling older adults.

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Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

2016-10-01

The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Understanding views on everyday use of personal health information: Insights from community dwelling older adults.

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Hartzler, A L; Osterhage, K; Demiris, G; Phelan, E A; Thielke, S M; Turner, A M

2018-09-01

Older adults apply various strategies to pursue healthy aging, but we know little about their views and use of personal health information to accomplish those ends. As a first step in formulating the role of personal health information management (PHIM) in healthy aging, we explored the perspectives of older adults on health and health information used in their everyday lives through four focus groups with 25 community-dwelling adults aged 60 and over. We found that the concept of wellness-the holistic and multidimensional nature of health and wellbeing-plays prominently in how older adults think about health and health information. Participants expressed wellness from a position of personal strength, rather than health-related deficits, by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement. Although these themes involve personal health information, existing PHIM systems that focus on disease management are generally not designed to support wellness activities. Substantial opportunity exists to fill this wellness support gap with innovative health information technology designed for older adults. Findings carry implications for the design of PHIM tools that support healthy aging and methods for engaging older adults as co-producers of this critical support.

Child-adult Creating Community as an Institution of Education

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Khaikin V.L.,

2014-08-01

Full Text Available The article analyzes the possibilities of education to overcome infantilism and consumer orientation of the younger generation. Even humanistic “pedagogy of relations” is being eroded in the consumer society. Nowadays, to talk about school and to build the school in which children feel only cozy, comfortable and convenient means to prepare new victims of consumerism. The authors state the need of moving from the usual methods and forms of education (formally ritualized, verbal, leisure and entertainment ones to the creative, activity methods and forms, which cultivate the relationships of responsible care. The new institute of education, which is child-adult creating community, is justified both theoretically and practically. The authors provide the examples of mutually beneficial and developing cooperation of adults and children based on the principles of technology, self-management, social entrepreneurship and social service

Spillover effects of community uninsurance on working-age adults and seniors: an instrumental variables analysis.

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Gresenz, Carole Roan; Escarce, José J

2011-09-01

: Previous research suggests, but does not definitively establish, that a high level of uninsurance in a community may negatively affect access to and quality of health care for insured persons. : To assess the effect of the level of uninsurance in a community on access to and satisfaction with care-an important dimension of quality-among insured persons. : The 1996 to 2006 Medical Expenditure Panel Survey Household Component data linked to data from the Current Population Survey, Area Resource File, and the InterStudy Competitive Edge. Analyses include 86,928 insured adult respondents living in approximately 200 large metropolitan areas. : Measures of whether an individual had a usual source of care, had any delay/difficulty obtaining needed care, used office-based services, used prescription drug services, and used any medical services, and measures of satisfaction with care. : Among privately insured adults, a higher community uninsurance rate resulted in a lower probability of having a usual source of care, having an office-based visit, having any medical expenditures, and reporting being satisfied with the quality of care provided by the usual source of care. A higher community uninsurance rate also led to a higher probability of reporting difficulty obtaining needed care. Among Medicare enrollees, a higher community uninsurance rate resulted in lower reported satisfaction with care and higher probability of experiencing difficulty or delay in getting needed care. : Our results suggest substantial spillover effects of the community uninsurance rate on access to and satisfaction with health care among insured working-age adults and seniors. Consequently, new efforts to address the problem of the uninsured may bring significant benefits to persons who already have insurance.

Fecal incontinence knowledge, attitudes, and help-seeking behaviors among community-dwelling adults in Korea.

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Joh, Hee-Kyung; Seong, Moo-Kyung; Ahn, Hyun-Jun

2018-04-01

Fecal incontinence (FI) is a common debilitating disorder that tends to be underreported. Although low health literacy likely contributes to the underreporting, studies on FI knowledge among the general population remain scarce. We investigated how FI knowledge is associated with attitudes and help-seeking behaviors. We conducted a cross-sectional survey among community-dwelling adults undergoing national health screening in Korea. A structured, self-administered questionnaire was used to assess FI knowledge, attitudes, and help-seeking behaviors. Odds ratios (ORs; 95% confidence intervals, CIs) were estimated using logistic regression with adjustment for covariables. Of the 601 participants completing the survey, only 29.8% were aware of the term FI, and their knowledge levels were insufficient. As for FI-related attitudes, 24.6% considered FI to be very rare, and 22.3% considered it to be moderately or less distressing. Individuals who knew the term FI tended to consider FI more common (OR: 2.45; 95%CI: 1.49-4.02) and distressing (OR: 1.68; 95%CI: 1.07-2.63) than those without knowledge. Assuming future FI occurrence, those considering FI to be distressing were less willing to ignore or self-manage the condition (OR: 0.25; 95%CI: 0.11-0.58). Among patients with FI (n = 83), only 30.1% had sought help and 8.4% had consulted doctors. Knowing the term FI was significantly associated with overall help-seeking behavior (OR: 9.23; 95%CI: 2.09-40.77). FI knowledge levels and help-seeking rates were low among community-dwelling adults. FI knowledge was significantly associated with attitudes and help-seeking behaviors. Future public education programs are warranted to improve FI knowledge, attitudes, and help-seeking behaviors. © 2018 Wiley Periodicals, Inc.

Teaching Community Survival Skills to Mentally Retarded Adults: A Review and Analysis.

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Martin, James E.; And Others

1982-01-01

The article reviews research on training mentally retarded adults in the following community survival skills: travel training, money management, meal preparation, clothing and personal care, telephone skill, housekeeping, self-medication, leisure skills, social skills, and conversation. Results are said to indicate the value of behavioral…

Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

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Yeom, Hye A; Fleury, Julie; Keller, Colleen

2008-01-01

Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

Life-Space Predicts Health Care Utilization in Community-Dwelling Older Adults.

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Kennedy, Richard E; Williams, Courtney P; Sawyer, Patricia; Lo, Alexander X; Connelly, Kay; Nassel, Ariann; Brown, Cynthia J

2017-09-01

To determine whether decline in life-space mobility predicts increased health care utilization among community-dwelling older adults. Health care utilization (number of emergency department [ED] visits and hospitalizations) was self-reported during monthly interviews among 419 community-dwelling African American and non-Hispanic White adults aged 75 years and older in The University of Alabama at Birmingham (UAB) Study of Aging II. Life-space was measured using the UAB Life-Space Assessment. Generalized estimating equations were used to examine associations of life-space at the beginning of each interval with health care utilization over the 1-month interval. Overall, 400 participants were followed for 36 months. A 10-point decrease in life-space was associated with 14% increased odds of an ED visit and/or hospitalization over the next month, adjusting for demographics, transportation difficulty, comorbidity, and having a doctor visit in the last month. Life-space is a practical alternative in predicting future health care utilization to performance-based measures, which can be difficult to incorporate into clinical or public health practice.

Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia.

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Siti Fatimah Kader Maideen

Full Text Available INTRODUCTION: Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor. METHODS: A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires. RESULTS: A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9 was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity. CONCLUSION: The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the

Physical performance measures that predict faller status in community-dwelling older adults.

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Macrae, P G; Lacourse, M; Moldavon, R

1992-01-01

Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

Pathways to Youth Empowerment and Community Connectedness: A Study of Youth-Adult Partnership in Malaysian After-School, Co-Curricular Programs.

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Zeldin, Shepherd; Krauss, Steven Eric; Kim, Taehan; Collura, Jessica; Abdullah, Haslinda

2016-08-01

After-school programs are prevalent across the world, but there is a paucity of research that examines quality within the "black box" of programs at the point of service. Grounded in current theory, this research examined hypothesized pathways between the experience of youth-adult partnership (youth voice in decision-making; supportive adult relationships), the mediators of program safety and engagement, and the developmental outcomes of youth empowerment (leadership competence, policy control) and community connectedness (community connections, school attachment). Surveys were administered to 207 ethnically diverse (47.3 % female; 63.3 % Malay) youth, age 15-16, attending after-school co-curricular programs in Kuala Lumpur, Malaysia. Results showed that youth voice in program decision-making predicted both indicators of youth empowerment. Neither youth voice nor supportive adult relationships was directly associated with community connectedness, however. Program engagement mediated the associations between youth-adult partnership and empowerment. In contrast, program safety mediated the associations between youth-adult partnership and community connectedness. The findings indicate that the two core components of youth-adult partnership-youth voice and supportive adult relationships-may operate through different, yet complementary, pathways of program quality to predict developmental outcomes. Implications for future research are highlighted. For reasons of youth development and youth rights, the immediate challenge is to create opportunities for youth to speak on issues of program concern and to elevate those adults who are able and willing to help youth exercise their voice.

The Prevalence and Correlates of Gambling Participation among Community-Dwelling Chinese Older Adults in the U.S.

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Ruijia Chen

2015-05-01

Full Text Available This study aimed to examine the prevalence and correlates of gambling participation and problems among community-dwelling Chinese older adults in the U.S. Based on a community-based participatory research approach, the study enrolled 3,159 Chinese older adults aged 60 years and above in the greater Chicago area. Among the participants, 58.9% were women and the average age was 72.8 years. Overall, 467 older adults had engaged in gambling in the past twelve months and 65 older adults had experienced any risk of problem gambling. Visiting a casino was the most commonly reported type of gambling, whereas betting on Mahjong had the highest frequency. Being male, lower educational levels, higher income levels, having more children, living in the U.S. for a longer period of time, living in the community for a longer period of time, better health status, lower quality of life, and improved health over the past year were significantly correlated with any gambling in the past year. Younger age, being male, and living with more people were significantly correlated with experiencing any risk of problem gambling in the past year. Future studies should be conducted to better examine the health effects of gambling and problem gambling among Chinese older adults.

Grad Nation: A Guidebook to Help Communities Tackle the Dropout Crisis

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Balfanz, Robert; Fox, Joanna Hornig; Bridgeland, John M.; McNaught, Mary

2009-01-01

With more than one million students dropping out of high school each year, Grad Nation is specifically designed to offer solutions and tools for every size community and presents a compelling case for all sectors of society to get involved. The guidebook is part of the Alliance's Dropout Prevention Campaign. The guide brings together the nation's…

Reach and Effectiveness of an Integrated Community-Based Intervention on Physical Activity and Healthy Eating of Older Adults in a Socioeconomically Disadvantaged Community

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Luten, Karla A.; Reijneveld, Sijmen A.; Dijkstra, Arie; de Winter, Andrea F.

2016-01-01

The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled pre-post quasi-experimental design, with 430…

Assessing control of postural stability in community-living older adults using performance-based limits of stability

DEFF Research Database (Denmark)

Jbabdi, Myriam; Boissy, Patrice; Hamel, Mathieu

2008-01-01

BACKGROUND: Balance disability measurements routinely used to identify fall risks in frail populations have limited value in the early detection of postural stability deficits in community-living older adults. The objectives of the study were to 1) measure performance-based limits of stability (LOS......-session performance variability during multiple trials using the performance-based LOS paradigm. METHODS: Twenty-four healthy community-living older adults (10 men, 14 women) aged between 62 to 85 (mean age +/- sd, 71.5 +/- 6 yrs) participated in the study. Subjects' performance-based LOS were established by asking...

Adult Learning for Social Change in Museums: An Exploration of Sociocultural Learning Approaches to Community Engagement

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Kim, Junghwan; You, Jieun; Yeon Park, Soo

2016-01-01

This integrative literature review critically examined how scholars were articulating the work of museums to make a space for "adult learning for social change through community engagement". We applied sociocultural adult learning theories (situated learning and cultural-historical activity theory), to 25 theoretical and empirical…

Effectiveness of community-based exercise intervention programme in obese adults with metabolic syndrome.

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Chang, Shu-Hung; Chen, Miao-Chuan; Chien, Nai-Hui; Lin, Hsih-Fong

2016-09-01

The objective of this study was to change the anthropometric, clinical, biochemical indicators and the rate of metabolic syndrome among obese adults in community. Obesity is an indicator of metabolic syndrome and cardiometabolic diseases. Obesity increases national health care expenditure in Taiwan. The high prevalence of obesity is not only a public health issue but also an economic problem. Changes in lifestyle can help to prevent metabolic syndrome for individuals with obesity. A randomised controlled trial was applied. In this randomised controlled trial by location, 136 metabolically abnormal obese individuals were included. The related indicators with metabolic syndrome were measured at baseline and after six months. The experimental group participated in a six-month community-based programme including provided exercise environments, exercise skills and volunteers' reminding. The control group was only provided environment and skills. One hundred and thirty-one participants completed this trail. In comparison with the baseline, the intervention group showed a significant increase in high-density lipoprotein cholesterol (2·34 mg/dl), and decrease in body weight (1·09 kg), waist circumference (3·63 cm), systolic blood pressure (10·52 mmHg), diastolic blood pressure (5·21 mmHg), fasting blood glucose (5·84 mg/dl) and body mass index (0·74 kg/m(2) ). In the control group, significant decrease in body mass index and waist circumference were discovered. Compared to the changes between the two groups, the results showed there were significant differences in waist circumference, systolic blood pressure, diastolic blood pressure and high-density lipoprotein cholesterol. The community-based intervention could help to improve high-density lipoprotein cholesterol, reduce body weight, body mass index, waist circumference, blood pressure and fasting blood glucose in metabolically abnormal obese. This community-based programme helped metabolically abnormal

A national survey on health department capacity for community engagement in emergency preparedness.

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Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

2015-01-01

Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

Time for National Renewal: Australian adult literacy and numeracy as ‘foundation skills’

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Stephen Black

2010-12-01

Full Text Available Those working in the field of adult literacy and numeracy are currently anticipating changes in the near future as the federal government has flagged the development of a National Foundation Skills Strategy (Australian Government 2010. ‘Foundation skills’ is a term that has recently been suggested as a way of simplifying discussions about literacy and numeracy (Perkins 2009:8, and it has gained traction in various Australian national policy environments (e.g. Gillard 2009, Council of Australian Governments [COAG] Reform Council 2009, Australian Government 2010. Foundation skills appears to encapsulate adult language, literacy and numeracy, and more broadly, it may also include so-called employability skills such as communication and teamwork (Roberts and Wignall 2010:1. In this paper, our main focus is on the adult literacy and numeracy dimensions of what is needed in the policy renewal.

Direct Marketing Promotion and Electronic Cigarette Use Among US Adults, National Adult Tobacco Survey, 2013-2014.

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Dai, Hongying; Hao, Jianqiang

2017-09-21

The use of electronic cigarettes (e-cigarettes) among US adults has increased since 2007. The objective of this study was to investigate the prevalence of direct marketing promotion of e-cigarettes and its association with e-cigarette use among US adults. We used using data from the 2013-2014 National Adult Tobacco Survey (NATS) to estimate prevalence of e-cigarette promotions received by mail or email. Multinomial logistic regression was used to examine the associations between e-cigarette promotions and the prevalence and frequency of e-cigarette use among US adults. In the 2013-2014 survey period, 7.1% of adults (about 16.0 million) reported receiving mail or email e-cigarette promotions in the previous 6 months; 3.2% received mail promotions, and 5.1% received email promotions. A higher prevalence of promotions was found among men versus women, adults aged under 65 years versus those older, current e-cigarette users, current smokers, and people with no smoking restriction rules in their homes or vehicles. In the multivariable analysis, receiving mail or email e-cigarette promotions was associated with higher odds of being current e-cigarette users (adjusted odds ratio [aOR] = 2.0; P marketing promotions was prevalent among US adults. Receiving e-cigarette promotions was associated with increased odds of both prevalence and frequency of e-cigarette use. Future longitudinal studies are needed to measure causal effects of e-cigarette promotions on e-cigarette use among adults.

The health benefits following regular ongoing exercise lifestyle in independent community-dwelling older Taiwanese adults.

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Wang, Ching-Yi; Yeh, Chih-Jung; Wang, Chia-Wei; Wang, Chun-Feng; Lin, Yen-Ling

2011-03-01

To examine the effect of regular ongoing exercise lifestyle on mental and physical health in a group of independent community-dwelling Taiwanese older adults over a 2-year period. 197 older adults (mean age 72.5 years; 106 men and 91 women) who were independent in walking, instrumental and basic activities of daily living completed the baseline and a 2-year follow-up assessment. Older adults regularly performing exercises during the 2-year study period were grouped into regular exercise group; otherwise in the irregular exercise group. Baseline and follow-up assessments included a face-to-face interview and a battery of performance tests. The regular exercise group showed significantly less depression (P = 0.03) and tended to regress less on the performance tests (P = 0.025-0.410) across 2 years compared to the irregular exercise group. Regular exercise is important for maintaining or even improving mental and functional health, even for independent community-dwelling older adults. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

Bisphenol-A and Sleep Adequacy among Adults in the National Health and Nutrition Examination Surveys

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Beydoun, Hind A.; Beydoun, May A.; Jeng, Hueiwang Anna; Zonderman, Alan B.; Eid, Shaker M.

2016-01-01

Study Objectives: To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. Methods: A population-based cross-sectional study was conducted using 2005–2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles ( 8 h); (Bisphenol-A and sleep adequacy among adults in the National Health and Nutrition Examination Surveys. SLEEP 2016;39(2):467–476. PMID:26446109

Self-perceived health status and sleep quality of older adults living in community after elastic band exercises.

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Chan, Shu-Ya; Chen, Kuei-Min

2017-07-01

To test the effectiveness of a six-month senior elastic band exercise programme on the self-perceived health status and sleep quality of older adults living in community settings. Health issues common among older adults living in community settings include poor physical and mental health conditions and sleep quality. Engagement in appropriate exercise programmes facilitates alleviating these health issues among older adults. A quasi-experimental design was applied. A convenience sample of older adults was drawn from six senior-citizen activity centres in southern Taiwan. Participants were assigned to either an experimental group (three centres, n = 97) or a control group (three centres, n = 102) based on the senior-citizen activity centres they attended. The participants in the experimental group carried out the Senior Elastic Band exercise programme for six months (three times per week and 40 minutes per session) in addition to their daily activities. The participants in the control group maintained their daily activities. The participants' self-perceived health status and sleep quality were examined at the baseline, three-month interval and six-month interval. In total, 169 participants completed the six-month study: 84 constituted the experimental group and 85 constituted the control group. At the three-month interval, the participants in the experimental group had greater improvements in self-perceived physical health, overall sleep quality, sleep latency and sleep duration compared with those in the control group; these significant changes continued throughout the six-month study. The Senior Elastic Band exercise programme showed promising effects in improving the self-perceived physical health and sleep quality of older adults living in community settings. Healthcare professionals can incorporate the Senior Elastic Band exercise programme as one of the health promotion activities for older adults living in community settings. © 2016 John Wiley & Sons

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

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Heidi H. Ewen

2017-03-01

Full Text Available Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%, homemaker services (19%, and transportation services (18%. More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Science.gov (United States)

Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

2017-01-01

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

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Yoshikawa, Masanori; Yamamoto, Yoshifumi; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Osa, Takao; Uyama, Hiroki; Okamoto, Nozomi; Kurumatani, Norio; Kimura, Hiroshi

2017-12-01

As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426. © 2017 Japan Geriatrics Society.

Health-social partnership intervention programme for community-dwelling older adults: a research protocol for a randomized controlled trial.

Science.gov (United States)

Wong, Kwan Ching; Wong, Frances Kam Yuet; Chang, Katherine Ka Pik

2015-11-01

This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. This is a randomized, controlled trial. Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. © 2015 John Wiley & Sons Ltd.

Social networks and health-related quality of life among Chinese old adults in urban areas: results from 4th National Household Health Survey.

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Lei, P; Xu, L; Nwaru, B I; Long, Q; Wu, Z

2016-02-01

To examine the associations between components of social networks and health-related quality of life (HRQoL) in community-dwelling old adults in urban areas in China. Data from the 4th National Household Health Survey (NHHS) in China, conducted in 2008, were used. HRQoL of respondents aged ≥15 years was assessed using EQ-5D in the NHHS. The sample for the current analysis included 9833 old adults aged ≥60 years. Multiple linear and logistic regression models were used to assess the associations between indicators of social network and HRQoL. Approximately 6% of the respondents saw their children once a year or less, and approximately 1% reported that they had no children. Thirteen percent of the sample seldom contacted their neighbours and seldom met with relatives or friends; approximately 62% seldom attended social gatherings. The five dimensions of HRQoL (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) were reported to be moderate or severe in 14.5%, 9.4%, 12.6%, 18.3% and 9.3% of the sample, respectively. The mean visual analogue scale (VAS) score and EQ-5D index using the time trade-off method was 70.96 [standard deviation (SD) 14.79] and 0.869 (SD 0.163), respectively. After adjusting for potential confounding variables, old adults with weaker social networks were more likely to report problems on EQ-5D dimensions, lower VAS scores and lower EQ-5D indexes. For old adults living in urban communities in China, increased social participation has a positive effect on various dimensions of HRQoL. There is a need for policy considerations that will improve integration of community-level public resources in order to encourage frequent social interaction among old adults, and promote health and social care as a whole. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Reviewing the National Courts in Creating Orderly International Law and Community

Directory of Open Access Journals (Sweden)

Johanis Leatemia

2017-08-01

Full Text Available Orderly international community and international law are determined by a national court. Essentially, the national court must be competent to maintain the balance between the national interest which based on the national sovereignty as well as the provisions of international law within the framework of peaceful coexistence. This article reviews the role of national courts in creating and developing the customary international law. As it turns out in practice, however, it has certain weaknesses, particularly in view of the accountability and legitimacy aspects of its establishment. This purpose could be achieved if national courts were able to maintain a balance between the national interest based on the sovereignty of State on the one hand and the provisions of international law on the other. The function of the national court was to maintain a balance between international law and national law.

