Community exercise program for older adults recovering from hip fracture: a pilot study

Community-based rehabilitative exercise programs might be an effective means to improve functional outcomes for hip-fracture patients. The purpose of this study was to evaluate the effectiveness of a community exercise program (CEP) for older adults recovering from hip fracture. Twenty-five older adults (mean age 80.0 +/- 6.0 years; 24 women; 71 +/- 23 days post-hip fracture) participated in this pilot study (17 exercise, 8 control). The CEP involved functional stepping and lower extremity-strengthening exercises. Control participants received only standard outpatient therapy. Measures of functional mobility, balance confidence, falls efficacy, lower extremity strength, and daily physical activity were evaluated at baseline and at 16 weeks. Improvements for self-reported physical activity, mobility, balance, and knee-extensor strength were observed for the CEP group. This study demonstrated that a CEP is beneficial for community-dwelling older adults post-hip fracture.     

Comparison of two methods of measuring physical activity in South African older adults

The aim of this study was to assess the validity and reliability of the Yale Physical Activity Survey (YPAS) and the short version of the International Physical Activity Questionnaire (IPAQ) in older South African adults. The YPAS includes measures of weekly energy expenditure (EE) for housework, yard work, caregiving, exercise, and recreation. The IPAQ measures total time and EE during vigorous and moderate activity, walking, and sitting. The instruments were administered twice for test-retest reliability (men, n = 52, 68 +/- 5.4 years, and women, n = 70, 66 +/- 5.8 years). Data for criterion validity were obtained from accelerometers. YPAS reliability ranged from r = .44 to.80 for men and r = .59 to .99 for women (p < .0001). IPAQ reliability was lower for men (r = .29 to .76) than for women (r = .46 to .77). Criterion validity of the YPAS was .31 to .54 for men and .26 to .29 for women. The YPAS and short IPAQ had comparable results for reliability and criterion validity.     

The Phone-FITT: a brief physical activity interview for older adults

The purpose of this study was to develop a brief physical activity interview for older adults (Phone-FITT) and evaluate its test-retest reliability and validity. Summary scores were derived for household, recreational, and total PA. Reliability was evaluated in a convenience sample from a fall-prevention study (N = 43, 79.4 +/- 2.9 years, 51% male), and validity, in a random sample of individuals in older adult exercise programs (N = 48, 77.4 +/- 4.7 years, 25% male). Mean time to complete the Phone-FITT was 10 min for participants sampled from exercise programs. Evaluation of test-retest reliability indicated substantial to almost perfect agreement for all scores, with intraclass correlation coefficients (95% confidence intervals) ranging from .74 (.58-.85) to .88 (.8-.94). For validity, Spearman's rho correlations of Phone-FITT scores with accelerometer counts ranged from .29 (.01-.53) to .57 (.34-.73). Correlations of Phone-FITT recreational scores with age and seconds to complete a self-paced step test ranged from -.29 (-.53 to -.01) to -.45 (-.68 to -.14). This study contributes preliminary evidence of the reliability and validity of the Phone-FITT.     

Impairments and perceived competence in persons living with HIV/AIDS

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.     

"Drinking is Fun" and "There's Nothing You Can Do About It": The Problem With the 21-Year-Old Minimum Drinking Age

Abstract

Objective: Public health messaging about physical activity (PA) sometimes combines moderate and vigorous intensity, but the variance/invariance of the motives for PA by intensity has received scant attention. Thus, the purpose of this study was to examine the beliefs and motivations associated with regular moderate- and vigorous-intensity PA in a college sample using the framework of Ajzen's Theory of Planned Behavior (TPB). Participants and Methods: A college sample of 337 participants was randomly assigned to complete measures of the TPB framed for either vigorous- or moderate-intensity PA and subsequently completed self-reported measures of PA 2 weeks later. Results: Mean comparisons indicated that participants held higher mean behavioral beliefs about the benefits of vigorous PA for improving appearance and fitness, but vigorous PA was perceived to take more time than moderate-intensity activities. A stacked structural equation model and follow-up Fisher z tests, however, suggested no differences between the associations of TPB constructs with intention or PA by intensity. Conclusions: The findings provide support for the current public health approach of combining moderate and vigorous physical activity messaging through the general invariance of motives by intensity.     