Association of chronic widespread pain with objectively measured physical activity in adults: findings from the National Health and Nutrition Examination survey.

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Dansie, Elizabeth J; Turk, Dennis C; Martin, Kathryn R; Van Domelen, Dane R; Patel, Kushang V

2014-05-01

Chronic widespread pain (CWP) is a common and potentially debilitating disorder. Patterns of physical activity (PA) in adults with CWP have primarily been investigated using subjective, self-report measures. The current study sought to characterize PA among community-dwelling individuals with CWP, chronic regional pain, or no chronic pain using objective measurements obtained via accelerometry in the 2003 to 2004 National Health and Nutrition Examination Survey. Data from 3,952 participants ages 20 and older were analyzed to assess relationships between pain status and objective measurements of PA. Prevalence of CWP was 3.3% and 5.4% in men and women, respectively. In men and women, the average activity counts per minute and time spent in moderate-to-vigorous PA were significantly lower for the CWP group than for the no chronic pain group. Interestingly, time spent in sedentary, light, and lifestyle activities was not associated with pain status. Statistical interaction tests indicated that the effects of chronic pain on counts per minute were stronger in men than in women. Despite recommendations for increased moderate-to-vigorous PA as a pain management strategy for CWP, results from this nationally representative study indicate that adults with CWP participate in less moderate-to-vigorous PA than individuals without chronic pain. Using objective measurement of PA in a nationally representative sample, this study demonstrates that adults with CWP participate in reduced daily and moderate-to-vigorous PA in comparison to people with no chronic pain. Findings indicate that clinicians should emphasize the importance of increasing PA in patients with CWP. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Comparison of the Berg Balance Scale and Fullerton Advanced Balance Scale to predict falls in community-dwelling adults

OpenAIRE

Jeon, Yong-Jin; Kim, Gyoung-Mo

2017-01-01

[Purpose] The purpose of this study was to investigate and compare the predictive properties of Berg Balance Scale and Fullerton Advanced Balance Scales, in a group of independently-functioning community dwelling older adults. [Subjects and Methods] Ninety-seven community-dwelling older adults (male=39, female=58) who were capable of walking independently on assessment were included in this study. A binary logistic regression analysis of the Berg Balance Scale and Fullerton Advanced Balance S...

Understanding Social Isolation Among Urban Aging Adults: Informing Occupation-Based Approaches.

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Hand, Carri; Retrum, Jessica; Ware, George; Iwasaki, Patricia; Moaalii, Gabe; Main, Deborah S

2017-10-01

Socially isolated aging adults are at risk of poor health and well-being. Occupational therapy can help address this issue; however, information is needed to guide such work. National surveys characterize social isolation in populations of aging adults but fail to provide meaningful information at a community level. The objective of this study is to describe multiple dimensions of social isolation and related factors among aging adults in diverse urban neighborhoods. Community-based participatory research involving a door-to-door survey of adults 50 years and older was used. Participants ( N = 161) reported social isolation in terms of small social networks (24%) and wanting more social engagement (43%). Participants aged 50 to 64 years reported the highest levels of isolation in most dimensions. Low income, poor health, lack of transportation, and infrequent information access appeared linked to social isolation. Occupational therapists can address social isolation in similar urban communities through policy and practice that facilitate social engagement and network building.

The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults.

Science.gov (United States)

Yamada, Minoru; Aoyama, Tomoki; Nakamura, Masatoshi; Tanaka, Buichi; Nagai, Koutatsu; Tatematsu, Noriatsu; Uemura, Kazuki; Nakamura, Takashi; Tsuboyama, Tadao; Ichihashi, Noriaki

2011-01-01

The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults. Copyright © 2011 Mosby, Inc. All rights reserved.

Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

Science.gov (United States)

Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

2017-04-01

Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (Pfall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

Community Resilience Education: Lessons Learned from an Emerging Community of Practice - NOAA's Environmental Literacy Grantees

Science.gov (United States)

Schoedinger, S. E.; McDougall, C.

2017-12-01

NOAA supports community resilience to extreme weather events, climate change and other environmental hazards by preparing communities through Weather Ready Nation and through programs addressing coastal community needs. These programs primarily target adult decisions makers in a professional capacity (emergency managers, city planners, et al.), leaving non-professional audiences without opportunities to understand and develop the skills to prepare for the threats and vulnerabilities that their communities face. As a result, resilience became the focus of NOAA's Environmental Literacy Grants in 2015. The goal of these investments is to strengthen the public's and/or K-12 students' environmental literacy to enable informed decision-making necessary for community resilience to extreme weather events and other environmental hazards. Funded projects build an understanding of Earth systems and the threats and vulnerabilities that are associated with a community's location, are aligned with existing adaptation/resilience plans, and connect audiences to relevant tools and resources to prepare for and respond to these hazards. These first few years of investment will create new models for how education can improve community resilience. Although these projects incorporate a variety of approaches, a few common themes stand out: empowering youth and adults to increase their understanding of locally relevant natural hazards and stresses; giving youth a voice in resilience planning; and student-led vulnerability assessments of their schools and communities. In this session we will report on the first convening of the principal investigators of our 13 funded projects, which represents the beginning of a new community of practice focused on resilience education. We will specifically share lessons learned about: engaging youth and adults about climate change and resiliency; working with local resilience/adaptation planners; and case studies on the use of NOAA's Digital Coast and

National STD Awareness Month and GYT: Get Yourself Tested PSA (:60)

Centers for Disease Control (CDC) Podcasts

2011-03-03

April is National STD Awareness Month. In this PSA, native communities, especially adolescents and young adults, are encouraged to get educated, tested, and treated by visiting gytnow.org.  Created: 3/3/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 3/3/2011.

High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults-A Systematic Review and Meta-Analysis.

Science.gov (United States)

Verlaan, Sjors; Ligthart-Melis, Gerdien C; Wijers, Sander L J; Cederholm, Tommy; Maier, Andrea B; de van der Schueren, Marian A E

2017-05-01

Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other. A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini- Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa. In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Source Water Protection Planning for Ontario First Nations Communities: Case Studies Identifying Challenges and Outcomes

Directory of Open Access Journals (Sweden)

Leslie Collins

2017-07-01

Full Text Available After the Walkerton tragedy in 2000, where drinking water contamination left seven people dead and many suffering from chronic illness, the Province of Ontario, Canada implemented policies to develop Source Water Protection (SWP plans. Under the Clean Water Act (2006, thirty-six regional Conservation Authorities were mandated to develop watershed-based SWP plans under 19 Source Protection Regions. Most First Nations in Ontario are outside of these Source Protection Regions and reserve lands are under Federal jurisdiction. This paper explores how First Nations in Ontario are attempting to address SWP to improve drinking water quality in their communities even though these communities are not part of the Ontario SWP framework. The case studies highlight the gap between the regulatory requirements of the Federal and Provincial governments and the challenges for First Nations in Ontario from lack of funding to implement solutions to address the threats identified in SWP planning. This analysis of different approaches taken by Ontario First Nations shows that the Ontario framework for SWP planning is not an option for the majority of First Nations communities, and does not adequately address threats originating on reserve lands. First Nations attempting to address on-reserve threats to drinking water are using a variety of resources and approaches to develop community SWP plans. However, a common theme of all the cases surveyed is a lack of funding to support implementing solutions for the threats identified by the SWP planning process. Federal government initiatives to address the chronic problem of boil water advisories within Indigenous communities do not recognize SWP planning as a cost-effective tool for improving drinking water quality.

The National Hartford Center of Gerontological Nursing Excellence: An Evolution of a Nursing Initiative to Improve Care of Older Adults.

Science.gov (United States)

Harden, J Taylor; Watman, Rachael A

2015-06-01

, which has become paramount as Hartford Foundation funding ends in 2016. Despite the auspicious beginnings of the National Hartford Center, system change has been slow. There remains a strong need to continue to grow the field of gerontological nursing and aging sciences. We are working diligently to drive health system reform, and develop and support gerontological nursing leaders and members of the National Hartford Center as exemplars for innovation in care of older adults. The contributing authors of this supplement are from member schools of the National Hartford Center or are current or past program Scholars or Fellows. Herein these authors showcase innovation for older adults through their research that addresses an array of diseases and conditions affecting human systems, embedded in a variety of environments, including in-home care, subsidized housing communities, nursing homes, assisted living facilities, memory care units, and rural community environs. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Further evidence for the validity of a response inconsistency scale for the Personality Inventory for DSM-5 in Italian community-dwelling adolescents, community-dwelling adults, and clinical adults.

Science.gov (United States)

Somma, Antonella; Borroni, Serena; Kelley, Shannon E; Edens, John F; Fossati, Andrea

2018-03-22

Response inconsistency represents a major component of careless responding. Keeley, J. W., Webb, Peterson, Roussin, and Flanagan (2016) proposed a measure of response inconsistency for the Personality Inventory for DSM-5 (PID-5-VRIN). In order to evaluate the ability of the PID-5-VRIN scale to detect inconsistent responding, we examined 3 independent archival samples of Italian community-dwelling adolescents (N = 1,264), community-dwelling adults (N = 2,143), and clinical adults (N = 706) who were administered the PID-5. The impact of PID-5-VRIN scores on the associations with interview-based personality disorder (PD) scores was also assessed among clinical adults. PID-5-VRIN item pairs showed correlational values of at least medium size by conventional standards. Moreover, the PID-5-VRIN seemed to be efficient in discriminating real data from random responses in all samples. In line with Keeley and colleagues' findings, a PID-5-VRIN total score of 17 represented the best balance between sensitivity and specificity in all samples. Clinical adult participants who met this threshold for invalidity also obtained significantly higher scores on the majority of PID-5 trait scales. When the correlations between selected PID-5 trait scale scores and the corresponding interview-based ratings of DSM-5 Section II PDs were considered, appreciable differences in the magnitude and/or direction of association were observed between participants scoring below the PID-5-VRIN cutoff and those meeting the threshold for invalidity (≥17). As a whole, our data suggest that the PID-5-VRIN represents an efficient means of assessing inconsistent responding on the PID-5. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults-National Adult Tobacco Survey, 2009-2010 and 2013-2014.

Science.gov (United States)

Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-10-26

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009-2010 and 2013-2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009-2010 to 2013-2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = -10.9%; p Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms.

Religiosity, Discrimination, and Community Engagement: Gendered Pathways of Muslim American Emerging Adults

Science.gov (United States)

Sirin, Selcuk R.; Katsiaficas, Dalal

2011-01-01

The attacks on September 11, 2001, changed the lives of all Americans. For many immigrant Muslims in the United States this meant dealing with an elevated amount of discrimination. This study investigated how perceived discrimination influenced levels of community engagement among Muslim American emerging adults and whether it varied by gender.…

Nation/non-nation

DEFF Research Database (Denmark)

Sonnichsen, André; Gad, Ulrik Pram

2008-01-01

Is nationality the only way of organizing political community? Given the ubiquity of the national principle, one might think so. But, in practice, the national principle is constantly challenged by what can be termed non-national identities. This article looks at manners in which such deviating...... identities can be conceptualized, how contemporary European states have attempted to deal with them when they arise and to what extent non-national modes of organizing political community can point towards a challenge to the national principle itself. In its capacity as an introduction to the special issue......, this article seeks to frame the subsequent articles within the overarching theme of the tension between national and non-national communities in contemporary Europe....

Measurement and visualization of face-to-face interaction among community-dwelling older adults using wearable sensors.

Science.gov (United States)

Masumoto, Kouhei; Yaguchi, Takaharu; Matsuda, Hiroshi; Tani, Hideaki; Tozuka, Keisuke; Kondo, Narihiko; Okada, Shuichi

2017-10-01

A number of interventions have been undertaken to develop and promote social networks among community-dwelling older adults. However, it has been difficult to examine the effects of these interventions, because of problems in assessing interactions. The present study was designed to quantitatively measure and visualize face-to-face interactions among elderly participants in an exercise program. We also examined relationships among interactional variables, personality and interest in community involvement, including interactions with the local community. Older adults living in the same community were recruited to participate in an exercise program that consisted of four sessions. We collected data on face-to-face interactions of the participants by using a wearable sensor technology device. Network analysis identified the communication networks of participants in the exercise program, as well as changes in these networks. Additionally, there were significant correlations between the number of people involved in face-to-face interactions and changes in both interest in community involvement and interactions with local community residents, as well as personality traits, including agreeableness. Social networks in the community are essential for solving problems caused by the aging society. We showed the possible applications of face-to-face interactional data for identifying core participants having many interactions, and isolated participants having only a few interactions within the community. Such data would be useful for carrying out efficient interventions for increasing participants' involvement with their community. Geriatr Gerontol Int 2017; 17: 1752-1758. © 2017 Japan Geriatrics Society.

Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008–2013 Korean Community Health Survey

Science.gov (United States)

Logan, Sarah

2016-01-01

Objective To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. Methods We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Results Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (pfall accidents decreased from 38.12% to 23.16% (pfall accidents than males (pfall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). Conclusion The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults. PMID:27606272

National Identity and Migration in an Emerging Gateway Community

Directory of Open Access Journals (Sweden)

Jennifer Byrne

2018-04-01

Full Text Available This paper examines how conceptions of national and local identity influence reactions to migration in the Shenandoah Valley, a rural location in Southwest Virginia with unique demographic characteristics. While Shenandoah Valley residents have been predominantly non-Hispanic whites of European descent, a recent visible influx of Hispanic laborers, a higher than national average Muslim population, a history of refugee resettlement and the migration of urbanites from Northern Virginia have made the Valley one of the most diverse locations in the state of Virginia today. Using a qualitative methods approach with both apriori and emergent coding, I offer some insights as to how a traditional ethnic and civic framework of national identity and emergent themes of local identity, including family values and traditionalism, influence reactions to the changing demographics in this rural community.

Sexuality in a Community Based Sample of Adults with Autism Spectrum Disorder

Science.gov (United States)

Gilmour, Laura; Schalomon, P. Melike; Smith, Veronica

2012-01-01

Few studies have examined the sexual attitudes and behaviours of individuals with high functioning autism spectrum disorders (ASDs) living in community settings. A total of 82 (55 female and 17 male) adults with autism were contrasted with 282 members of the general population on their responses to an online survey of sexual knowledge and…

Improving Interactive Health Literacy Skills of Older Adults: Lessons Learned From Formative Organizational Research With Community Partners.

Science.gov (United States)

Parmer, John; Furtado, Debra; Rubin, Donald L; Freimuth, Vicki; Kaley, Terry; Okundaye, Mumbi

2015-01-01

Meals on Wheels (MOW) organizations are ideal community partners for delivering social support relating to health information exchange for vulnerable and home-bound older adults. This article illustrates how formative organizational evaluation can be used to adapt health literacy interventions delivered by community partners. Key informant interviews and ethnographic observations were conducted as part of a formative organizational evaluation of potential community partners. The observed brevity of volunteer-client interaction led program planners to incorporate substantial emphasis on communicating with older adults into the health literacy coach training curriculum. Ethnographic observations made clear that program materials had to be portable and fit it in with the mobile nature of MOW delivery. Formative organizational research can greatly increase the chance of successful implementation of public health interventions when those interventions will be implemented in partnerships with community-based organizations in diverse settings and with varying practices.

Transition to Community College: The Journey of Adult Basic Education English Learners from Non-Credit to Credit Programs

Science.gov (United States)

Csepelyi, Tunde

2012-01-01

This phenomenological study examined the transition of a group of adult English language learners from an Adult Basic Education program to a community college. The purpose of the study was to gain a deeper understanding of the driving forces of Adult Basic Education English language learners who had successfully transitioned from a non-credit…

The role of social engagement and identity in community mobility among older adults aging in place.

Science.gov (United States)

Gardner, Paula

2014-01-01

The purpose of this study was to understand how neighbourhoods - as physical and social environments - influence community mobility. Seeking an insider's perspective, the study employed an ethnographic research design. Immersed within the daily lives of 6 older adults over an 8-month period, auditory, textual, and visual data was collected using the "go-along" interview method. During these interviews, the researcher accompanied participants on their natural outings while actively exploring their physical and social practices by asking questions, listening, and observing. Findings highlight a process of community mobility that is complex, dynamic and often difficult as participant's ability and willingness to journey into their neighborhoods were challenged by a myriad of individual and environmental factors that changed from one day to the next. Concerned in particular with the social environment, final analysis reveals how key social factors - social engagement and identity - play a critical role in the community mobility of older adults aging in place. Identity and social engagement are important social factors that play a role in community mobility. The need for social engagement and the preservation of identity are such strong motivators for community mobility that they can "trump" poor health, pain, functional ability and hazardous conditions. To effectively promote community mobility, the social lives and needs of individuals must be addressed.

Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

Directory of Open Access Journals (Sweden)

Ling Na PhD

2017-03-01

Full Text Available Objectives: Activity of daily living (ADL stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002 were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D], only the complete limitation stage (Stage IV showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

Adult-Rated Oceanography Part 1: A Project Integrating Ocean Sciences into Adult Basic Education Programs.

Science.gov (United States)

Cowles, S.; Collier, R.; Torres, M. K.

2004-12-01

Busy scientists seek opportunities to implement education and outreach efforts, but often don't know where to start. One easy and tested method is to form collaborations with federally-funded adult education and adult literacy programs. These programs exist in every U.S. state and territory and serve underrepresented populations through such major initiatives as adult basic education, adult secondary education (and GED preparation), and English language acquisition. These students are workers, consumers, voters, parents, grandparents, and members of every community. They have specific needs that are often overlooked in outreach activities. This presentation will describe the steps by which the Oregon Ocean Science and Math Collaborative program was developed. It is based on a partnership between the Oregon Department of Community Colleges and Workforce Development, Oregon State University College of Oceanic and Atmospheric Sciences, Oregon Sea Grant, and the OSU Hatfield Marine Science Center. It includes professional development through instructor institutes; teachers at sea and informal education opportunities; curriculum and web site development. Through the partnership described here, instructors in adult basic education programs participate in a yearlong experience in which they develop, test, and adapt innovative instructional strategies to meet the specific needs of adult learners. This, in turn, leads to new prospects for study in the areas of ocean science and math and introduces non-academic careers in marine science to a new community. Working directly with instructors, we have identified expertise level, instructional environment, instructor background and current teaching strategies used to address science literacy and numeracy goals of the adult learners in the State of Oregon. Preliminary evaluation of our ongoing project in meeting these goals will be discussed. These efforts contribute to national goals of science literacy for all, by providing

Factors associated with poor balance ability in older adults of nine high-altitude communities.

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Urrunaga-Pastor, Diego; Moncada-Mapelli, Enrique; Runzer-Colmenares, Fernando M; Bailon-Valdez, Zaira; Samper-Ternent, Rafael; Rodriguez-Mañas, Leocadio; Parodi, Jose F

2018-05-01

Poor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities. Analytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013-2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented. A total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05-1.73), exhaustion (PR = 2.22; 95%CI: 1.49-3.31), gait speed (PR = 0.67; 95%CI: 0.50-0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19-3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10-2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07-2.42) compared to none. Approximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals. Copyright © 2018 Elsevier B.V. All rights reserved.

Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

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Thomas, Kali S; Keohane, Laura; Mor, Vincent

2014-11-01

We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

Building a future : First Nations communities look to oilsands developers for jobs, business partnerships, and much more

Energy Technology Data Exchange (ETDEWEB)

Stonehouse, D.

2009-02-15

This article reported on socio-economic factors related to the expansion of oilsands development in northeastern Alberta. Despite massive investment into the region, local First Nations communities continue to struggle economically. Living conditions on reserves are substandard, education is below provincial levels and unemployment remains high. In 1998, First Nations communities formed the Athabasca Tribal Council (ATC)Industry Agreement Group to build capacity in the 5 First Nations making up the ATC to deal with the challenges of oilsands development. In 2003, a new agreement was initiated in which central economic development efforts were decentralized, allowing money to be spent at the band level. Industry relations offices were set up in each community to consult with industry and identify areas of concern. The broad issues were reducing unemployment on reserves and the social side of capacity building. The 5 Athabasca First Nations are currently working to develop entrepreneurship in the communities through the ATC's Economic Development department. They are in a good position to get money in place to ensure the future sustainability of their communities. 3 figs.

Attitudes Towards the Sexuality of Adults with an Intellectual Disability: Parents, Support Staff, and a Community Sample

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Cuskelly, Monica; Bryde, Rachel

2004-01-01

Attitudes toward the sexuality of adults with intellectual disability were assessed in parents and carers of adults with intellectual disability and in a community sample. An instrument that contained items relating to eight aspects of sexuality (sexual feelings, sex education, masturbation, personal relationships, sexual intercourse,…

Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training

DEFF Research Database (Denmark)

Jørgensen, Martin Grønbech

The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables...... in community-dwelling older adults. In Study I balance control was investigated using force plate analysis of Centre of Pressure (COP) excursion during static bilateral standing in 32 community-dwelling older adults at three different time-points (09:00, 12:30, and 16:00) throughout the day. An overall...... significant time-of-day effect was observed for all selected COP variables. The greatest change in all COP variables was observed (on average ~15%) between midday (12:30) and the afternoon (16:00), indicating that a systematic time-of-day influence on static postural balance exists in community-dwelling older...

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

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Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial.

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Pai, Yi-Chung; Bhatt, Tanvi; Yang, Feng; Wang, Edward

2014-12-01

Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Working for Equality and Diversity in Adult and Community Learning: Leadership, Representation and Racialised "Outsiders within"

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Hunter, Shona

2006-01-01

This article uses empirical material from a qualitative study of adult and community learning (ACL) to explore issues around leading for equality and diversity in educational organisations. What the author is interested in is the way that the commitment to a "community" context in ACL opens up (or keeps open) certain possibilities for "diverse"…

Estimating peer density effects on oral health for community-based older adults.

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Chakraborty, Bibhas; Widener, Michael J; Mirzaei Salehabadi, Sedigheh; Northridge, Mary E; Kum, Susan S; Jin, Zhu; Kunzel, Carol; Palmer, Harvey D; Metcalf, Sara S

2017-12-29

As part of a long-standing line of research regarding how peer density affects health, researchers have sought to understand the multifaceted ways that the density of contemporaries living and interacting in proximity to one another influence social networks and knowledge diffusion, and subsequently health and well-being. This study examined peer density effects on oral health for racial/ethnic minority older adults living in northern Manhattan and the Bronx, New York, NY. Peer age-group density was estimated by smoothing US Census data with 4 kernel bandwidths ranging from 0.25 to 1.50 mile. Logistic regression models were developed using these spatial measures and data from the ElderSmile oral and general health screening program that serves predominantly racial/ethnic minority older adults at community centers in northern Manhattan and the Bronx. The oral health outcomes modeled as dependent variables were ordinal dentition status and binary self-rated oral health. After construction of kernel density surfaces and multiple imputation of missing data, logistic regression analyses were performed to estimate the effects of peer density and other sociodemographic characteristics on the oral health outcomes of dentition status and self-rated oral health. Overall, higher peer density was associated with better oral health for older adults when estimated using smaller bandwidths (0.25 and 0.50 mile). That is, statistically significant relationships (p density and improved dentition status were found when peer density was measured assuming a more local social network. As with dentition status, a positive significant association was found between peer density and fair or better self-rated oral health when peer density was measured assuming a more local social network. This study provides novel evidence that the oral health of community-based older adults is affected by peer density in an urban environment. To the extent that peer density signifies the potential for

Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults.

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Yamada, Minoru; Arai, Hidenori

2017-05-15

Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

Mapping vegetation communities using statistical data fusion in the Ozark National Scenic Riverways, Missouri, USA

Science.gov (United States)

Chastain, R.A.; Struckhoff, M.A.; He, H.S.; Larsen, D.R.

2008-01-01

A vegetation community map was produced for the Ozark National Scenic Riverways consistent with the association level of the National Vegetation Classification System. Vegetation communities were differentiated using a large array of variables derived from remote sensing and topographic data, which were fused into independent mathematical functions using a discriminant analysis classification approach. Remote sensing data provided variables that discriminated vegetation communities based on differences in color, spectral reflectance, greenness, brightness, and texture. Topographic data facilitated differentiation of vegetation communities based on indirect gradients (e.g., landform position, slope, aspect), which relate to variations in resource and disturbance gradients. Variables derived from these data sources represent both actual and potential vegetation community patterns on the landscape. A hybrid combination of statistical and photointerpretation methods was used to obtain an overall accuracy of 63 percent for a map with 49 vegetation community and land-cover classes, and 78 percent for a 33-class map of the study area. ?? 2008 American Society for Photogrammetry and Remote Sensing.

12 CFR Appendix 1 to Part 24 - CD-1-National Bank Community Development (Part 24) Investments

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false CD-1-National Bank Community Development (Part 24) Investments 1 Appendix 1 To Part 24 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF... PUBLIC WELFARE INVESTMENTS Pt. 24, App. 1 Appendix 1 To Part 24—CD-1—National Bank Community Development...

Innovating for Transformation in First Nations Health Using Community-Based Participatory Research.

Science.gov (United States)

Kyoon-Achan, Grace; Lavoie, Josée; Avery Kinew, Kathi; Phillips-Beck, Wanda; Ibrahim, Naser; Sinclair, Stephanie; Katz, Alan

2018-06-01

Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.

2014 National Park visitor spending effects: economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine; Huber, Christopher; Koontz, Lynne

2015-01-01

The National Park System covers more than 84 million acres and is comprised of more than 401 sites across the Nation. These lands managed by the National Park Service (NPS) serve as recreational destinations for visitors from across the Nation and around the world. On vacations or on day trips, NPS visitors spend time and money in the gateway communities surrounding NPS sites. Spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway economies. The NPS has been measuring and reporting visitor spending and economic effects for the past 25 years. The 2012 analysis marked a major revision to the NPS visitor spending effects analyses, with the development of the Visitor Spending Effects model (VSE model) which replaced the previous Money Generation Model (see Cullinane Thomas et al. (2014) for a description of how the VSE model differs from the previous model). This report provides updated VSE estimates associated with 2014 NPS visitation.

Delayed transition of care: a national study of visits to pediatricians by young adults.

Science.gov (United States)

Fortuna, Robert J; Halterman, Jill S; Pulcino, Tiffany; Robbins, Brett W

2012-01-01

Despite numerous policy statements and an increased focus on transition of care, little is known about young adults who experience delayed transition to adult providers. We used cross-sectional data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey between 1998 and 2008 to examine delayed transition among young adults ages 22 to 30. We defined delayed transition as continuing to visit a pediatrician after the age of 21 years. Overall, we found that 1.3% (95% confidence interval [CI] 1.1-1.7) of visits by young adults to primary care physicians were seen by pediatricians, approximately 445,000 visits per year. We did not find a significant change in delayed transition during the past decade (β = -.01; P = .77). Among young adults, visits to pediatricians were more likely than visits to adult-focused providers to be for a chronic disease (25.7% vs 12.6%; P = .002) and more likely to be billed to public health insurance (23.5% vs 14.1%; P = .01). In adjusted models, visits by young adults to pediatric healthcare providers were more likely associated with chronic disease (adjusted relative risk [ARR] 2.2; 95% CI 1.5-3.4), with public health insurance (ARR 1.9; 95% CI 1.3-2.9), or with no health insurance (ARR 1.9; 95% CI 1.1-3.4). Although most young adult visits were to adult providers, a considerable number of visits were to pediatricians, indicating delayed transition of care. There has been no substantial change in delayed transition during the past decade. Visits by young adults with chronic disease, public health insurance, or no health insurance were more likely to experience delayed transition of care. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

"Really Useful Research" for Real Equality and Justice in Adult and Community Education

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Connolly, Bríd

2016-01-01

In recent decades, adult and community education has emerged as a distinctive discipline in its own right, based on scholarship in the quest for real equality and social justice. This distinctive discipline is already characterised by "really useful practice", that is, critical, creative pedagogy, heavily influenced by women's studies…

The Epidemiology of Social Isolation: National Health & Aging Trends Study.

Science.gov (United States)

Cudjoe, Thomas K M; Roth, David L; Szanton, Sarah L; Wolff, Jennifer L; Boyd, Cynthia M; Thorpe, Roland J

2018-03-26

Social isolation among older adults is an important but under-recognized risk for poor health outcomes. Methods are needed to identify subgroups of older adults at risk for social isolation. We constructed a typology of social isolation using data from the National Health and Aging Trends Study (NHATS) and estimated the prevalence and correlates of social isolation among community-dwelling older adults. The typology was formed from four domains: living arrangement, core discussion network size, religious attendance, and social participation. In 2011, 24% of self-responding, community-dwelling older adults (65+ years), approximately 7.7 million people, were characterized as socially isolated, including 1.3 million (4%) who were characterized as severely socially isolated. Multinomial multivariable logistic regression indicated that being unmarried, male, having low education, and low income were all independently associated with social isolation. Black and Hispanic older adults had lower odds of social isolation compared to White older adults, after adjusting for covariates. Social isolation is an important and potentially modifiable risk that affects a significant proportion of the older adult population.

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

Science.gov (United States)

Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

2017-01-01

Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

Multi-morbidity, disability and adaptation strategies among community-dwelling adults aged 75 years and older.

Science.gov (United States)

Yuen, Hon K; Vogtle, Laura K

2016-10-01

The impact of multi-morbidity and disability on the use of adaptation strategies in older adults has not been well researched. This study investigated categories of adaptation strategies that community-dwelling older adults use to complete their daily activities, identified factors that are associated with the use of behavioral adaptations, and examined the relationship among multi-morbidity, disability and adaptation strategies in this population. A mixed methods research design was used. 105 community-dwelling older adults with ages ranging from 75 to 94 years completed a questionnaire and semi-structured interview on types of chronic illnesses (multi-morbidity), amount of difficulty in completing daily activities (degree of disability), and types of behavioral efforts made to complete daily activities that are challenging (adaptation strategies). The model of selective optimization with compensation (SOC) was used to categorize these strategies. The findings revealed that older adults use a wide range of adaptations with compensation and selection the most (40.4%) and least (16.5%) frequently reported respectively. Degree of disability was uniquely associated with the frequency of using SOC strategies while controlling for other factors. Furthermore, degree of disability was a mediator for multi-morbidity in predicting frequency of using SOC strategies. The findings support that older adults using behavioral adaptations to cope with functional decline is prevalent. Knowing the types of adaptation that older adults employed and the indirect relationship between multi-morbidity and frequency of using SOC strategies, with degree of disability as the mediator will be helpful in planning interventions and prevention programs for educating older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

Intra-community coalitionary lethal attack of an adult male southern muriqui (Brachyteles arachnoides).

Science.gov (United States)

Talebi, M G; Beltrão-Mendes, R; Lee, P C

2009-10-01

We report on the first evidence of intra-community coalitionary lethal aggression in muriquis (Brachyteles). The event occurred in southern muriquis (Brachyteles arachnoides) during a long-term study (>15 years) of two social groups inhabiting mostly pristine Atlantic forest habitat in the Parque Estadual Carlos Botelho, southern São Paulo State, Brazil. The attack took place deep in the core area of the Group Caetê home range. Tense agonistic behaviors and vocalizations preceded the lethal coalitionary attack, and the tension increased over a 36-48 hr period. One adult female and two unidentified individuals also took part in a coalition led by six adult males. The members of the coalition collectively approached, embraced, immobilized and repeatedly bit the entire body of an adult male, resulting in severe bleeding injuries and the victim's death in less than 1 hr after the attack commenced. Combined ecological, behavioral and spatial data related to the event indicate that this was an intra-community attack and suggest social tensions related to mating competition as the proximate trigger of the coalitionary killing. The attack resembled those reported for chimpanzees, with clear numeric superiority and a low risk of injury to aggressors, resulting in the death of a lone conspecific victim. This observation (n=1) is suggestive of a capacity for escalated aggression in muriquis and reinforces arguments for the potential adaptive significance of intra-community aggression in male philopatric societies, as reported for spider monkeys and chimpanzees. These characteristics challenge the view of the muriquis as a peaceful primate and support the general hypothesis that imbalances of power contribute to intra-specific killing in primates, such as chimpanzees and humans.

National survey and community advisory board development for a bipolar disorder biobank.

Science.gov (United States)

Frye, Mark A; Doederlein, Allen; Koenig, Barbara; McElroy, Susan L; Nassan, Malik; Seymour, Lisa R; Biernacka, Joanna M; Daniels, Allen S

2015-09-01

The aim of the present study was to engage a national advocacy group and local stakeholders for guidance in developing a bipolar disorder biobank through a web-based survey and a community advisory board. The Depression and Bipolar Support Alliance and the Mayo Clinic Bipolar Biobank conducted a national web-based survey inquiring about interest in participating in a biobank (i.e., giving DNA and clinical information). A community advisory board was convened to guide establishment of the biobank and identify key deliverables from the research project and for the community. Among 385 survey respondents, funding source (87%), professional opinion (76%), mental health consumer opinion (79%), and return of research results (91%) were believed to be important for considering study participation. Significantly more patients were willing to participate in a biobank managed by a university or clinic (78.2%) than one managed by government (63.4%) or industry (58.2%; both p bipolar disorder developing in a child of an affected parent and which medications to avoid. The advisory board endorsed the use of a comprehension questionnaire to evaluate participants' understanding of the study (e.g., longevity of DNA specimens, right to remove samples, accessing medical records) as a means to strengthen the informed consent process. These national survey and community advisory data support the merit of establishing a biobank to enable studies of disease risk, provided that health records and research results are adequately protected. The goals of earlier diagnosis and individualized treatment of bipolar disorder were endorsed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Engaging First Nation and Inuit communities in asthma management and control: assessing cultural appropriateness of educational resources.

Science.gov (United States)

Latycheva, O; Chera, R; Hampson, C; Masuda, J R; Stewart, M; Elliott, S J; Fenton, N E

2013-01-01

Asthma is a growing concern in First Nations and Inuit communities. As with many health indicators and outcomes, Aboriginal peoples living in remote areas experience greater disparities in respiratory health compared with non-Aboriginal Canadians. Therefore, it is critically important to take into account their unique needs when developing asthma educational materials and resources. The purpose of this study is to assess the cultural relevance of existing asthma education materials for First Nations and Inuit peoples. Five First Nations and Inuit communities from across Canada participated in the project. A combination of quantitative evaluations (eg surveys) and qualitative approaches (eg open discussion, live chats) were used to assess printed and web-based asthma education materials. Participants represented First Nations and Inuit communities from across Canada and were selected on the basis of age and role: 6 to 12 years old (children), 12 and over (youth), parents and grandparents, community leaders and teachers, and community advisory group members. In general, the results showed that although participants of all age categories liked the selection of asthma educational materials and resources, they identified pictures and images related to First Nations and Inuit people living and coping with asthma as ways of improving cultural relevance. This reinforces findings that tailoring materials to include Aboriginal languages, ceremonies and traditions would enhance their uptake. Our findings also demonstrate that visually based content in both printed and virtual form were the preferred style of learning of all participants, except young children who preferred to learn through play and interactive activities. Asthma is a growing concern in First Nations and Inuit communities. Given this concern, it is essential to understand cultural needs and preferences when developing asthma education materials and resources. The findings from this research emphasize the need

Tree Changes or Wholesale Changes: The Role of Adult Education in Transitions in Regional Life

Science.gov (United States)

Townsend, Robert; Delves, Melinda

2009-01-01

Regional adult education and training providers have been required in recent decades to adapt to funding structures rather than engage with their local communities. This has meant providing education programs that are funded based on national or State and Territory based policy frameworks, often linked to human capital development. Adult education…

Closing the Gender Gap: Improved Performance of U.S.-Born Females on the National Assessment of Adult Literacy

Science.gov (United States)

Cohen, Dale J.; White, Sheida; Cohen, Steffaney B.

2012-01-01

This study analyzed the current state of the gender literacy gap and the change in the gender literacy gap between 1992 and 2003, using the 1992 National Adult Literacy Survey (NALS) and the 2003 National Assessment of Adult Literacy (NAAL). The results revealed that although there were significant gender literacy gaps in 1992, virtually all…

Technical Report and Data File User's Manual for the 1992 National Adult Literacy Survey.

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Kirsch, Irwin; Yamamoto, Kentaro; Norris, Norma; Rock, Donald; Jungeblut, Ann; O'Reilly, Patricia; Berlin, Martha; Mohadjer, Leyla; Waksberg, Joseph; Goksel, Huseyin; Burke, John; Rieger, Susan; Green, James; Klein, Merle; Campbell, Anne; Jenkins, Lynn; Kolstad, Andrew; Mosenthal, Peter; Baldi, Stephane

Chapter 1 of this report and user's manual describes design and implementation of the 1992 National Adult Literacy Survey (NALS). Chapter 2 reviews stages of sampling for national and state survey components; presents weighted and unweighted response rates for the household component; and describes non-incentive and prison sample designs. Chapter…

Challenges to the provision of diabetes care in first nations communities: results from a national survey of healthcare providers in Canada

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Macaulay Ann C

2011-10-01

Full Text Available Abstract Background Aboriginal peoples globally, and First Nations peoples in Canada particularly, suffer from high rates of type 2 diabetes and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. Methods In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations Diabetes Clinical Management and Epidemiologic (CIRCLE study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated. Interviews, focus groups and survey questions all related to barriers to providing optimal diabetes care in First Nations communities. Results the key factors emerging from interviews and focus group discussions were at the patient, provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived patient factors as having the largest impact on diabetes care. However, physicians and nurses were more likely to rank patient factors as having a large impact on care than community health representatives (CHRs and physicians were significantly less likely to rank patient-provider communication as having a large impact than CHRs. Conclusions Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services

The Impact of Computer Assisted Instruction As It Relates to Learning Disabled Adults in California Community Colleges.

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Brower, Mary Jo

A study was conducted to determine the advantages and disadvantages of using computer-assisted instruction (CAI) with learning disabled (LD) adults attending California community colleges. A questionnaire survey of the directors of the LD programs solicited information on the availability of CAI for LD adults, methods of course advertisement,…

Does life satisfaction predict five-year mortality in community-living older adults?

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St John, Philip D; Mackenzie, Corey; Menec, Verena

2015-01-01

Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

Effects of an Aerobic Exercise Program on Community-Based Adults with Mental Retardation.

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Pommering, Thomas L.; And Others

1994-01-01

Evaluation of a 10-week aerobic exercise program on 14 community-based adults with mental retardation found a 91.3% attendance rate and significant increases in maximal oxygen consumption, oxygen pulse, maximum ventilation, exercise stress test duration, and flexibility. However, no significant changes were observed in weight or body composition.…

Factors affecting aging cognitive function among community-dwelling older adults.

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Kim, Chun-Ja; Park, JeeWon; Kang, Se-Won; Schlenk, Elizabeth A

2017-08-01

The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. © 2017 John Wiley & Sons Australia, Ltd.

Promoting community readiness for physical activity among older adults in Germany--protocol of the ready to change intervention trial.

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Brand, Tilman; Gansefort, Dirk; Rothgang, Heinz; Röseler, Sabine; Meyer, Jochen; Zeeb, Hajo

2016-02-01

Healthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups. We designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation. This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform

Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline.

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Shirooka, Hidehiko; Nishiguchi, Shu; Fukutani, Naoto; Tashiro, Yuto; Nozaki, Yuma; Aoyama, Tomoki

2018-05-01

The association between subjective cognitive decline and falls has not been clearly determined. Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline. We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without. A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04). The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults. The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.

Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults

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Caballer, Vicent-Benavent; Lisón, Juan Francisco; Rosado-Calatayud, Pedro; Amer-Cuenca, Juan José; Segura-Orti, Eva

2015-01-01

[Purpose] The main objective of this study was to determine the contributions and extent to which certain physical measurements explain performance in the 6-minute walk test in healthy older adults living in a geriatric nursing home and for older adults dwelling in the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive impairment who were independent in their daily activities. [Methods] The 6-minute walk test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery, and hand-grip strength were examined. [Results] Strong significant associations were found between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise multiple regression on the entire sample showed that lower-limb function was a significant and independent predictor for the 6-minute walk test. Additionally, lower-limb function was a strong predictor for the 6-minute walk test in our nursing home group, whereas mobility was found to be the best predictor in our community-dwelling group. [Conclusion] Better lower-limb function, balance, and mobility result in a higher distance covered by healthy older adults. Lower-limb function and mobility appeared to best determine walking performance in the nursing home and community-dwelling groups, respectively. PMID:26696740

Attitudes toward Bisexual Men and Women among a Nationally Representative Probability Sample of Adults in the United States.

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Dodge, Brian; Herbenick, Debby; Friedman, M Reuel; Schick, Vanessa; Fu, Tsung-Chieh Jane; Bostwick, Wendy; Bartelt, Elizabeth; Muñoz-Laboy, Miguel; Pletta, David; Reece, Michael; Sandfort, Theo G M

2016-01-01

As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S. Our study provides an assessment of attitudes toward bisexual men and women among a nationally representative probability sample of heterosexual, gay, lesbian, and other-identified adults in the U.S. Data were collected from the 2015 National Survey of Sexual Health and Behavior (NSSHB), via an online questionnaire with a probability sample of adults (18 years and over) from throughout the U.S. We included two modified 5-item versions of the Bisexualities: Indiana Attitudes Scale (BIAS), validated sub-scales that were developed to measure attitudes toward bisexual men and women. Data were analyzed using descriptive statistics, gamma regression, and paired t-tests. Gender, sexual identity, age, race/ethnicity, income, and educational attainment were all significantly associated with participants' attitudes toward bisexual individuals. In terms of responses to individual scale items, participants were most likely to "neither agree nor disagree" with all attitudinal statements. Across sexual identities, self-identified other participants reported the most positive attitudes, while heterosexual male participants reported the least positive attitudes. As in previous research on convenience samples, we found a wide range of demographic characteristics were related with attitudes toward bisexual individuals in our nationally-representative study of heterosexual, gay/lesbian, and other-identified adults in the U.S. In particular, gender emerged as a significant characteristic

Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results From the National Young Adult Health Survey.

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Wackowski, Olivia A; Delnevo, Cristine D

2016-06-01

Objectives Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method We examined risk perception responses among a nationally representative sample of young adults (age 18-34 years; n = 2,871, including tobacco and non-tobacco users) from the 2011 National Young Adult Health Survey. Results Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to noncombustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22% and 33% of all respondents believed that SLT, snus, menthol cigarettes, and cigars were more risky than cigarettes, but differences in this belief between current and nonusers of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being "less risky" and rate cigars and SLT as being "more risky" than older young adults. Conclusion The public's views of comparative tobacco risk perceptions vary widely by tobacco product type and age-group. While "less risky" perceptions may be associated with product use, perceptions that products are "more risky" than cigarettes may not necessarily dissuade people from their use. © 2015 Society for Public Health Education.

Symptom burden predicts hospitalization independent of comorbidity in community-dwelling older adults.

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Salanitro, Amanda H; Hovater, Martha; Hearld, Kristine R; Roth, David L; Sawyer, Patricia; Locher, Julie L; Bodner, Eric; Brown, Cynthia J; Allman, Richard M; Ritchie, Christine S

2012-09-01

To determine whether cumulative symptom burden predicts hospitalization or emergency department (ED) visits in a cohort of older adults. Prospective, observational study with a baseline in-home assessment of symptom burden. Central Alabama. Nine hundred eighty community-dwelling adults aged 65 and older (mean 75.3 ± 6.7) recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban/rural residence. Symptom burden score (range 0-10). One point was given for each symptom reported: shortness of breath, tiredness or fatigue, problems with balance or dizziness, leg weakness, poor appetite, pain, stiffness, constipation, anxiety, and loss of interest in activities. Dependent variables were hospitalizations and ED visits, assessed every 6 months during the 8.5-year follow-up period. Using Cox proportional hazards models, time from the baseline in-home assessment to the first hospitalization and first hospitalization or ED visit was determined. During the 8.5-year follow-up period, 545 (55.6%) participants were hospitalized or had an ED visit. Participants with greater symptom burden had higher risk of hospitalization (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.05-1.14) and hospitalization or ED visit (HR = 1.10, 95% CI = 1.06-1.14) than those with lower scores. Participants living in rural areas had significantly lower risk of hospitalization (HR = 0.83, 95% CI = 0.69-0.99) and hospitalization or ED visit (HR = 0.80, 95% CI = 0.70-0.95) than individuals in urban areas, independent of symptom burden and comorbidity. Greater symptom burden was associated with higher risk of hospitalization and ED visits in community-dwelling older adults. Healthcare providers treating older adults should consider symptom burden to be an additional risk factor for subsequent hospital utilization. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

The National Adult Reading Test: restandardisation against the Wechsler Adult Intelligence Scale-Fourth edition.

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Bright, Peter; Hale, Emily; Gooch, Vikki Jayne; Myhill, Thomas; van der Linde, Ian

2018-09-01

Since publication in 1982, the 50-item National Adult Reading Test (NART; Nelson, 1982; NART-R; Nelson & Willison, 1991) has remained a widely adopted method for estimating premorbid intelligence both for clinical and research purposes. However, the NART has not been standardised against the most recent revisions of the Wechsler Adult Intelligence Scale (WAIS-III; Wechsler, 1997, and WAIS-IV; Wechsler, 2008). Our objective, therefore, was to produce reliable standardised estimates of WAIS-IV IQ from the NART. Ninety-two neurologically healthy British adults were assessed and regression equations calculated to produce population estimates of WAIS-IV full-scale IQ (FSIQ) and constituent index scores. Results showed strong NART/WAIS-IV FSIQ correlations with more moderate correlations observed between NART error and constituent index scores. FSIQ estimates were closely similar to the published WAIS and WAIS-R estimates at the high end of the distribution, but at the lower end were approximately equidistant from the highly discrepant WAIS (low) and WAIS-R (high) values. We conclude that the NART is likely to remain an important tool for estimating the impact of neurological damage on general cognitive ability. We advise caution in the use of older published WAIS and/or WAIS-R estimates for estimating premorbid WAIS-IV FSIQ, particularly for those with low NART scores.

Strategic Priorities for Increasing Physical Activity Among Adults Age 50 and Older: The National Blueprint Consensus Conference Summary Report

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Sheppard, Lisa; Senior, Jane; Park, Chae Hee; Mockenhaupt, Robin; Bazzarre, Terry; Chodzko-Zajko, Wojtek

2003-01-01

On May 1, 2001, a coalition of national organizations released a major planning document designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was developed with input from 46 organizations with expertise in health, medicine, social and behavioral sciences, epidemiology, gerontology/geriatrics, clinical science, public policy, ma...

Validation of a Culturally Appropriate Social Capital Framework to Explore Health Conditions in Canadian First Nations Communities

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Brenda Elias

2011-05-01

Full Text Available An earlier study of our research group formulated a conceptual framework of social capital for First Nation communities and developed a culturally appropriate instrument for its measurement. We tested this instrument further with the Manitoba (Canada First Nations Regional Health Survey, 2003. Using data from this survey, we investigated the bonding dimension of the social capital conceptual framework, with a total sample of 2,765 First Nations individuals living in 24 Manitoba First Nations communities. Twenty seven Likert-scale survey questions measured aspects of bonding social capital, socially-invested resources, ethos,and networks. Validation analyses included an evaluation of internal consistency, factor analyses to explore how well the items clustered together into the components of the social capital framework, and the ability of the items to discriminate across the communities represented in the sample. Cronbach’s Alpha was computed on the 27 scale items, producing an Alpha of 0.84 indicating high internal consistency. The factor analyses produced five distinct factors with a total explained variance of 54.3%. Lastly, a one-way analysis of variancerun by community produced highly significant F-ratios between the groups on all twenty-seven bonding items. The culturally-sensitive items included in the social capital framework were found to be an appropriate tool to measure bonding aspects among Manitoba First Nations communities. Research and policy implications are discussed.

Cultural Diversity and the National Parks: Working Together for Change. The National Parks Community Partners Program.

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Spears, Alan

This guidebook was developed to assist in the creation of partnerships. It discusses some of the best practices and lessons learned in the program's first year, and gives novice community-based organizers a sense of how effective partnerships can be formed. The guidebook will help the more experienced organizers of National Park Service employees…

Multiple DSM-5 substance use disorders: A national study of US adults.

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McCabe, Sean Esteban; West, Brady T; Jutkiewicz, Emily M; Boyd, Carol J

2017-09-01

Our aim is to determine the lifetime and past-year prevalence estimates of multiple Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) substance use disorders (SUDs) among U.S. adults. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions featured in-person interviews with a nationally representative sample of adults aged 18 and older. The majority of past-year nonalcohol DSM-5 SUDs had at least 1 other co-occurring past-year SUD, ranging from 56.8% (SE = 3.4) for past-year prescription opioid use disorder to 97.5% (SE = 2.7) for past-year hallucinogen use disorder. In contrast, only 15.0% (SE = 0.6) of past-year alcohol use disorders had a co-occurring past-year SUD. The odds of past-year multiple SUDs were greater among males, younger adults, African-Americans, and those with mood, personality, posttraumatic stress, or multiple psychiatric disorders. Assessment, diagnosis, and treatment often focus on individual substance-specific SUDs rather than multiple SUDs, despite evidence for substantial rates of polysubstance use in clinical and epidemiological studies. There are notable differences in the prevalence of multiple SUDs between alcohol use disorders and other nonalcohol SUDs that have important clinical implications; for example, multiple SUDs are more persistent than individual SUDs. These findings suggest that clinical assessment and diagnosis should screen for multiple SUDs, especially among adults with nonalcohol DSM-5 SUDs. Copyright © 2017 John Wiley & Sons, Ltd.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

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Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

IMPACT OF A SERIOUS GAME FOR HEALTH ON CHRONIC DISEASE SELF-MANAGEMENT: PRELIMINARY EFFICACY AMONG COMMUNITY DWELLING ADULTS WITH HYPERTENSION.

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Hickman, Ronald L; Clochesy, John M; Pinto, Melissa D; Burant, Christopher; Pignatiello, Grant

2015-01-01

Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN.

Community mobility among older adults with reduced kidney function: a study of life-space.

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Bowling, C Barrett; Muntner, Paul; Sawyer, Patricia; Sanders, Paul W; Kutner, Nancy; Kennedy, Richard; Allman, Richard M

2014-03-01

Life-Space Assessment captures community mobility and social participation and quantifies the distance, frequency, and independence obtained as an older adult moves through his or her environment. Reduced estimated glomerular filtration rate (eGFR) is associated with decline in activities of daily living among older adults, but less is known about the association of eGFR with restrictions in mobility. Prospective observational cohort study. Community-dwelling Medicare beneficiaries from the University of Alabama at Birmingham Study of Aging who had serum creatinine measured during a baseline in-home study visit and completed at least one telephone follow-up (N = 390). eGFR ≥ 60, 45-59, and space mobility trajectory. Life-space mobility was evaluated by telephone every 6 months for up to 4.5 years using the previously validated Life-Space Assessment. Scores using this tool range from 0-120 (higher scores indicate greater mobility). Mean age of the 390 participants was 77.6 ± 5.8 (SD) years, 41% were African American, 50.5% were women; 30.0% had eGFR of 45-59 mL/min/1.73 m(2), and 20.2% had eGFR space mobility scores were 64.8(95% CI, 62.0-67.6), 63.8 (95% CI, 60.3-67.4), and 58.3 (95% CI, 53.8-62.7) among those with eGFR categories ≥ 60, 45-59, and space mobility was found among those with eGFRs space mobility among community-dwelling older adults. Findings should be confirmed in a larger population. Published by Elsevier Inc.

Administrative Law in the Andean Community of Nations

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Jorge Enrique Santos Rodríguez

2013-12-01

Full Text Available One of the contemporary tendencies of Administrative Law is the recognition of its existence beyond the borders of a State. Under such premise, this paper aims to demonstrate that in the Andean Community of Nations sufficient elements to consider the existence of an Andean administrative Law. In the Andean statutes and rules, it is possible to identify an administrative function, as well as an administrative organization inside the Andean Integration System; and a system of Andean administrative rules and an administrative justice system.

An Adult Education Model of Resident Participation: Building Community Capacity and Strengthening Neighborhood-Based Activities in a Comprehensive Community Initiative (CCI.

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Daniel Brisson

2008-12-01

Full Text Available Comprehensive Community Initiatives (CCIs are of growing interest to social work and the social services field as they are an effort to move away from remediation of individual problems within neighborhoods to a comprehensive change effort that builds resident and institutional capacity for long term sustainability of healthy communities. Built on ongoing lessons learned from the community development field, CCIs are largely foundation supported projects that engage low-income neighborhood residents in a holistic change effort. However, based on what is known about community organizing, CCIs will likely face challenges as long as they involve a top-down approach with an outside funder entering a community to make change. This manuscript frames an adult education model of resident participation that can be used in CCIs and provides a case example illustrating the model in action. A discussion of how the model can be an effective means for communities to take advantage of outside resources while maintaining their power and voice for change is offered in conclusion.

National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015.

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Geller, Andrew I; Lovegrove, Maribeth C; Shehab, Nadine; Hicks, Lauri A; Sapiano, Mathew R P; Budnitz, Daniel S

2018-04-20

Detailed, nationally representative data describing high-risk populations and circumstances involved in antibiotic adverse events (AEs) can inform approaches to prevention. Describe US burden, rates, and characteristics of emergency department (ED) visits by adults for antibiotic AEs. Nationally representative, public health surveillance of adverse drug events (National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance [NEISS-CADES]) and a nationally projected database of dispensed prescriptions (QuintilesIMS), 2011-2015. Antibiotic-treated adults (≥ 20 years) seeking ED care. Estimated annual numbers and rates of ED visits for antibiotic AEs among outpatients treated with systemically administered antibiotics. Based on 10,225 cases, US adults aged ≥ 20 years made an estimated 145,490 (95% confidence interval, 115,279-175,701) ED visits for antibiotic AEs each year in 2011-2015. Antibiotics were implicated in 13.7% (12.3-15.2%) of all estimated adult ED visits for adverse drug events. Most (56.6%; 54.8-58.4%) antibiotic AE visits involved adults aged Accounting for prescriptions dispensed from retail and long-term care pharmacies, adults aged 20-34 years had twice the estimated rate of ED visits for oral antibiotic AEs compared with those aged ≥ 65 years (9.7 [7.6-11.8] versus 4.6 [3.6-5.7] visits per 10,000 dispensed prescriptions, respectively). Allergic reactions accounted for three quarters (74.3%; 70.0-78.6%) of estimated ED visits for antibiotic AEs. The three most frequently implicated antibiotic classes in ED visits for antibiotic AEs were oral sulfonamides (23.2%; 20.6-25.8%), penicillins (20.8%; 19.3-22.4%), and quinolones (15.7%; 14.2-17.1%). Per-prescription rates declined with increasing age group. Antibiotics are a common cause of ED visits by adults for adverse drug events and represent an important safety issue. Quantifying risks of AEs from specific antibiotics for specific patient populations, such

Effects of a dietary self-management programme for community-dwelling older adults: a quasi-experimental design.

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Chen, Su-Hui; Huang, Yu-Ping; Shao, Jung-Hua

2017-09-01

Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations. To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults. For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis. Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts. Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable

The impacts of community social capital on the life satisfaction of older adults in Hong Kong: the moderator role of intergenerational family capital.

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Lu, Nan; Lum, Terry Y S; Lou, Vivian W Q

2016-11-01

This study examined the moderator role of intergenerational family capital on the relationship between community social capital and life satisfaction of older Chinese adults. The data were derived from a quota sampling of 372 older adults aged 60 and above, who were interviewed at four districts in Hong Kong in 2011. Multiple group analysis was employed to examine the proposed model. For the low family capital group, community social capital was found to be a significant predictor of life satisfaction, even when the well-known covariates were controlled. However, the association between community social capital and life satisfaction was statistically non-significant among the high family capital group. The findings highlighted the interplay between community social capital and intergenerational family capital, which supported community social capital replacement theory in understanding the mechanism linking social capital to life satisfaction in older age in a Chinese context. Community social capital can play a compensatory role in maintaining the mental health of older people. It is particularly important for older adults who lack family support and/or suffer from social isolation and loneliness in local communities.

Obesity and central adiposity in Mexican adults: results from the Mexican National Health and Nutrition Survey 2006.

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Barquera, Simón; Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Flores, Mario; Durazo-Arvizu, Ramón; Kanter, Rebecca; Rivera, Juan A

2009-01-01

To estimate the prevalence of overweight, obesity and central adiposity in Mexico, and to explore trends compared to the previous Mexican National Health Survey (ENSA 2000) and to Mexican-Americans. The Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) was used to describe overweight, obesity and central adiposity. Trends over time were assessed using the ENSA 2000 and by comparing the ENSANUT 2006 results to those of Mexican-Americans using the United States National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2005-2006. A total of 33023 adults > 20 years old were included; 39.7% were found to be overweight and 29.9% were found to be obese; 75.9% of all adults had abdominal obesity. In Mexico between 2000 and 2006, the combined prevalence of overweight and obesity in adults increased approximately 12%. Mexican-Americans showed a higher prevalence of morbid obesity compared to native Mexicans. Mexico has experienced a rapid increase in the number of adults who have experienced excess weight gain between the years 2000 and 2006.

Understanding the social costs of psychosis: the experience of adults affected by psychosis identified within the second Australian National Survey of Psychosis.

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Stain, Helen J; Galletly, Cherrie A; Clark, Scott; Wilson, Jacqueline; Killen, Emily A; Anthes, Lauren; Campbell, Linda E; Hanlon, Mary-Claire; Harvey, Carol

2012-09-01

Social inclusion is a key priority of the Fourth National Mental Health Plan for Australia (2009-2014), with strong evidence for its protective impact on mental health. Social integration has been associated with enhanced well-being for people with mental illnesses such as psychosis. To explore the impact of psychosis on an individual's social and community participation. The second Australian national survey of psychosis was conducted across seven Australian sites. Semi-structured interviews with adults living with psychosis assessed mental health status, social and role functioning, life satisfaction and future goals. The cohort comprised 1825 adults with a psychotic illness (59.6% were male; 42.4% were aged 18-34 years; 31.5% had 12 years or more of education) of whom 32.7% had been employed in the past year. Most adults indicated experiencing loneliness (80.1%) and a need for more friends (48.1%). Men were more likely to have never had a long-term relationship (59.4% M, 33.2% F). Even though women were more likely to experience anxiety in social situations [(χ(2)(1) = 8.95, p social activity in the past year [χ(2)(2) = 11.84, p social activity and 43% described stigma as a barrier. Although 63.2% showed significant impairment in social functioning, only 29.5% had received help for this in the last year. Social isolation and loneliness were rated as major challenges by 37.2% of the cohort. Social isolation and dysfunction experienced by people with psychosis have not decreased since the last Australian national survey of people with psychosis. Alongside education and employment, social functioning and participation must be addressed to improve social inclusion for people with psychosis. Programs targeting social opportunities (befriending, peer support), social anxiety and social functioning for all stages of psychosis are warranted.

Awareness and intervention status of prediabetes among Chinese adults: implications from a community-based investigation

OpenAIRE

Zhuang, Qianling; Wu, Lirong; Lu, Yiqun; Du, Jiangang; Guo, Guifang

2015-01-01

With the rapid changes in lifestyle of China, the prevalence of diabetes and prediabetes is increasing. This study aims to evaluate the prevalence of prediabetes and study the disease awareness of prediabetes in a Southern China community. Furthermore, it also aimed to investigate the intervention status of lifestyle changes for pre-diabetes prevention. 881 adults without diabetes mellitus were recruited from the Suzhou community of China in 2012-2013. Self-report questionnaires including dem...

Predictors of older adults' personal and community mobility: using a comprehensive theoretical mobility framework.

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Umstattd Meyer, M Renée; Janke, Megan C; Beaujean, A Alexander

2014-06-01

Forty-six percent of older adults report limitations in their mobility, and maintaining mobility is considered an important factor in keeping adults independent and active in later life. This study tests a comprehensive theoretical framework of mobility (Webber, S. C., Porter, M. M., & Menec, V. H. [2010]. Mobility in older adults: A comprehensive framework. The Gerontologist, 50[4], 443-450. doi:10.1093/geront/gnq013) identifying multiple determinants that additively influence mobility (financial, psychosocial, environmental, physical, and cognitive), as well as cross-cutting influences of gender, culture, and biography. Structural equation modeling was used to examine several models of mobility using data from 6,112 respondents in the Health and Retirement Study (mean age: 74.74, 85% white, 41% male, 57% married). The original measurement model fit the data well. When both personal and community mobility were simultaneously predicted, only the physical, cognitive, psychosocial, and environmental determinants were retained in the independent models. Age and marital status also predicted personal and community mobility. Although most of these relationships were in the expected direction, interestingly when both forms of mobility were included in the model, poorer cognitive ability was associated with greater personal mobility in the final model. Results indicate the importance of accounting for and examining comprehensive models of mobility. The factors affecting older adults' mobility are complex, and these relationships need to be explored in more depth to ensure the maintenance of individuals' independence and quality of life.

Attitude towards Community Building in Association of Southeast Asian Nations: A Public Opinion Survey

OpenAIRE

Ravichandran Moorthy; Guido Benny

2012-01-01

Problem statement: The Association of Southeast Asian Nations (ASEAN) envisioned an integrated regional community by the year 2015, following the European Union model. However, unlike the European Community which was formed after years of discussion at different levels of society, institutions and government, ASEAN was rather quick to conceptualize this initiative, without seeking the feedbacks for the public. Consequently, ASEAN Community initiative has been criticized for being elitist in i...

Feasibility of a Brief Community-Based Train-the-Trainer Lesson to Reduce the Risk of Falls among Community Dwelling Older Adults

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Gunter, Katherine B.; John, Deborah H.

2014-01-01

The Better Balance, Better Bones, Better Bodies (B-Better©) program was developed to disseminate simple home-based strategies to prevent falls and improve functional health of older adults using a train-the-trainer model. Delivered by Family & Community Education Study Group program volunteers, the lesson stresses the importance of a…

Mobility device use in older adults and incidence of falls and worry about falling: findings from the 2011-2012 national health and aging trends study.

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Gell, Nancy M; Wallace, Robert B; LaCroix, Andrea Z; Mroz, Tracy M; Patel, Kushang V

2015-05-01

To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. Analysis of cross-sectional and longitudinal data from the 2011-12 National Health and Aging Trends Study. In-person interviews in the homes of study participants. Nationally representative sample of Medicare beneficiaries (n=7,609). Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, 1-year fall history and worry about falling. Twenty-four percent of adults aged 65 and older reported mobility device use in 2011, and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with nonwhite race and ethnicity, female sex, lower education level, greater multimorbidity, and obesity (all Pfalls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users than in nonusers. The percentage of older adults reporting mobility device use is higher than results from previous national surveys, and multiple device use is common in those who use any device. Mobility device use is not associated with greater incidence of falls. Cane-only users may compensate for worry about falling by limiting activity. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Adult and Community Education Policy in Aotearoa New Zealand 2000-2014: Neoliberal Influences?

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Leach, Linda

2014-01-01

Changes in tertiary education policy in Aotearoa New Zealand in the last decade have impacted on adult and community education (ACE). Marginalized and understood as non-formal education at the turn of the century, ACE is now part of the "tertiary landscape". It is explicitly steered by education policy, its role severely narrowed, its…

Relationships Between Simple Toe Elevation Angle in the Standing Position and Dynamic Balance and Fall Risk Among Community-Dwelling Older Adults.

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Takatori, Katsuhiko; Matsumoto, Daisuke

2015-10-01

To investigate the relationships between toe elevation ability in the standing position and dynamic balance and fall risk among community-dwelling older adults. Cross-sectional survey. General community. Community-dwelling older adults (N = 287). Toe elevation angles in the standing position. Intra-rater and inter-rater reliability of measurements of the toe elevation angle was high (internal coefficient of correlation [ICC] (1,2) = 0.94 for the former and ICC (2,1) = 0.90 for the latter). Significant correlations were found between the toe elevation angle and age (r = -0.20, P fall in the previous 6 months had a significantly lower toe elevation angle compared with subjects who did not experience a fall (t = 2.19, P balance ability and appears to be a simple screening test for fall risk in community-dwelling older adults. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Exploring the "Obesity Paradox" as a Correlate of Cognitive and Physical Function in Community-dwelling Black and White Older Adults.

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Skinner, Jeannine S; Abel, Willie Mae; McCoy, Katryna; Wilkins, Consuelo H

2017-01-01

The obesity paradox has been documented in aged populations, yet it remains unclear if this paradox persists for physical and cognitive outcomes in community-dwelling older adult populations. Our study examines associations between body mass index (BMI) classification, cognitive function, and physical function. We also investigate whether these associations are modified by race or age. Cross-sectional study. Senior residential sites and community centers in Saint Louis, Missouri. Study participants included 331 adults, aged >55 years. Age was stratified into young-old (aged 55-74 years) and older (aged ≥75 years). Physical function was measured using the mini-Physical Performance Test (mini-PPT) and grip strength. Cognitive function was assessed with the Short Blessed Test (SBT) and the Trail Making Tests (TMT-A and TMT-B) performance. Older adults who were obese had significantly better cognitive flexibility (TMT-B) performance than normal weight older adults (P=.02), and this association was not influenced by age or race. Adiposity was not associated with psychomotor speed (TMT-A), general cognition (SBT), or measures of physical function (Ps>.05). In a diverse sample of community-dwelling older adults, we found partial support for the controversial obesity paradox. Our results suggest excess adiposity may be protective for executive function processes. Future research is needed to examine the underlying physiological processes linking adiposity to executive function in older adults.

Affinity communities in United Nations voting: Implications for democracy, cooperation, and conflict

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Pauls, Scott D.; Cranmer, Skyler J.

2017-10-01

A network oriented examination of the co-voting network of the United Nations (UN) provides powerful insights into the international alignment of states, as well as normatively important processes such as democracy, defensive cooperation, and armed conflict. Here, we investigate the UN co-voting network using the tools of community detection and inductively identify "affinity communities" in which states articulate similar policy preferences through their voting patterns. Analysis of these communities reveals that there is more information contained in UN voting and co-voting patterns than has previously been thought. Affinity communities have complex relationships with some of the most normatively important international outcomes: they reflect transitions to democracy, have a feedback loop with the formation of defensive alliances, and actively help states avoid armed conflict.

Perception and Attitude of a Rural Community Regarding Adult Blindness in North Central Nigeria.

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Olatunji, Victoria A; Adepoju, Feyi G; Owoeye, Joshua F A

2015-01-01

To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.

A model for partnering first-year student pharmacists with community-based older adults.

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Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E

2012-06-18

To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.

Pharmacists as immunizers: a survey of community pharmacists' willingness to administer adult immunizations.

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Edwards, Nicholas; Gorman Corsten, Erin; Kiberd, Mathew; Bowles, Susan; Isenor, Jennifer; Slayter, Kathryn; McNeil, Shelly

2015-04-01

Adult immunization rates worldwide fall below desired targets. Pharmacists are highly accessible healthcare providers with the potential to increase immunization rates among adults by administering vaccines in their practice setting. To determine the attitudes of community-based Canadian pharmacists with respect to expanding their scope of practice to include administration of immunizations. An internet-based survey was emailed to community pharmacists across Canada. The survey was piloted through focus groups for qualitative feedback, tested for content validity, and test-retest reliability prior to dissemination. There were 495 responses to the survey. The majority (88 %) agreed that pharmacists as immunizers would increase public access, improve rates (84 %), and be acceptable to the public (72 %). However, only 68 % agreed that pharmacists should be permitted to immunize. The majority of respondents (90 %) agreed that certification in vaccine administration should be required for pharmacists to administer vaccines. Pharmacists identified education, reimbursement, and negative interactions with other providers as barriers to pharmacists administering vaccines. Canadian pharmacists are willing to expand their scope of practice to include immunization. However, implementation requires professional development and certification in vaccine administration.

Health of adults caring for orphaned children in an HIV endemic community in South Africa

OpenAIRE

Kuo, Caroline; Operario, Don

2011-01-01

In South Africa, an estimated 2.5 million children have been orphaned by AIDS and other causes of adult mortality. Although there is a growing body of research on the well-being of South African orphaned children, few research studies have examined the health of adult individuals caring for children in HIV endemic communities. The cross-sectional survey assessed prevalence of general health and functioning (based on Short-Form 36 version 2 scale), depression (based on Center for Epidemiologic...

Predictors of handgrip strength among adults of a rural community in Malaysia.

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Moy, Foong-Ming; Darus, Azlan; Hairi, Noran Naqiah

2015-03-01

Handgrip strength is useful for screening the nutritional status of adult population as it is strongly associated with physical disabilities and mortality. Therefore, we aimed to determine the predictors of handgrip strength among adults of a rural community in Malaysia using a cross-sectional study design with multistage sampling. All adults aged 30 years and older from 1250 households were invited to our study. Structured questionnaire on sociodemographic characteristics, medical history, occupation history, lifestyle practices, and measurements, including anthropometry and handgrip strength were taken. There were 2199 respondents with 55.2% females and majority were of Malay ethnicity. Their mean (standard deviation) age was 53.4 (13.2) years. The response rate for handgrip strength was 94.2%. Females had significantly lower handgrip strength than males (P < .05). In the multiple linear regression models, significant predictors of handgrip strength for males were age, height, job groups, and diabetes, while for females, the significant predictors were age, weight, height, and diabetes. © 2013 APJPH.

Dual-tasking over an extended walking distance is associated with falls among community-dwelling older adults

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Hirashima K

2015-04-01

Full Text Available Kenichi Hirashima,1,2 Yumi Higuchi,1 Masakazu Imaoka,1 Emiko Todo,1 Tomomi Kitagawa,1 Tetsuya Ueda11Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan; 2Faculty of Health and Welfare, Department of Physical Therapy, Tokushima Bunri University, Nishihamaboji, Yamashiro Town, Tokushima City, Tokushima, Japan Aim: Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults.Methods: We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50–100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys. Results: Ninety-two of 118 subjects (mean age, 75.4±5.5 years completed the 12-month follow-up. Sixteen (17.4% of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan–Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps.Conclusion: Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults. Keywords: cohort study, community-dwelling older adults, dual-task, falls

Metabolic syndrome in Mexican adults: results from the National Health and Nutrition Survey 2006.

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Rojas, Rosalba; Aguilar-Salinas, Carlos A; Jiménez-Corona, Aída; Shamah-Levy, Teresa; Rauda, Juan; Avila-Burgos, Leticia; Villalpando, Salvador; Ponce, Eduardo Lazcano

2010-01-01

To examine the prevalence of metabolic syndrome (MS) and its associated risk factors in Mexican adults aged 20 years or older, using data derived from the National Health and Nutrition Survey 2006 (ENSANUT 2006). The ENSANUT 2006 was conducted between October 2005 and May 2006. Questionnaires were administered to 45 446 adult subjects aged 20 years or older who were residents from urban and rural areas. Anthropometric and blood pressure measurements were obtained from all subjects and fasting blood specimens were provided by 30% of participants. We randomly selected a sub-sample of 6 613 from which laboratory measurements were carried out for glucose, insulin, triglycerides, total cholesterol and HDL-cholesterol. For this analysis, we included only results from eight or more hours of fasting samples (n=6 021). We used individual weighted factors in the statistical analysis and considered the survey's complex sampling design to obtain variances and confidence intervals. All analyses were done using SPSS 15.0. In accordance with definitions by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and the International Diabetes Federation (IDF), the prevalence of MS in Mexican adults aged 20 years or older was 36.8, 41.6 and 49.8%, respectively. Women were more affected than men due to the higher prevalence of central obesity among females. Prevalence of MS increased with age and was higher among populations living in metropolitan areas, in the west-central region, and those with lower education. Regardless of the MS definition, a large proportion of Mexican adults has the condition, so preventive measures are needed to decrease the prevalence of the MS components in this population. MS can predict type 2 diabetes and cardiovascular disease, two of the main causes of death in the adult population in Mexico. The intentional search of MS components allows

Adult-Rated Oceanography Part 2: Examples from the Trenches

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Torres, M. E.; Collier, R.; Cowles, S.

2004-12-01

We will share experiences and specific examples from an ongoing Ocean Science and Math Collaborative Project between OSU faculty and Community College instructors from the Oregon system of adult education and workforce development. The participants represent such diverse instructional programs as workforce training, workplace education (cannery workers), adult basic education, adult secondary education (GED preparation), English to Speakers of Other Languages, Family Literacy, and Tribal Education (Confederated Tribes of the Siletz Indians). This collaborative project is designed to integrate ocean sciences into the science, math, and critical thinking curriculum through the professional development activities of adult educators. Our strategy is to tailor new and existing ocean science resources to the needs of adult education instructors. This project provides a wide range of opportunities in time and effort for scientist involvement. Some scientists have chosen to participate in short interviews or conversations with adult educators, which give added value through real-world connections in the context of the larger project. Other participating scientists have made larger time investments, which include presentations at workshops, hosting teacher-at-sea opportunities and leading project planning and implementation efforts. This project serves as an efficient model for scientists to address the broader impact goals of their research. It takes advantage of a variety of established educational outreach resources funded through NSF (e.g. the national COSEE network and GeoEducation grants), NOAA (e.g. SeaGrant education and Ocean Explorer) as well as State and Federal adult education programs (e.g. The National Institute for Literacy Science and Numeracy Special Collection). We recognize the value and creativity inherent in these resources, and we are developing a model to "tune" their presentation, as well as their connection to new oceanographic research, in a manner

Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study.

Science.gov (United States)

Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

2017-03-01

Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.

The relation between social network site usage and loneliness and mental health in community-dwelling older adults.

Science.gov (United States)

Aarts, S; Peek, S T M; Wouters, E J M

2015-09-01

Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults. Copyright © 2014 John Wiley & Sons, Ltd.

Resuscitating voter interest in Zambia: the Adult Education Association of Zambia's role in national elections.

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Chakanika, W W; Chuma, P C

1999-08-01

This paper examines the role of the Adult Education Association of Zambia (AEAZ) in the Zambian national elections. Outlined in this paper are workshop topics, challenges encountered, and outcomes of the education campaign by the AEAZ in its crusade to inform voters of their rights and obligations. The six interrelated topics presented at various civic awareness campaigns were leadership qualities; community participation in national development; responsible citizenship; electoral process and the management of elections; the role of a member parliament; and human rights. The primary problem of the AEAZ campaign was language. Although English is preferred in urban areas, most of the residents in the rural areas are illiterate, and the campaign had to be conducted in several local languages, where most of the people were unfamiliar to campaigners. Other challenges affecting the AEAZ outreach efforts were lack of reliable transportation and lack of funds. Despite these challenges, the campaign was successful in encouraging citizens to vote, lobbying, advocacy, and holding political representatives accountable for their actions. This was evident in the 1996 presidential and general elections, in which there was a significant increase in the number of voters who took part in the electoral process. This paper concludes that nongovernmental organizations involved in the sensitization campaigns should coordinate and collaborate in order to enhance their capacity.

Adult Nutrient Intakes from Current National Dietary Surveys of European Populations

Directory of Open Access Journals (Sweden)

Holly L. Rippin

2017-11-01

Full Text Available The World Health Organization (WHO encourages countries to undertake national dietary survey (NDS but implementation and reporting is inconsistent. This paper provides an up-to-date review of adult macro and micronutrient intakes in European populations as reported by NDS. It uses WHO Recommended Nutrient Intakes (RNIs to assess intake adequacy and highlight areas of concern. NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. Survey characteristics and adult intakes by gender/age group were extracted for selected nutrients and weighted means calculated by region. Of the 53 WHO Europe countries, over a third (n = 19, mainly Central & Eastern European countries (CEEC, had no identifiable NDS. Energy and nutrient intakes were extracted for 21 (40% countries but differences in age group, methodology, under-reporting and nutrient composition databases hindered inter-country comparisons. No country met more than 39% WHO RNIs in all age/gender groups; macronutrient RNI achievement was poorer than micronutrient. Overall RNI attainment was slightly worse in CEEC and lower in women and female elderly. Only 40% countries provided adult energy and nutrient intakes. The main gaps lie in CEEC, where unknown nutrient deficiencies may occur. WHO RNI attainment was universally poor for macronutrients, especially for women, the female elderly and CEEC. All countries could be encouraged to report a uniform nutrient set and sub-analyses of nationally representative nutrient intakes.

Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults.

LENUS (Irish Health Repository)

O'Caoimh, Rónán

2015-09-01

Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5\\/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community.

Institutional Sustainability Barriers of Community Conservation Agreement as a Collaboration Management in Lore Lindu National Park

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Sudirman Daeng Massiri

2015-12-01

Full Text Available The main problem of forest institutional arrangement is the issue of institutional sustainability in achieving sustainable forest ecosystem. This study aimed to explain the barriers of institutional sustainability Community Conservation Agreement (CCA designed in Lore Lindu National Park (LLNP, in Indonesia, as a collaborative management of national parks. This study is of descriptive which used qualitative approach, i.e. asking open-ended questions, reviewing documentation and analyzing textual of community conservation agreements. We found that the institutional sustainability barriers of CCA were the local decisions on collective-choice level and that the rules at operational level arranged in CCA were not in line with formal rules of national park management at the constitutional level. Furthermore, the low capacity of local institutions in heterogeneous villages with many migrants in controlling and regulating the forest use, especially in rehabilitation zone areas, also became a barrier to institutional sustainability of CCA. Therefore, institutional sustainability of CCA requires support of national park management policy that accommodates the sustainability of livelihoods of local communities in national parks, strengthening local institution's capacity, and ultimately integrating institution of CCA as part of LLNP management.

Assessment of postural balance in community-dwelling older adults - methodological aspects and effects of biofeedback-based Nintendo Wii training.

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Jørgensen, Martin Grønbech

2014-01-01

The overall purpose of this thesis was to examine selected methodological aspects and novel approaches for measuring postural balance older adults, and to examine the effects of biofeedback-based Nintendo Wii training on selected physiological, psychological and functional outcome variables in community-dwelling older adults. In Study I balance control was investigated using force plate analysis of Centre of Pressure (COP) excursion during static bilateral standing in 32 community-dwelling older adults at three different time-points (09:00, 12:30, and 16:00) throughout the day. An overall significant time-of-day effect was observed for all selected COP variables. The greatest change in all COP variables was observed (on average ~15%) between midday (12:30) and the afternoon (16:00), indicating that a systematic time-of-day influence on static postural balance exists in community-dwelling older adults. Consequently, longitudinal (i.e. pre-to-post training) comparisons of postural balance in in older adults with repeated assessments should be conducted at the same time-of-day. In Study II a novel approach for measuring postural balance (using the Nintendo Wii Stillness and Agility tests) was examined for reproducibility and concurrent validity in 30 community-dwelling older adults. While the Nintendo Wii Stillness test showed a high reproducibility, a systematic learning effect between successive sessions was observed for the Agility test. Moderate-to-excellent concurrent validity was seen for the Stillness test. In contrast, the Agility test revealed a poor concurrent validity. In conclusion, the Wii Stillness test seems to represent a low-cost objective reproducible test of postural balance in community-dwelling older adults and appears feasible in various clinical settings. A habituation (familiarization) period is necessary for the Wii Agility test to avoid a systematic learning effect between successive test sessions. Study III investigated the effect of ten

45 CFR 2515.10 - What are the service-learning programs of the Corporation for National and Community Service?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What are the service-learning programs of the... Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SERVICE-LEARNING PROGRAM PURPOSES § 2515.10 What are the service-learning programs of the Corporation for National and Community...

Acute presentation of craniopharyngioma in children and adults in a Danish national cohort

DEFF Research Database (Denmark)

Nielsen, E H; Jørgensen, J O; Bjerre, Peter Bjørn

2013-01-01

We aimed to study the occurrence of acute-onset symptoms at initial presentation in a national Danish cohort of patients with childhood- or adult-onset craniopharyngioma, and to investigate potential risk factors for acute presentation. Medical records of 189 consecutive patients (39 children, 150...... adults) presenting with craniopharyngioma during the period 1985-2004 were reviewed, and data regarding initial symptoms, neuroimaging results, vision and pituitary function were systematically collected. Acute symptoms preceding hospital admission were noted. Subgroup analyses were based on age, gender...

The Development of Adult and Community Education Policy in New Zealand: Insights from Popper

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Slater, Gloria

2009-01-01

This paper examines the process by which all post-compulsory education in New Zealand has become integrated under one administrative structure, the Tertiary Education Commission (TEC), with the intention of developing a single coordinated system of tertiary education. In particular, adult and community education (ACE), the least formal and…

Field Guide to the Plant Community Types of Voyageurs National Park

Science.gov (United States)

Faber-Langendoen, Don; Aaseng, Norman; Hop, Kevin; Lew-Smith, Michael

2007-01-01

INTRODUCTION The objective of the U.S. Geological Survey-National Park Service Vegetation Mapping Program is to classify, describe, and map vegetation for most of the park units within the National Park Service (NPS). The program was created in response to the NPS Natural Resources Inventory and Monitoring Guidelines issued in 1992. Products for each park include digital files of the vegetation map and field data, keys and descriptions to the plant communities, reports, metadata, map accuracy verification summaries, and aerial photographs. Interagency teams work in each park and, following standardized mapping and field sampling protocols, develop products and vegetation classification standards that document the various vegetation types found in a given park. The use of a standard national vegetation classification system and mapping protocol facilitate effective resource stewardship by ensuring compatibility and widespread use of the information throughout the NPS as well as by other Federal and state agencies. These vegetation classifications and maps and associated information support a wide variety of resource assessment, park management, and planning needs, and provide a structure for framing and answering critical scientific questions about plant communities and their relation to environmental processes across the landscape. This field guide is intended to make the classification accessible to park visitors and researchers at Voyageurs National Park, allowing them to identify any stand of natural vegetation and showing how the classification can be used in conjunction with the vegetation map (Hop and others, 2001).

“Conviv\\^{e}ncia” Groups: Building Active and Healthy Communities of Older Adults in Brazil

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Tânia R. Bertoldo Benedetti

2012-01-01

Full Text Available In old age, social groups can be a crucial component for health and well-being. In 2009-2010, a follow-up survey was carried out in Florianópolis, Brazil to understand the impact of a variety of programs established since 2002 that were designed to enhance social activities among the older adult population. This study employed two surveys within the population of older adults in Florianópolis. The first survey interviewed a total of 875 older adults in 2002, and the second survey involved 1,705 older adults between 2009 and 2010. By 2010, many new programs were offered in the community and the enrollment of older adults in social programs followed similar trends. “Convivência” groups stood out as extremely popular social groups among this population. This paper discusses some of the potential outcomes associated with participation in “convivência” groups.

the role of mass media in the delivery of adult education for national

African Journals Online (AJOL)

in the promotion of adult education delivery for national development in our society. Medium as ... that affects the well-being of all citizens within any given ... those decisions for themselves. ..... if the commonest is given free, ability to purchase.

Further Examination of Two Measures of Community-Based Social Skills for Adolescents and Young Adults with Emotional and Behavioral Disorders.

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Bullis, Michael; Davis, Cheryl

1997-01-01

Two measures of community-based social behavior for adolescents and young adults with emotional and behavioral disorders, the male and female forms of the Test of Community-Based Social Skill Knowledge and the Scale of Community-Based Social Skill Performance, were examined. Results found the measures yielded acceptable reliabilities and exhibited…

Management and treatment perceptions among young adults with asthma in Melbourne: the Australian experience from the European Community Respiratory Health Survey.

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Reid, D; Abramson, M; Raven, J; Walters, H E

2000-09-01

As part of the European Community Respiratory Health Survey (ECRHS) in 1992-1993 we assessed management practices and treatment perceptions among young asthmatic adults in Melbourne, Australia. We conducted a postal questionnaire survey of 4500 randomly selected adults (aged 20-44 years), drawn from three electoral districts, of whom 3200 (71%) subjects responded. A randomly selected sample of 1642 respondents, 'enriched' by a further 433 symptomatic subjects, was invited to complete a second phase respiratory questionnaire. The questionnaire was completed by 757 subjects who underwent laboratory testing. A further 119 subjects who were unable to attend the laboratory completed an identical questionnaire by telephone interview (42% response rate). In the second phase, 16% of subjects reported 'current asthma' (group I) as defined by physician confirmation and a recent attack (within 1 year), 10% had confirmed asthma but reported no recent attack (group II) and 74% did not have asthma (group III). Inhaled corticosteroid use was significantly higher in group I than in group II subjects (45% vs 24%, Ptime. Despite national education campaigns, the majority of young asthmatic adults in Melbourne did not adhere to prescribed treatment, but continued to rely upon beta2-agonists alone with neglect of regular inhaled corticosteroid which has probably contributed to Australia's continued high asthma morbidity and mortality rates.

Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan.

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Hsiao-Ting Chang

Full Text Available Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored.To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan.This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews.A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling.Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.

The effect of therapeutic horseback riding on balance in community-dwelling older adults: a pilot study.

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Homnick, Tamara D; Henning, Kim M; Swain, Charlene V; Homnick, Douglas N

2015-02-01

Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-week, single blind, controlled trial of the effect of a therapeutic horseback riding course on measures of balance in community-dwelling adults 65 years and older. Nine riders and six controls completed the trial. Controls were age matched to riders and all participants were recruited from the local community. Both groups showed improvements in balance during the trial, but did not reach statistical significance. Sample size was small, participants had relatively high initial balance scores, and controls tended to increase their physical activities, likely influencing outcomes. No adverse events occurred and the supervised therapeutic riding program appeared to be a safe and effective form of exercise to improve balance in older adults. A power analysis was performed to estimate numbers of participants needed for a larger study. © The Author(s) 2012.

Mobility Device Use Among Older Adults and Incidence of Falls and Worry About Falling: Findings From the 2011–2012 National Health and Aging Trends Study

Science.gov (United States)

Gell, Nancy M.; Wallace, Robert B.; LaCroix, Andrea Z.; Mroz, Tracy M.; Patel, Kushang V.

2015-01-01

OBJECTIVES To examine mobility device use prevalence among community-dwelling older adults in the U.S. and to investigate the incidence of falls and worry about falling by the type and number of mobility devices used. DESIGN Analysis of cross-sectional and longitudinal data from the 2011–2012 National Health and Aging Trends Study SETTING In-person interviews in the homes of study participants PARTICIPANTS Nationally representative sample of Medicare beneficiaries(N=7609). MEASUREMENTS Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, one-year fall history and worry about falling. RESULTS Twenty-four percent of adults age ≥65 reported mobility device use in 2011 and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with non-White race/ethnicity, female sex, lower education level, greater multi-morbidity, and obesity (all P-values falls and recurrent falls were not associated with the use of multiple devices or any one particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users, compared with non-users. CONCLUSION The percentage of older adults reporting mobility device use is higher compared to results from previous national surveys and multiple device use is common among those who use any device. Mobility device use is not associated with increased incidence of falls compared to non-device users. Cane-only users may compensate for worry about falling by limiting activity. PMID:25953070

ADULT CADDISFLY (TRICHOPTERA) PHENOLOGY AT THE HANFORD REACH NATIONAL MONUMENT, WASHINGTON STATE

International Nuclear Information System (INIS)

Zack, Richard S.; Ruiter, David E.; Strenge, Dennis L.; Landolt, Peter J.

2006-01-01

Adult caddisflies were sampled on the Wahluke Wildlife Area and Saddle Mountain National Wildlife Refuge subunits of the newly created (2000) Hanford Reach National Monument using 15-watt ''black lights'' from April 2002 through April 2003. A diverse fauna consisting of nine families, 21 genera, and 33 species were collected. Protoptila Coloma Ross, Agraylea multipunctata Curtis, Hydroptila xera Ross, Ceraclea alagma (Ross), Nectopsych Iahontanensis Haddock Oecetis cinerascens (Hagen), and Ylodes reuteri (MacLachlan) represent new records for Washington State. Species composition and phenology are presented in tabular form

Factors Affecting Participation by Adults in Community Educational Activities Concerned with the Cultural Arts.

Science.gov (United States)

Warlum, Michael Frank

The study seeks to determine and describe factors which are related to, and which may be responsible for, adult participation or lack of participation in a large-scale, community-wide, cultural arts project involving considerable volunteer effort. While serving as a participant observer, the researcher gathered data from sources directly related…

The diabetes online community: Older adults supporting self-care through peer health.

Science.gov (United States)

Litchman, Michelle L; Rothwell, Erin; Edelman, Linda S

2018-03-01

The use of the diabetes online community (DOC) is growing across all age groups. The aim of this exploratory study was to describe why older adults participated in the DOC, and how DOC users interacted with their healthcare providers. Telephone interviews (N=20) were conducted with older adult DOC users (born between 1946 and 1964) living in the United States. Interviews were analyzed using qualitative content analysis adhering to rigor and reproducibility standards. Themes that emerged from the data related to DOC participation included: information to improve self-care, emotional support, belonging to a community, validation of information, cause for concern and interaction with healthcare providers. Participants used the DOC for day to day diabetes management advice and healthcare providers for medical information and care. Participants highly valued the DOC and regarded their participation as a way to increase knowledge to improve self-care and reciprocate emotional support with others for diabetes management. The DOC filled gaps in knowledge and support participants were not able to get elsewhere. The DOC serves as an important source of information and support for individuals with diabetes and may be a cost-effective strategy to augment standard diabetes care. Copyright © 2017 Elsevier B.V. All rights reserved.

Using a community advisory board to develop a serious game for older adults undergoing treatment for cancer.

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Loerzel, Victoria; Clochesy, John; Geddie, Patricia

2018-02-01

Older adults undergoing treatment for cancer are at risk for serious complications such as chemotherapy-induced nausea and vomiting (CINV). Older adults are often overwhelmed by information and under-manage cancer treatment-related side effects. New educational strategies such as serious gaming may help teach or reinforce key symptom self-management strategies. This paper describes how a community advisory board of older adults, their caregivers, and oncology nurses were consulted to develop a serious game for CINV. A formative evaluation process using a community advisory board (CAB) and a series of three focus groups were used to develop this serious game about managing CINV at home. The formative evaluation process and involvement of the CAB allowed researchers to learn about the experience of having CINV from an older adult perspective. Common themes related to CINV onset, severity and self-management formed the basis for the serious games' script and scenarios. Themes were validated and CAB members provided feedback on a game prototype. Feedback from CAB members indicated that the serious game was realistic and reflective of their CINV experience. Including older adults in the development of a serious game was instrumental in creating a relevant educational opportunity. Serious gaming should be considered as a way to add to the educational experiences of older adults as generic teaching methods may not address the needs of all age groups. Exploring for new ways to emphasize key points related to symptom management and prioritize learning may impact outcomes for older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

The Mobile College Community: A Study of Adult Learners' Adoption and Use of Digital Communication Technologies on the Campuses of Florida's Community Colleges

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Weidert, John William

2012-01-01

Rapid advancements in technology and the proliferation of mobile communication devices available in the marketplace require that community college administrators and teachers better understand levels of digital communication technology adoption and how adult learners currently use them. Such an understanding is necessary to developing the…

Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

Science.gov (United States)

Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

2012-01-01

The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults.

Directory of Open Access Journals (Sweden)

Lake-Hui eQuek

2013-11-01

Full Text Available Background: Alcohol use and illicit drug use peak during young adulthood (around 18-29 years of age, but comparatively little is known about polydrug use in nationally representative samples of young adults. Drawing on a nationally representative cross-sectional survey (Australian National Drug Strategy Household Survey, this study examines polydrug use patterns and associated psychosocial risk factors among young adults (n = 3,333; age 19-29. Method: The use of a broad range of licit and illicit drugs were examined, including alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers and tranquillizers/sleeping pills. Latent class analysis was employed to identify patterns of polydrug use. Results: Polydrug use in this sample was best described using a 5-class solution. The majority of young adults predominantly used alcohol only (52.3%, alcohol and tobacco (34.18%. The other classes were cannabis, ecstasy, and licit drug use (9.4%, cannabis, amphetamine derivative, and licit drug use (2.8%, and sedative and alcohol use (1.3%. Young adult males with low education and/or high income were most at risk of polydrug use. Conclusion: Almost half of young adults reported polydrug use, highlighting the importance of post-high school screening for key risk factors and polydrug use profiles, and the delivery of early intervention strategies targeting illicit drugs.

The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

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Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

2016-04-01

To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

Child physical abuse and adult mental health: a national study.

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Sugaya, Luisa; Hasin, Deborah S; Olfson, Mark; Lin, Keng-Han; Grant, Bridget F; Blanco, Carlos

2012-08-01

This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000-2001 and 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16-2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention. Copyright © 2012 International Society for Traumatic Stress Studies.

Frailty as a Predictor of Nursing Home Placement Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis.

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Kojima, Gotaro

Frailty has been recognized as a medical syndrome characterized by decreased physiological reserve and vulnerability to poor resolution of homeostasis. Frailty is common in nursing homes and as many as 90% of nursing home patients are frail or prefrail. Previous studies have examined frailty as a risk factor for nursing home placement and yielded inconsistent results. The current study aims to systematically review the literature and to conduct a meta-analysis to combine the risk measures to provide the evidence on frailty as a predictor of nursing home placement among community-dwelling older adults. A systematic literature search was performed in July 2015 using 6 databases (Scopus, Embase, CINAHL Plus, MEDLINE, PsycINFO, and the Cochrane Library). Any cohort studies examining associations between frailty and risk of subsequent nursing home placement among community-dwelling older adults published from 2000 to July 2015 were potentially eligible. The numbers of those who were admitted to nursing homes and who were not, according to frailty categories, were used to calculate pooled odds ratio (OR) using fixed-effect models. The included studies were assessed for heterogeneity, methodological quality, and publication bias. The systematic literature search and hand-search identified 885 potentially relevant studies, among which 5 studies including 3528 community-dwelling older adults were selected for this review. Meta-analyses were performed using data from these studies and showed that both frailty and prefrailty significantly predicted nursing home placement (5 studies: pooled OR = 5.58, 95% confidence interval [CI] = 2.94-10.60, P dwelling older adults. It is noteworthy that adherence to the exercise programs was high and adverse events were not reported in most of the trials. These findings suggest that physical exercise can potentially prevent or reverse frailty and may lead to decreased risks of nursing home placement in older adults. This systematic review

Archaeal and bacterial community analysis of several Yellowstone National Park hot springs

Science.gov (United States)

Colman, D. R.; Takacs-Vesbach, C. D.

2012-12-01

The hot springs of Yellowstone National Park (YNP) are home to a diverse assemblage of microorganisms. Culture-independent studies have significantly expanded our understanding of the diversity of both Bacteria and Archaea present in YNP springs as well as the geochemical and ecological controls on communities. While the ecological analysis of Bacteria among the physicochemically heterogenous springs of YNP has been previously conducted, less is known about the extent of diversity of Archaeal communities and the chemical and ecological controls on their populations. Here we report a culture-independent analysis of 31 hot spring archaeal and bacterial communities of YNP springs using next generation sequencing. We found the phylogenetic diversity of Archaea to be generally comparable to that of co-occurring bacterial communities although overall, in the springs we investigated, diversity was higher for Bacteria than Archaea. Chemical and physical controls were similar for both domains with pH correlating most strongly with community composition. Community differences reflected the partitioning of taxonomic groups in low or high pH springs for both domains. Results will be discussed in a geochemical and ecological context.

Creating a Village: The Impact of the Opportunity to Participate in Synchronous Web Conferencing on Adult Learner Sense of Community

Science.gov (United States)

Gable, Karla

2012-01-01

Community is a place where people go to feel comfortable. It is important to develop strategies for enhancing a sense of community in the online learning environment designed for adult learners. The purpose of this study was to determine if adding a synchronous conferencing experience to an asynchronous course impacted overall sense of community,…

Young adult outcomes of children growing up with chronic illness: an analysis of the National Longitudinal Study of Adolescent Health.

Science.gov (United States)

Maslow, Gary R; Haydon, Abigail A; Ford, Carol Ann; Halpern, Carolyn Tucker

2011-03-01

To examine young adult outcomes in a nationally representative US cohort of young adults growing up with a chronic illness. Secondary analysis of nationally representative data from wave III (in 2001) of the National Longitudinal Study of Adolescent Health. United States. The analytic sample comprised 13 236 young adults aged 18 to 28 years at wave III. Self-report of a chronic physical illness (asthma, cancer, diabetes mellitus, or epilepsy) in adolescence. Respondents with asthma or nonasthmatic chronic illness (cancer, diabetes mellitus, or epilepsy) were compared with individuals without these conditions. Self-report of high school graduation, ever having employment, currently having employment, living with a parent/guardian, and ever receiving public assistance. Three percent of young adults had nonasthmatic chronic illness (cancer, diabetes, or epilepsy), and 16.0% had asthma. Most young adults with chronic illness graduated high school (81.3%) and currently had employment (60.4%). However, compared with healthy young adults, those with nonasthmatic chronic illness were significantly less likely to graduate high school, ever have had employment, or currently have employment and were more likely to receive public assistance. Compared with young adults with asthma, those with nonasthmatic chronic illness again had significantly worse young adult outcomes on all measures. Most young adults growing up with a chronic illness graduate high school and have employment. However, these young adults are significantly less likely than their healthy peers to achieve these important educational and vocational milestones.

Attitudes toward Bisexual Men and Women among a Nationally Representative Probability Sample of Adults in the United States

Science.gov (United States)

Herbenick, Debby; Friedman, M. Reuel; Schick, Vanessa; Fu, Tsung-Chieh (Jane); Bostwick, Wendy; Bartelt, Elizabeth; Muñoz-Laboy, Miguel; Pletta, David; Reece, Michael; Sandfort, Theo G. M.

2016-01-01

As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S. population. Our study provides an assessment of attitudes toward bisexual men and women among a nationally representative probability sample of heterosexual, gay, lesbian, and other-identified adults in the U.S. Data were collected from the 2015 National Survey of Sexual Health and Behavior (NSSHB), via an online questionnaire with a probability sample of adults (18 years and over) from throughout the U.S. We included two modified 5-item versions of the Bisexualities: Indiana Attitudes Scale (BIAS), validated sub-scales that were developed to measure attitudes toward bisexual men and women. Data were analyzed using descriptive statistics, gamma regression, and paired t-tests. Gender, sexual identity, age, race/ethnicity, income, and educational attainment were all significantly associated with participants' attitudes toward bisexual individuals. In terms of responses to individual scale items, participants were most likely to “neither agree nor disagree” with all attitudinal statements. Across sexual identities, self-identified other participants reported the most positive attitudes, while heterosexual male participants reported the least positive attitudes. As in previous research on convenience samples, we found a wide range of demographic characteristics were related with attitudes toward bisexual individuals in our nationally-representative study of heterosexual, gay/lesbian, and other-identified adults in the U.S. In particular, gender emerged as a significant

Acceptability of the Fetzer/NIA Multidimensional Measure of Religiousness and Spirituality in a sample of community-dwelling Black adults.

Science.gov (United States)

Mokel, Melissa J; Shellman, Juliette M

2014-01-01

To examine the acceptability of the National Institute on Aging/Fetzer Multidimensional Measure of Religiousness and Spirituality in a sample of Black, community-dwelling, older adults using focus group inquiry (N =15). Focus group methodology was used for data collection and analysis. Three focus groups (N = 15) were conducted in two different urban settings in the northeastern part of the United States. Key findings were that (a) self-rating on religiousness was uncomfortable for many participants, (b) selfless was a word many participants confused with selfish, and (c) spirituality was an important concept. Overall, the Measure was found to be culturally acceptable and required little modification. Religious health beliefs such as "rebuking" or "not claiming" medical diagnoses are important considerations to bear in mind in seeking to understand the impact of religiousness on health in this population.

Carotid intima-media thickness and cognitive function in a middle-aged and older adult community: a cross-sectional study.

Science.gov (United States)

Wang, Anxin; Chen, Guojuan; Su, Zhaoping; Liu, Xiaoxue; Yuan, Xiaodong; Jiang, Ruixuan; Cao, Yibin; Chen, Shuohua; Luo, Yanxia; Guo, Xiuhua; Wu, Shouling; Zhao, Xingquan

2016-10-01

The relationship between atherosclerosis and cognitive function is less well studied in Chinese populations. In addition, the results among middle-aged adults have been mixed. We aimed to investigate the association of atherosclerosis measured by carotid intima-media thickness (CIMT) and cognitive function in middle-aged and older adults from a Chinese community. Participants in the Asymptomatic Polyvascular Abnormalities in Community study (APAC) who had completed the CIMT detection and cognitive function measurements in 2012/2013 were included. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Multivariate linear regression analysis was used to analyze the association between CIMT and MMSE. Then, a stratified analysis was performed separately in middle-aged and older adults. A total of 3227 participants were included in this study (mean age 57.9 years, range 43-93 years); 56.6 % of them were men, 66.0 % were middle-aged adults. After adjusting for potential confounders, larger CIMT was associated with lower MMSE scores, with a 0.75-point decrease in MMSE score for every 1-mm increase in CIMT (β = - 0.75, P = 0.0020). The association remained statistically significant in middle-aged adults (β = - 0.57, P = 0.0390), and was stronger in older adults and adults with low education levels. There is a significant association between CIMT and cognitive function among middle-aged and older adults sampled from a Chinese population. This association was stronger in older adults and adults with low education levels.

Factor Analysis of the HEW National Strategy for Youth Development Model's Community Program Impact Scales.

Science.gov (United States)

Truckenmiller, James L.

The former HEW (Health, Education, and Welfare) National Strategy for Youth Development Model proposed a community-based program to promote positive youth development and to prevent delinquency through a sequence of youth needs assessments, needs-targeted programs, and program impact evaluation. HEW Community Program Impact Scales data obtained…

Pain profiles in a community dwelling population following spinal cord injury: a national survey.

Science.gov (United States)

Burke, Dearbhla; Fullen, Brona M; Lennon, Olive

2017-07-24

While as many as 60% of patients with spinal cord injury (SCI) develop chronic pain, limited data currently exists on the prevalence and profile of pain post-SCI in community dwelling populations. A cross-sectional population survey. Primary care. Community dwelling adults with SCI. Following ethical approval members registered to a national SCI database (n=1,574) were surveyed. The survey included demographic and SCI characteristics items, the International Spinal Cord Injury Pain Basic Data Set (version 1) the Douleur Neuropathique 4 questionnaire (interview) and questions relating to health care utilisation. Data were entered into the Statistical Package for the Social Sciences (version 20) Significance was set P < 0.05 for between group comparisons. In total 643 (41%) surveys were returned with 458 (71%) respondents experiencing pain in the previous week. Neuropathic pain (NP) was indicated in 236 (37%) of responses and nociceptive pain in 206 (32%) Common treatments for pain included medications n=347 (76%) massage n=133 (29%) and heat n=115 (25%). Respondents with NP reported higher pain intensities and increased healthcare service utilisation (P= < 0.001) when compared to those with nociceptive pain presentations. A higher proportion of females than males reported pain (P = 0.003) and NP (P = 0.001) and those unemployed presented with greater NP profiles compared with those in education or employment (P = 0.006). Pain, in particular NP post SCI interferes with daily life, increases health service utilisation and remains refractory to current management strategies. Increased availability of multi-disciplinary pain management and further research into management strategies is warranted.

Health Promotion Outcomes of a Newly Developed Elastic Band Exercise Program for Older Adults in the Community: A Pilot Test.

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Chan, Shu-Ya; Kuo, Chang-Chih; Chen, Kuei-Min; Tseng, Wei-Shyuan; Huang, Hsin-Ting; Li, Chun-Huw

2016-06-01

Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.

An assessment of energy options for a remote first nation community. Paper no. IGEC-1-055

International Nuclear Information System (INIS)

Ianniciello, C.; Wild, P.; Pitt, L.; Artz, S.

2005-01-01

Development of renewable energy systems for remote communities is gaining interest among government, utilities, NGOs and the communities themselves as a means of improving lifestyles of community members and showcasing renewable energy systems. The Huu-ay-aht First Nation, whose traditional territory is located on the west side of Vancouver Island in British Columbia, is a community which has energy related problems and energy related opportunities. The objective of this study is to assess possible energy options for the Huu-ay-aht First Nation traditional territory. Current and future energy services within the territory were used as the starting point for developing energy system options. Extensive consultation with community members was instrumental in clearly defining the objectives of the study and understanding the territory's energy demand. The energy demand assessment included an estimation of the electric, heating and transportation loads in the community, an assessment of efficiency and demand side management (DSM) options, and an estimation of potential future demand scenarios. Energy resources were assessed, with viable ones retained for consideration in potential energy system options. The information from the community consultations, demand estimates and resource assessments are being used in the development and analysis of energy system options to support the Huu-ay-aht's energy needs and community goals. (author)

Understanding the Health Literacy of America Results of the National Assessment of Adult Literacy

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Cutilli, Carolyn Crane; Bennett, Ian M.

2009-01-01

Health literacy refers to an individual’s ability to understand healthcare information to make appropriate decisions (S. C Ratzen & R. M. Parker, 2000). Healthcare professionals are obligated to make sure that patients understand information to maximize the benefits of healthcare. The National Assessment of Adult Literacy (NAAL) provides information on the literacy/health literacy levels of the U.S. adult population. The NAAL is the only large-scale survey of health literacy. The results of t...

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

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Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Community-based intervention to improve dietary habits and promote physical activity among older adults: a cluster randomized trial

Directory of Open Access Journals (Sweden)

Kimura Mika

2013-01-01

Full Text Available Abstract Background The fastest growing age group globally is older adults, and preventing the need for long-term nursing care in this group is important for social and financial reasons. A population approach to diet and physical activity through the use of social services can play an important role in prevention. This study examined the effectiveness of a social health program for community-dwelling older adults aimed at introducing and promoting physical activity in the home at each individual’s pace, helping participants maintain good dietary habits by keeping self-check sheets, and determining whether long-standing unhealthy or less-than-ideal physical and dietary habits can be changed. Method This cluster randomized trial conducted at 6 community centers in an urban community involved 92 community-dwelling older adults aged 65–90 years. The intervention group (3 community centers; n = 57 participated in the social health program “Sumida TAKE10!” which is an educational program incorporating the “TAKE10!® for Older Adults” program, once every 2 weeks for 3 months. The control group (3 community centers; n=35 was subsequently provided with the same program as a crossover intervention group. The main outcome measures were changes in food intake frequency, food frequency score (FFS, dietary variety score (DVS, and frequency of walking and exercise. The secondary outcome measures were changes in self-rated health, appetite, and the Tokyo Metropolitan Institute of Gerontology (TMIG Index of Competence score. Results Compared to baseline, post-intervention food intake frequency for 6 of 10 food groups (meat, fish/shellfish, eggs, potatoes, fruits, and seaweed, FFS, and DVS were significantly increased in the intervention group, and interaction effects of FFS and DVS were seen between the two groups. No significant differences were observed between baseline and post-intervention in the control group. Frequency of walking and

The Experiences of Reciprocity among Filipino Older Adults in Canada: Intergenerational, Transnational, and Community Considerations.

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Ferrer, Ilyan; Brotman, Shari; Grenier, Amanda

2017-01-01

This article illustrates the concept of reciprocity in the context of immigrant families. It recommends that definition of reciprocity account for exchanges beyond the immediate family, and render visible the simultaneous location of older people as care recipients and providers, and care arrangements across generations, borders, community, and time. Adopting a critical ethnographic study on the aging and care experiences of older Filipinos in Canada, this article analyzes data from extended observations and in-depth semi-structured interviews with 18 older people, 6 adult children, and 13 community stakeholders. Findings highlight the unique configurations of care among the Filipino community whereby older people engage in care exchange as active participants across intergenerational, transnational, and fictive kin networks.

Homeopathy Use by US Adults: Results of a National Survey.

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Dossett, Michelle L; Davis, Roger B; Kaptchuk, Ted J; Yeh, Gloria Y

2016-04-01

We used the 2012 National Health Interview Survey to compare homeopathy users with supplement users and those using other forms of complementary and integrative medicine. Among US adults, 2.1% used homeopathy within the past 12 months. Respiratory and otorhinolaryngology complaints were most commonly treated (18.5%). Homeopathy users were more likely to use multiple complementary and integrative medicine therapies and to perceive the therapy as helpful than were supplement users. US homeopathy use remains uncommon; however, users perceive it as helpful.

Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis.

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Schmidt, Catherine T; Ward, Rachel E; Suri, Pradeep; Kiely, Dan K; Ni, Pengsheng; Anderson, Dennis E; Bean, Jonathan F

2017-07-01

To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility. Cross-sectional; secondary data analysis of a cohort study. Outpatient rehabilitation center. Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54). Not applicable. Short Physical Performance Battery score, habitual gait speed, and chair stand test. Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry

National approaches to promote sports and physical activity in adults with disabilities: examples from the Netherlands and Canada.

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Hoekstra, Femke; Roberts, Lynn; van Lindert, Caroline; Martin Ginis, Kathleen A; van der Woude, Lucas H V; McColl, Mary Ann

2018-01-15

This study described how the Dutch and Canadian governments promote high performance sports, recreational sports, and physical activity (PA) among adults with disabilities on a national level. An internet-based study was conducted to identify and select relevant documents and websites containing information about the national approach to promote disability sports and physical activities in the Netherlands and Canada. Both governments promote high performance sports in similar ways, but use different strategies to promote recreational sports and physical activities. The Dutch approach is characterized by using time-limited programs focusing on enhancement of sports infrastructure and inter-sector collaboration in which municipalities have key roles. The Canadian government promotes recreational sports in disabled populations by supporting programs via bilateral agreements with provinces and territories. Furthermore, the level of integration of disability sports into mainstream sports differs between countries. The findings of this study may inspire policy makers from different countries to learn from one another's policies in order to optimize national approaches to promote disability sports and PA on all levels. Implications for rehabilitation It is recommended for policy makers of national governments to develop and implement policy programs that promote sports and physical activities among people with disabilities because of its potential impact on functioning, participation, quality of life, and health. Insight into national approaches to promote sport and physical activities is relevant for rehabilitation practice to understand ongoing opportunities for people with disabilities to stay physically active after rehabilitation through participation in home and/or community-based sport and physical activities. It seems worthwhile to integrate activities to promote sport and physical activities in rehabilitation in such a way that it fits with the current

Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke

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Pollock, Courtney L.; Brouwer, Brenda; Garland, S. Jayne

2016-01-01

Background The Community Balance and Mobility Scale (CB&M) is increasingly used to evaluate walking balance following stroke. Objective This study applied Rasch analysis to evaluate and refine the CB&M for use in ambulatory community-dwelling adults following stroke. Methods The CB&M content was linked to task demands and motor skill classifications. Rasch analysis was used to evaluate internal construct validity (structural validity) and refine the CB&M for use with ambulatory community-dwelling adults following stroke. The CB&M data were collected at 3 time points: at discharge from inpatient rehabilitation and at 6 and 12 months postdischarge (N=238). Rasch analysis evaluated scale dimensionality, item and person fit, item response bias, scoring hierarchy, and targeting. Disordered scoring hierarchy was resolved by collapsing scoring categories. Highly correlated and “misfitting” items were removed. Sensitivity to change was evaluated with standardized response means (SRMs) and one-way repeated-measures analysis of variance. Results The CB&M was primarily linked to closed body transport task demands. Significant item-trait interaction, disordered scoring hierarchies, and multidimensionality were found. Scoring categories were collapsed in 15/19 items, and 5 misfitting items were removed. The resulting stroke-specific 14-item unidimensional CB&M (CB&MStroke) fit Rasch model expectations, with no item response bias, acceptable targeting (13% floor effects and 0% ceiling effects), and moderate-to-strong sensitivity to change at 6 months postdischarge (SRM=0.63; 95% confidence interval=−1.523, −0.142) and 12 months postdischarge (SRM=0.73; 95% confidence interval=−2.318, −0.760). Limitations Findings are limited to a modest-sized sample of individuals with mild-to-moderate balance impairment following stroke. Conclusions The CB&MStroke shows promise as a clinical scale for measuring change in walking balance in ambulatory community-dwelling adults

A Community-Based Leadership Development Program for First Nations Women: Revaluing and Honoring Women’s Strengths

Directory of Open Access Journals (Sweden)

K. Amanda Maranzan

2013-06-01

Full Text Available Over 400 First Nation women participated in leadership development workshops developed by First Nation women for First Nation women. We collected survey data and conducted focus groups and interviews with workshop participants to identify outcomes and determine barriers and resources to women in leadership. Outcomes of the workshop included increased perception of women as leaders, increased personal capacity, and encouragement to seek opportunities for formal and informal leadership positions. Family and home responsibility, community pressure, and lack of support were identified as barriers faced by women in leadership or considering leadership positions. This program represents an effort to empower women to participate in social, cultural, and political life within their communities and obtain equitable political representation.

Relationship between chronic kidney disease with diabetes or hypertension and frailty in community-dwelling Japanese older adults.

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Lee, Sungchul; Lee, Sangyoon; Harada, Kazuhiro; Bae, Seongryu; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Park, Hyuntae; Suzuki, Takao; Shimada, Hiroyuki

2017-10-01

The aim of the present study was to evaluate the relationship between kidney function with concomitant diabetes or hypertension and frailty in community-dwelling Japanese older adults. The participants were 9606 residents (community-dwelling Japanese older adults) who completed baseline assessments. The estimated glomerular filtration rate (mL/min/1.73 m 2 ) was determined according to the serum creatinine level, and participants were classified into four mutually exclusive categories: ≥60.0 (normal range), 45.0-59.9, 30.0-44.9 and who met three, four or five criteria satisfied the definition of having frailty. Multivariate logistic regression was used to examine the relationships between estimated glomerular filtration rate and frailty. After multivariate adjustment, participants with lower kidney function (estimated glomerular filtration rate hypertension (OR 2.53, 95% CI 1.45-5.12) showed a significantly increased risk of frailty in the lower kidney function group, regardless of multivariate controls. Furthermore, the analyses showed an even greater increase in the risk of frailty in patients with a history of both diabetes and hypertension (OR 3.67, 95% CI 1.13-14.1) CONCLUSIONS: A lower level of kidney function was associated with a higher risk of frailty in community-dwelling Japanese older adults. Geriatr Gerontol Int 2017; 17: 1527-1533. © 2016 Japan Geriatrics Society.

National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults.

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Mojtabai, Ramin; Olfson, Mark; Han, Beth

2016-12-01

This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014. Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services. The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents. The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group. Copyright © 2016 by the American Academy of Pediatrics.

Subjective memory impairment and well-being in community-dwelling older adults.

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Zuniga, Krystle E; Mackenzie, Michael J; Kramer, Arthur; McAuley, Edward

2016-01-01

The relationship between subjective memory impairment (SMI), future cognitive decline, and negative health status provides an opportunity for interventions to reduce memory complaints in high-risk groups. This study aimed to examine the relationship between SMI and indicators of well-being in older adults enrolled in an exercise trial. Additionally, the study examined whether two different modes of exercise training, aerobic walking and non-aerobic flexibility, toning, and balance, differentially influenced subjective memory across the trial. Community-dwelling older adults (n = 179, mean age = 66.4 years) were randomly assigned to a walking or flexibility, toning, and balance group for 12 months. Subjective memory, happiness, perceived stress, and symptom reporting were measured at baseline, 6 months, and 12 months. A main effect of subjective memory indicated that individuals with the fewest memory complaints had lower perceived stress (P happiness levels (P memory complaints in high-risk groups. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration.

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Tseng, Wei-Che; Hsieh, Ru-Lan

2013-06-01

The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF. Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version. Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured. Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.

Communities' vision of benefits derived from ecotourism in Amacayacu National Park (Amazon region, Colombia)

International Nuclear Information System (INIS)

Ochoa Fonseca, Fredy Alfonso; James, Johannie; Marquez, German

2013-01-01

Ecotourism is an opportunity to create development, conservation and benefits for communities. Under these principles in 2004 National Parks gave in concession the ecotourism services of PNN Amacayacu. This process has generated questions and discomfort. This research analyzes the communities' vision of the PNN Amacayacu about the benefits derived from ecotourism through a qualitative methodology that establishes the community perception on the issue. Results show ecotourism as an exogenous development model that generates some economic income but also impacts livelihoods and local culture. It also shows that there are benefits more valued by the community as participation in decision-making. This research highlights the relevance of inquiring which type of development ecotourism brings and the importance that communities themselves decide on development through ecotourism.

Linking community-based and national REDD+ monitoring: a review of the potential

NARCIS (Netherlands)

Pratihast, A.K.; Herold, M.; Sy, de V.; Murdiyarso, D.; Skutsch, M.

2013-01-01

Countries participating in REDD+ schemes are required to establish a national monitoring system that keeps track of forest carbon changes over time. Community-based monitoring (CBM) can be useful for tracking locally driven forest change activities and their impacts. In this paper, we review some of

The National LGBT Cancer Action Plan: A White Paper of the 2014 National Summit on Cancer in the LGBT Communities

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Margolies, Liz; Sigurdsson, Hrafn Oli; Walland, Jonathan; Radix, Asa; Rice, David; Buchting, Francisco O.; Sanchez, Nelson F.; Bare, Michael G.; Boehmer, Ulrike; Cahill, Sean; Griebling, Tomas L.; Bruessow, Diane; Maingi, Shail

2016-01-01

Abstract Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.

Using Biographical Prompts to Build Community in an Online Graduate Course: An Adult Learning Perspective

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Lohr, Kathy D.; Haley, Karen J.

2018-01-01

Adult learners are taking advantage of the availability and convenience of online education. Mature learners in online higher education classrooms bring a wealth of experience filtered through cultural, generational, and socioeconomical differences. The purpose of this research was to explore community building in an online graduate course by…

Comparison of the Berg Balance Scale and Fullerton Advanced Balance Scale to predict falls in community-dwelling adults.

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Jeon, Yong-Jin; Kim, Gyoung-Mo

2017-02-01

[Purpose] The purpose of this study was to investigate and compare the predictive properties of Berg Balance Scale and Fullerton Advanced Balance Scales, in a group of independently-functioning community dwelling older adults. [Subjects and Methods] Ninety-seven community-dwelling older adults (male=39, female=58) who were capable of walking independently on assessment were included in this study. A binary logistic regression analysis of the Berg Balance Scale and Fullerton Advanced Balance Scale scores was used to investigate a predictive model for fall risk. A receiver operating characteristic analysis was conducted for each, to determine the cut-off for optimal levels of sensitivity and specificity. [Results] The overall prediction success rate was 89.7%; the total Berg Balance Scale and Fullerton Advanced Balance Scale scores were significant in predicting fall risk. Receiver operating characteristic analysis determined that a cut-off score of 40 out of 56 on the Berg Balance Scale produced the highest sensitivity (0.82) and specificity (0.67), and a cut-off score of 22 out of 40 on the Fullerton Advanced Balance Scale produced the highest sensitivity (0.85) and specificity (0.65) in predicting faller status. [Conclusion] The Berg Balance Scale and Fullerton Advanced Balance Scales can predict fall risk, when used for independently-functioning community-dwelling older adults.

Reliability and validity of the Japanese version of the simplified nutritional appetite questionnaire in community-dwelling older adults.

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Nakatsu, Nobuyuki; Sawa, Ryuichi; Misu, Shogo; Ueda, Yuya; Ono, Rei

2015-12-01

To translate the Simplified Nutritional Appetite Questionnaire (SNAQ) into Japanese, and assess its reliability and validity in Japanese community-dwelling older adults. A total of 84 community-dwelling older adults people aged 65 years or older were included in the present study, and those with a Mini-Mental State Examination score of validity was evaluated by measuring the Pearson's correlation coefficient between the SNAQ and Mini-Nutritional Assessment Short-Form scores, Geriatric Depression Scale scores, walking speed test, chair-stand test, hand grip strength test, or the Timed Up and Go test. The mean score of the Japanese version of the SNAQ was 15.5, with a Cronbach's alpha coefficient of 0.545 and intraclass correlation coefficient of 0.754. Factor analysis showed a single factor with 50.0% explained variance. The SNAQ was significantly associated with the Mini-Nutritional Assessment Short-Form, Geriatric Depression Scale, walking speed test, chair-stand test and the Timed Up and Go test. Handgrip strength test did not show a significant association with the SNAQ. The Japanese version of the SNAQ had sufficient reliability and validity. Furthermore, SNAQ (Japanese version) is useful for evaluating the appetite of community-dwelling older adults in Japan. Geriatr Gerontol Int 2015; 15: 1264-1269. © 2014 Japan Geriatrics Society.

Health of adults caring for orphaned children in an HIV-endemic community in South Africa.

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Kuo, Caroline; Operario, Don

2011-09-01

In South Africa, an estimated 2.5 million children have been orphaned by AIDS and other causes of adult mortality. Although there is a growing body of research on the well-being of South African orphaned children, few research studies have examined the health of adult individuals caring for children in HIV-endemic communities. The cross-sectional survey assessed prevalence of general health and functioning (based on Short-Form 36 version 2 scale), depression (based on Center for Epidemiologic Studies-Depression scale), anxiety (using Kessler-10 scale), and post-traumatic stress (using the Harvard Trauma Questionnaire) among a representative community sample of adults caring for children in Umlazi Township, an HIV-endemic community in South Africa. Of 1599 respondents, 33% (n=530) were carers of orphaned children. Results showed that, overall, carers reported poor general health and functioning and elevated levels of depression, anxiety, and post-traumatic stress. Carers of orphaned children reported significantly poorer general health and functioning and higher rates of depression and post-traumatic stress compared with carers of non-orphaned children. In multivariate analyses, orphan carer and non-orphan carer differences in general health were accounted for by age, gender, education, economic assets, and source of income, but differences in depression were independent of these cofactors. Interventions are needed to address physical and mental health of carers in general. Greater health problems among orphan carers appeared to be fully explained by socioeconomic characteristics, which offer opportunities for targeting of programs. More research is needed to understand determinants of mental health disparities among orphan carers, which were not explained by socioeconomic characteristics.

Avian influenza prevalence among hunter-harvested birds in a remote Canadian First Nation community.

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Liberda, Eric N; Meldrum, Richard; Charania, Nadia A; Davey, Robert; Tsuji, Leonard Js

2017-01-01

Avian influenza virus (AIV) prevalence has been associated with wild game and other bird species. The contamination of these birds may pose a greater risk to those who regularly hunt and consumed infected species. Due to resident concerns communicated by local Band Council, hunter-harvested birds from a remote First Nation community in subArctic Ontario, Canada were assessed for AIV. Hunters, and especially those who live a subsistence lifestyle, are at higher risk of AIV exposure due to their increased contact with wild birds, which represent an important part of their diet. Cloacal swabs from 304 harvested game birds representing several species of wild birds commonly hunted and consumed in this First Nation community were analyzed for AIV using real-time reverse transcription polymerase chain reaction. Subtyping was performed using reverse transcription polymerase chain reaction. Sequences were assembled using Lasergene, and the sequences were compared to Genbank. In total, 16 of the 304 cloacal swab samples were positive for AIV. Of the 16 positive samples, 12 were found in mallard ducks, 3 were found in snow geese (wavies), and 1 positive sample was found in partridge. The AIV samples were subtyped, when possible, and found to be positive for the low pathogenic avian influenza virus subtypes H3 and H4. No samples were positive for subtypes of human concern, namely H5 and H7. This work represents the first AIV monitoring program results of hunter-harvested birds in a remote subsistence First Nation community. Community-level surveillance of AIV in remote subsistence hunting communities may help to identify future risks, while educating those who may have the highest exposure about proper handling of hunted birds. Ultimately, only low pathogenic strains of AIV were found, but monitoring should be continued and expanded to safeguard those with the highest exposure risk to AIV.

Rethinking Environmental Science Education from Indigenous Knowledge Perspectives: An Experience with a Dene First Nation Community

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Datta, Ranjan Kumar

2018-01-01

This auto-ethnographic article explores how land-based education might challenge Western environmental science education (ESE) in an Indigenous community. This learning experience was developed from two perspectives: first, land-based educational stories from Dene First Nation community Elders, knowledge holders, teachers, and students; and…

Hypertension awareness and control among young adults in the national longitudinal study of adolescent health.

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Gooding, Holly C; McGinty, Shannon; Richmond, Tracy K; Gillman, Matthew W; Field, Alison E

2014-08-01

Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension. To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group. Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008. We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was young adults with hypertension, 2,531 (76%) were uncontrolled, and 1,893 (75%) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95% confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64% less likely to be aware they had hypertension (OR 0.36, 95% CI 0.23-0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control. In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.

Adults and Children in Low-Income Households that Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption.

Science.gov (United States)

Hanson, Karla L; Kolodinsky, Jane; Wang, Weiwei; Morgan, Emily H; Pitts, Stephanie B Jilcott; Ammerman, Alice S; Sitaker, Marilyn; Seguin, Rebecca A

2017-07-08

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 ( n = 41) and February 2016 ( n = 23). FVI was measured by the National Cancer Institute's (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t -tests ( p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes.

Postural changes versus balance control and falls in community-living older adults: a systematic review

Directory of Open Access Journals (Sweden)

Viviane Lemos Silva Fernandes

2018-06-01

Full Text Available Abstract Introduction: Since falls are considered to be a public health problem, it is important to identify whether postural changes over time contribute to the risk of falls in older adults. Objective: To investigate whether postural changes increase fall risk and/or postural imbalance in healthy, community-dwelling older adults. Methods: In April 2016, two reviewers independently searched the PubMed, Web of Science, SPORTDiscus, and CINAHL databases for studies in English published in the previous 10 years, using the following combined keywords: “posture” or (“kyphosis”,“lumbar lordosis”,“flexed posture”,“spinal curvature”,“spinal sagittal contour” AND “elderly” AND “fall”. Study quality was assessed according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology guidelines for observational studies. Results: The search retrieved 1,734 articles. Only observational studies that assessed posture, balance, and/or falls in older adults were considered eligible for review. The final sample included 17 articles: reliability and reproducibility of the instruments were not reported in five studies, while two studies offered a questionable description of the instruments used. Fourteen articles analyzed postural changes at the trunk level and three articles assessed them at the ankles and feet. Most studies found a positive association between postural changes and an increased risk for loss of balance and falls. Conclusion: Thoracic hyperkyphosis, loss of lumbar lordosis, and decreased plantar arch seem to contribute to greater postural instability, and thus to a higher risk of falls in community-living older adults.

Factors impacting the household and recreation participation of older adults living in the community.

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Pritchard, Elizabeth; Barker, Anna; Day, Lesley; Clemson, Lindy; Brown, Ted; Haines, Terry

2015-01-01

To identify demographic, physical and psychosocial determinants associated with participation in daily activities of community-dwelling older adults. A cross-sectional design of older adults (≥70 years) from Victoria, Australia, residing in their homes was drawn from a convenience sample. The outcomes were recent participation in household and recreational activities as measured by the Phone-FITT. Explanatory variables included demographics, physical and mental health functioning (Short Form-12 version 2, Geriatric Depression Scale 15). Associations were analyzed through linear regression. There were 244 participants (60% female), with a mean age of 77.5 years (SD 5.7). Higher levels of depression and fewer falls (during the previous year) were independently associated with restrictions in household participation (p falls and restricted household participation were associated, but no association was observed between falls and recreational participation. Further studies are required to explore this association in more detail. Implications for Rehabilitation Depression is significantly correlated with the level of participation in daily activities for older adults. Health professionals need to screen for depression when working with older adults.

The development of national quality performance standards for disposable absorbent products for adult incontinence.

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Muller, Nancy; McInnis, Elaine

2013-09-01

Disposable absorbent products are widely used in inpatient care settings and in the community to manage adult urinary and fecal incontinence, but few product standards exist to help guide their production or optimal use. Increasing costs and reduced revenues have caused a number of states to evaluate absorbent product use among persons who receive care at home with the assistance of the Medicaid Waiver Program, further increasing concerns about the lack of product performance standards. To address these issues, the National Association For Continence (NAFC) formed a council of experts and key stakeholders with the objective of establishing national, independent quality performance standards for disposable absorbent products provided by states to Waiver Program recipients. The Council consisted of representatives from five purposefully selected states, technical directors from six nonwoven product manufacturers, an officer of the nonwoven manufactures trade association, a delegate from an academic nursing program and professional societies, a family caregiver, and a patient representative. Following a consensus method and guidelines for use, nine specific recommendations were developed, posted for public comment, and further refined. Final recommendations for product performance assessment include: rewet rate (a measure of a product's ability to withstand multiple incontinent episodes between changes), rate of acquisition (a measure of the speed at which urine is drawn away from the skin by a product, product retention capacity (a measure of a product's capacity to hold fluid without rewetting the skin), sizing options, absorbency levels, product safety, closure technology, breathable zones (a measure of the air permeability across a textile-like fabric at a controlled differential pressure), and elasticity. The Council also set values for and recommended four quantifiable parameters, and the testing methodology associated with each, to help consumers and states

The Jamaica asthma and allergies national prevalence survey: rationale and methods

Directory of Open Access Journals (Sweden)

Edwards Nancy C

2010-04-01

Full Text Available Abstract Background Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. Methods/Design An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates. Discussion The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.

Hypertension among US adults by disability status and type, National Health and Nutrition Examination Survey, 2001-2010.

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Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S

2014-08-14

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001-2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16-1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts.

The association between physical activity and social isolation in community-dwelling older adults.

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Robins, Lauren M; Hill, Keith D; Finch, Caroline F; Clemson, Lindy; Haines, Terry

2018-02-01

Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01-1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R 2 = 0.104). Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Life-space mobility and dimensions of depressive symptoms among community-dwelling older adults.

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Polku, Hannele; Mikkola, Tuija M; Portegijs, Erja; Rantakokko, Merja; Kokko, Katja; Kauppinen, Markku; Rantanen, Taina; Viljanen, Anne

2015-01-01

To examine the association between life-space mobility and different dimensions of depressive symptoms among older community-dwelling people. Cross-sectional analyses of baseline data of the 'Life-Space Mobility in Old Age' cohort study were carried out. The participants were community-dwelling women and men aged 75-90 years (N = 848). Data were gathered via structured interviews in participants' home. Life-space mobility (the University of Alabama at Birmingham (UAB) Life-Space Assessment - questionnaire) and depressive symptoms (Centre for Epidemiological Studies Depression Scale, CES-D) were assessed. Other factors examined included sociodemographic factors, difficulties walking 500 m, number of chronic diseases and the sense of autonomy in participation outdoors (subscale of Impact on Participation and Autonomy questionnaire). Poorer life-space mobility was associated with higher prevalence of different dimensions of depressive symptoms. The associations were partially mediated through walking difficulties, health and the sense of autonomy in participation outdoor activities. Poorer life-space mobility interrelates with higher probability for depressive symptoms, thus compromising older adults' mental wellbeing. A focus on older adults' life-space mobility may assist early identification of persons, who have elevated risk for depressive symptoms. The association between life-space mobility and depressive symptoms should be studied further utilizing longitudinal study designs to examine temporality and potential causality.

Adolescent experiences of discrimination, harassment, connectedness to community and comfort with sexual orientation reported by adult men who have sex with men as a predictor of adult HIV status.

Science.gov (United States)

Raymond, H Fisher; Chen, Yea-Hung; Stall, Ron D; McFarland, Willi

2011-04-01

Using data from a probability based sample of adult men who have sex with men (MSM) we examined the association of negative life factors during adolescence and adult HIV status. 521 MSM reported on experiences of connectedness to community, comfort with sexuality, harassment and discrimination due to their sexual orientation at ages 12-18 years. HIV status was determined by serological testing. Overall, men reported moderate levels of being harassed, being discriminated against and high levels of feeling disconnected from gay communities while reporting high levels of being uncomfortable with their sexuality at those ages. However, in analyses of scores on these factors, higher experiences of harassment, higher levels of discrimination and more discomfort with sexuality at these ages are associated with HIV-negative status as adults. This study suggests that the relationship between negative adolescent experiences among MSM and adult HIV infection may not be straightforward, but may also dependent upon aspects of the intensity of the negative experiences, the relationship of the victim and the perpertrator(s), the sexual identity of the victim at the time and/or the number of these experiences or the length of time over which they occurred. Studies investigating specific multiple stressors in adolescent gay development and their effect on adult health outcomes are needed.

Maintaining the balance: older adults with chronic health problems manage life in the community.

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Jacelon, Cynthia S

2010-01-01

The purpose of this research was to identify themes in the daily lives of community-dwelling older adults with chronic health problems. Qualitative descriptive methods based on symbolic interaction were used. Data were generated through unstructured interviews, participant diaries, and researcher logs. Participants were interviewed twice and kept diaries in between. Measures to enhance trustworthiness included bracketing, multiple data sources, repeated interviews, prolonged engagement, an audit trail, participant checking, and consultation with an expert qualitative researcher. Ten older adults 75-98 years of age living in their own homes with at least one self-reported chronic health problem participated in the research. Participants' health problems varied, and they developed strategies to maintain balance in activity, attitude, autonomy, health, and relationships. This research provides a new perspective on living with chronic illness, and the model may provide a framework for rehabilitation nurses who work with older adults.

Relationship of functional fitness with daily steps in community-dwelling older adults.

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de Melo, Lucelia Luna; Menec, Verena H; Ready, A Elizabeth

2014-01-01

Walking is the main type of physical activity among community-dwelling older adults and it is associated with various health benefits. However, there is limited evidence about the relationship between functional fitness and walking performed under independent living conditions among older adults. This study examined the relationship between functional fitness and steps walked per day among older adults, both assessed objectively, with performance-based measures accounting for the effect of age, gender, and chronic conditions. In this cross-sectional study, 60 participants aged 65 years or older (mean = 76.9 ± 7.3 years, range 65-92 years) wore pedometers for 3 consecutive days. Functional fitness was measured using the Functional Fitness Test (lower and upper body strength, endurance, lower and upper body flexibility, agility/balance). The outcome measure was the mean number of steps walked for 3 days with participants classified into tertiles: low walkers (age, gender, and the number of chronic conditions, none of the functional fitness parameters was significantly associated with steps taken per day when comparing medium walkers with low walkers. In contrast, all functional fitness parameters, except upper body flexibility, were significantly associated with steps taken per day when comparing high walkers with low walkers. In this sample of older adults, greater functional fitness was associated only with relatively high levels of walking involving 6500 steps per day or more. It was not related to medium walking levels. The findings point to the importance of interventions to maintain or enhance functional fitness among older adults.

Mediators of the relationship between life events and memory functioning in a community sample of adults

NARCIS (Netherlands)

Korten, N.C.M.; Sliwinski, M.J.; Comijs, H.C.; Smyth, J.M.

2014-01-01

The present study examines the association of frequency and severity of life events with memory functioning in a community sample of adults. We tested the hypothesis that stress-related cognitive interference mediated the effects of recent life events on cognition, in addition to examining the

Challenges in the delivery of nutrition services to hospital discharged older adults: the community connections demonstration project.

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Sahyoun, Nadine R; Akobundu, Ucheoma; Coray, Kevin; Netterville, Linda

2009-04-01

The objective of this project was to explore the effort necessary to transform the Older Americans Act Nutrition Program (OAANP) into core programs within an integrated health care delivery system that serves hospital-discharged older adults in order to assist them in reintegrating into the community. Six OAANPs in six states were funded and provided technical assistance to develop coalitions with hospitals and community organizations. Each demonstration site was unique and faced many challenges in reaching out to a hospitalized vulnerable population. This project also provided opportunities to try out new initiatives and examine their sustainability within the community.

Morphological and qualitative characteristics of the quadriceps muscle of community-dwelling older adults based on ultrasound imaging: classification using latent class analysis.

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Kawai, Hisashi; Kera, Takeshi; Hirayama, Ryo; Hirano, Hirohiko; Fujiwara, Yoshinori; Ihara, Kazushige; Kojima, Motonaga; Obuchi, Shuichi

2018-04-01

Muscle thickness and echo intensity measured using ultrasound imaging represent both increased muscle volume and connective tissue accumulation. In combination, these ultrasound measurements can be utilized for assessing sarcopenia in community-dwelling older adults. This study aimed to determine whether morphological and qualitative characteristics classified by quadriceps muscle thickness and echo intensity measured using ultrasound are associated with muscle strength, physical function, and sarcopenia in community-dwelling older adults. Quadriceps muscle thickness and echo intensity were measured using ultrasound imaging in 1239 community-dwelling older adults. Latent class analyses were conducted to classify participants based on similarity in the subcutaneous fat thickness (FT), quadriceps muscle thickness (MT), subcutaneous fat echo intensity (FEI), and muscle echo intensity (MEI), which were assessed using ultrasound imaging. Morphological and qualitative characteristics were classified into four types as follows: (A) normal, (B) sarcopenic obesity, (C) obesity, and (D) sarcopenia type. Knee extension strength was significantly greater in A than in B and D. FT and percent body fat were greater in C than in the other types. The correlation between the ultrasound measures and knee extension strength differed among the classification types. The classification types were significantly associated with sarcopenia prevalence. Classification of the morphological and qualitative characteristics obtained from ultrasound imaging may be useful for assessing sarcopenia in community-dwelling older adults.

National Cholesterol Education Panel III performance in preventing myocardial infarction in young adults

International Nuclear Information System (INIS)

Dib, Jean J.; Alameddine, Y.; Geitany, R.; Afiouni, F.

2008-01-01

Only one published has directly evaluated the utility of National Cholesterol Education Program (NCEP) guidelines in young adults that study population consisted of young Americans. We examined the utility of the latest NCEP Adult Treatment Panel III (ATPIII) guidelines in a group of young Lebanese adults. A group of 234 young adults admitted for myocardial infarction at a Lebanese teaching hospital over a 2-year period were evaluated retrospectively. The Framingham risk predictor model was used to calculate the 10-year risk for coronary events in all subjects. Two hundred young Lebanese adults with a mean age of 49+-7.6 years were included in the analysis. The majority of the study population had a history of smoking (67%) and LDL cholesterol <130 mg/dL (70.5%) and were considered overweight and obese (80.5%). As a group, 80% did not meat the criteria to qualify for antilipiemic pharmacotherapy prior to their presentation. The predictive model did not detect the majority of these patients. Clinicians should treat modifiable risk factors with the same intensity given to cholesterol even if the patient has a normal lipid profile. (author)

Community awareness and predictors of uptake of pertussis booster vaccine in South Australian adults.

Science.gov (United States)

Clarke, Michelle; Thomas, Natalie; Giles, Lynne; Marshall, Helen

2015-12-16

Pertussis is a highly virulent vaccine preventable disease that remains a global challenge. This study aimed to assess community knowledge of pertussis infection as well as awareness and uptake of adult pertussis booster vaccine. A cross-sectional survey was conducted of randomly selected households in South Australia by Computer Assisted Telephone Interviews in 2011. Survey data were weighted to the age, gender and geographical area profile of the population. From 3124 randomly sampled contactable households, 1967 interviews were conducted (participation rate 63%) with individuals aged 18-93 years, including 608 parents of children aged pertussis (whooping cough) and 18% reported that a household member had previously contracted whooping cough infection. Most respondents considered whooping cough to be highly contagious (73%) and severe for infants (89%). Over half (51%) of those surveyed were aware that family members commonly transmit pertussis to infants. Despite high knowledge, pertussis vaccine uptake was low, with only 10% of respondents reporting pertussis vaccination in the previous five years. Whilst 61% of respondents were aware of the availability of an adult pertussis booster vaccine, only 8% (n=154) reported their Family Physician had discussed it with them. If provided free, 77% agreed that they would be more likely to accept a booster pertussis vaccination. Independent predictors of recent pertussis vaccination included higher education, larger household size, perception of greater disease severity for infants and discussion with a Family Physician about pertussis vaccination. Whilst knowledge regarding transmission and severity of Bordetella pertussis was high, uptake of pertussis vaccination for adults is remarkably low amongst the South Australian community. Improved awareness regarding the availability of a booster pertussis vaccine through Family Physicians and/or provision of funded pertussis vaccination for adults has the potential to improve

Innovations in adult influenza vaccination in China, 2014-2015: Leveraging a chronic disease management system in a community-based intervention.

Science.gov (United States)

Yi, Bo; Zhou, Suizan; Song, Ying; Chen, Enfu; Lao, Xuyin; Cai, Jian; Greene, Carolyn M; Feng, Luzhao; Zheng, Jiandong; Yu, Hongjie; Dong, Hongjun

2018-04-03

To evaluate a community-based intervention that leveraged the non-communicable disease management system to increase seasonal influenza vaccination coverage among older adults in Ningbo, China. From October 2014 - March 2015, we piloted the following on one street in Ningbo, China: educating community healthcare workers (C-HCWs) about influenza and vaccination; requiring C-HCWs to recommend influenza vaccination to older adults during routine chronic disease follow-up; and opening 14 additional temporary vaccination clinics. We selected a non-intervention street for comparison pre- and post-intervention vaccine coverage. In April 2016, we interviewed a random sample of unvaccinated older adults on the intervention street to ask why they remained unvaccinated. Pre-intervention influenza vaccine coverage among adults aged 60 years and older on both streets was 0.3%. Post-intervention, coverage among adults 60 years and older was 19% (1338/7013) on the intervention street and 0.4% (20/5500) on the non-intervention street (phealth (39%); not trusting C-HCWs' recommendations (24%); not knowing where to get vaccinated (17%); and not wanting to pay (9%). Recommending influenza vaccination within a non-communicable disease management system, combined with adding vaccination sites, increased vaccine coverage among older adults in Ningbo, China.

Walking can be more effective than balance training in fall prevention among community-dwelling older adults.

Science.gov (United States)

Okubo, Yoshiro; Osuka, Yosuke; Jung, Songee; Rafael, Figueroa; Tsujimoto, Takehiko; Aiba, Tatsuya; Kim, Teaho; Tanaka, Kiyoji

2016-01-01

To examine the effects of walking on falls among community-dwelling older adults while accounting for exposures. A total of 90 older adults, ranging in age from 65 to 79 years, were allocated into either the walking (brisk walking, n = 50) or the balance (balance and strength training, n = 40) group to participate in a 3-month supervised and 13-month unsupervised fall-prevention program held from 2012 to 2014 in Japan. Falls and trips that occurred during the 16-month period were monitored with a monthly fall calendar. The risk of falls and trips was evaluated by person-year, physically active person-day and person-step. The walking group showed a significant reduction in the fall risk when evaluated by the falls per physically active person-day (rate ratio 0.38, 95% confidence interval 0.19-0.77) and falls per person-step (rate ratio 0.47, 95% confidence interval 0.26-0.85) compared with the balance group. In contrast, the number of trips significantly increased with walking, even when evaluated as trips per physically active person-day (rate ratio 1.50, 95% confidence interval 1.12-2.00). The present findings suggest that walking among community-dwelling older adults can be more effective for fall prevention than balance training. However, because walking can induce more trips, walking should not be recommended for older adults who are susceptible to falling or frailty. © 2015 Japan Geriatrics Society.

Disability status, mortality, and leading causes of death in the United States community population.

Science.gov (United States)

Forman-Hoffman, Valerie L; Ault, Kimberly L; Anderson, Wayne L; Weiner, Joshua M; Stevens, Alissa; Campbell, Vincent A; Armour, Brian S

2015-04-01

We examined the effect of functional disability on all-cause mortality and cause-specific deaths among community-dwelling US adults. We used data from 142,636 adults who participated in the 1994-1995 National Health Interview Survey-Disability Supplement eligible for linkage to National Death Index records from 1994 to 2006 to estimate the effects of disability on mortality and leading causes of death. Adults with any disability were more likely to die than adults without disability (19.92% vs. 10.94%; hazard ratio=1.51, 95% confidence interval, 1.45-1.57). This association was statistically significant for most causes of death and for most types of disability studied. The leading cause of death for adults with and without disability differed (heart disease and malignant neoplasms, respectively). Our results suggest that all-cause mortality rates are higher among adults with disabilities than among adults without disabilities and that significant associations exist between several types of disability and cause-specific mortality. Interventions are needed that effectively address the poorer health status of people with disabilities and reduce the risk of death.

Food intake and blood cholesterol levels of community-based adults with mood disorders

Directory of Open Access Journals (Sweden)

Davison Karen M

2012-02-01

Full Text Available Abstract Background A growing body of literature links nutrition to mood, especially in epidemiological surveys, but there is little information characterizing food intake in people with diagnosed mood disorders. Methods Food intake obtained from 3-day food records was evaluated in 97 adults with mood disorders, whose diagnoses were confirmed in structured interviews. Information from a population nutrition survey, national guidelines for nutritional intakes (Eating Well with Canada's Food Guide and North American dietary guidelines (Dietary Reference Intakes was utilized to evaluate the quality of their food intake. Results Compared to the regional nutrition survey data and national guidelines, a greater proportion of study participants consumed fewer of the recommended servings of grains (p p p p p p 5.2 and ≤ 6.2 mmol/L and 21% had hypercholesterolemia (> 6.2 mmol/L. Conclusions Much research has proposed multiple ways in which healthier diets may exert protective effects on mental health. The results of this study suggest that adults with mood disorders could benefit from nutritional interventions to improve diet quality.

Post-Inpatient Brain Injury Rehabilitation Outcomes: Report from the National OutcomeInfo Database

OpenAIRE

Malec, James F.; Kean, Jacob

2016-01-01

This study examined outcomes for intensive residential and outpatient/community-based post-inpatient brain injury rehabilitation (PBIR) programs compared with supported living programs. The goal of supported living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through National Institutes of Health (NIH) Small Business Technology Transfer...

Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older

OpenAIRE

Colonvega Makasha; Rupert Ronald; Hyland John K; Hawk Cheryl; Hall Stephanie

2006-01-01

Abstract Background Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiro...

Association between Smoking and Periodontal Disease in Korean Adults: The Fifth Korea National Health and Nutrition Examination Survey (2010 and 2012).

Science.gov (United States)

Jang, Ah-Young; Lee, Jung-Kwon; Shin, Jin-Young; Lee, Hae-Young

2016-03-01

This study aimed to evaluate an association between smoking, smoking cessation, and periodontal disease in Korean adults. The data were collected from 8,336 participants, aged between 20 and 64 years, who participated in the fifth Korea National Health and Nutrition Examination (2010 and 2012). Smoking status was assessed using self-administered questionnaires. Periodontal disease was defined as a community periodontal index ≥3 points. Logistic regression analysis was used to evaluate an association between smoking, smoking cessation, and periodontal disease after adjusting for age, sex, education, monthly income, diabetes, obesity, alcohol intake, and frequency of tooth brushing. The risk of periodontal disease was higher among current smokers (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.21-1.83) than never smokers. Among current smokers, the risk of periodontal disease was increased in smokers of ≥10 cigarettes/d, ≥20 years duration, and >10 pack-years compared with never smokers (Pperiodontal disease after 10 years since cessation declined to 0.56 (95% CI, 0.42-0.75) compared with current smokers and was indistinguishable statistically from never smokers. Periodontal disease is significantly associated with smoking status in Korean adults.

The dark side of development : First Nations worry the oilsands is irreparably harming the environment and community health

Energy Technology Data Exchange (ETDEWEB)

Stonehouse, D.

2009-03-15

This article reported on the concerns of the First Nations communities living in northern Alberta where oilsand development has impacted the environment. There are significant worries about water use and health concerns, with reported incidents of unusual cancers in their communities. Although no direct evidence blaming the oilsands industry has emerged, many in the community are convinced development is to blame. The All Parties Core Agreement was signed between the Athabasca Tribal Council (ATC) and the oilsands industry in an effort to address environmental challenges. Under the agreement, industry funded 5 environmental coordinators for each of the First Nations in the Athabasca region. The All Parties Core Agreement will build a community-based monitoring system and a cumulative effects assessment for the region. In 2008, the Metis Nation of northern Alberta discovered that many of the province's in situ oilsands developments lie over a vast groundwater system that flows into the Athabasca River. The group is concerned that blowouts at thermal operations could pollute the water system. Despite these concerns, the First Nations in the Athabasca region still tentatively support oilsands development, but only on the condition that their concerns are answered and that development progresses in a safe and sustainable manner. 1 fig.

Drinking patterns and adherence to "low-risk" guidelines among community-residing older adults.

Science.gov (United States)

Lewis, Ben; Garcia, Christian C; Nixon, Sara Jo

2018-06-01

Older adults constitute a rapidly expanding proportion of the U.S. Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance. Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern. Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups. These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults. Copyright © 2018. Published by Elsevier B.V.

Transportation use in community-dwelling older adults: association with participation and leisure activities.

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Dahan-Oliel, Noémi; Mazer, Barbara; Gélinas, Isabelle; Dobbs, Bonnie; Lefebvre, Hélène

2010-12-01

This article presents a study that compared participation by elderly individuals living in the community according to primary transportation mode used, and estimated the association between transportation, personal factors, and environmental factors. Participants included 90 adults aged 65 and older (M=76.3 years; SD=7.7). They were classified according to their primary transportation mode: driver, passenger, public transport user, walk, or adapted transport/taxi user. Participation was measured with the Craig Handicap Assessment and Reporting Technique (CHART) and the Nottingham Leisure Questionnaire (NLQ). Overall, results indicated that drivers, public transport users, and walkers had higher participation levels compared to passengers and adapted transport/taxi users. This study suggests that clinicians should consider older adults' use of transportation in an attempt to encourage and maximize their participation.

Adult testicular cancer: Two decades of Saudi national data.

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