Creating neighborhood recreational space for youth and children in the urban environment: Play(ing in the) Streets in San Francisco

In 2013, San Francisco was one of eight sites funded by Partnership for a Healthier America to implement Play Streets, a smaller-scale Open Streets-type initiative, aimed at increasing physical activity (PA) among children and youth by closing neighborhood streets for recreational activities. This paper evaluates the pilot Play Streets events held in summer of 2013 in San Francisco with a focus on examining the characteristics of users of such events, the impact on youth and children's physical activities, use of open space and level of community engagement. The study uses survey data, observational data, existing secondary data as well as GIS mapping to measure the space created by Play Streets. Demographic characteristics, levels/types of PA and level of community engagement for a sample of 1364 participants were examined. Engagement in vigorous PA increased three-fold (11.5% to 35%) during PS and 93.3% of participants agreed that “PS strengthens our community.” Open space for PA and recreation added through Play Streets ranged from 47%–100% of available space depending on the site. Play Streets offers a significant opportunity for neighborhoods and small communities to implement a health-benefiting recreational event for its youth and families. However, specific programming is an important key to the success of Play Streets implementation and for attracting the targeted participants.     

Patterns of employment among individuals with mental illness in vocational recovery

This article provides empirical evidence about the patterns of competitive employment among individuals with serious mental illness who are in vocational recovery. The findings are based on a 5-year longitudinal study on sustained employment, conducted with a national sample of 529 individuals with serious mental illness who were in vocational recovery at the time of study enrollment. Data analysis from the 328 participants who completed the study-from baseline through all five annual follow-up assessments-revealed three different postrecovery employment patterns: continuous, stable, and fluctuating. Although many participants demonstrated the capacity to sustain competitive employment during prolonged periods of time, others experienced employment interruptions. Work interruptions were most frequently attributed to exacerbation of psychiatric symptoms. Schizophrenia spectrum disorder, difficulties with daily functioning, and current receipt of disability benefits predicted the psychiatric-based work interruptions in this sample. Implications for clinical practice are also discussed.     

A Longitudinal Study: Casino Gambling Attitudes, Motivations, and Gambling Patterns Among Urban Elders

Guided by self-determination theory, the main purpose of this study was to explore demographic characteristics, attitudes toward casinos, and self-reported intrinsic and extrinsic reasons for casino gambling by urban elders. The study hypothesized that individuals would more frequently report intrinsic motivations for casino gambling (e.g., entertainment, enjoyment) rather than extrinsic motivation (e.g., financial gain). This longitudinal sample included 247 urban elders older who were 60 years and older and who had participated in surveys in 2002 and 2004. The initial survey consisted of (a) demographic items, (b) five items to measure attitudes toward casino gambling, (c) questions inquiring about motivations for casino gambling, and (d) questions about gambling frequency. The follow-up survey was an expanded questionnaire which still included these items. The sample consisted of the 247 participants, over 200 of whom were African-Americans, 188 were female, and 98 of the participants had a post graduate education. About half were widowed, and the sample generally reported a low income. The results supported the theoretical perspective underlying the project. The hypothesis that more participants would endorse intrinsic motivations for casino gambling rather than extrinsic motivations was supported. The implications of these findings represent for social workers, gambling counselors and health care services providers an important step toward understanding the attitudes, behaviors, and motivational factors involved in casino gambling among older adults.     

Processes of Sexual Orientation Questioning among Heterosexual Women

Because very little is known about heterosexual identity development, this study assesses and describes sexual orientation questioning processes of heterosexual-identified women and offers a comparison of these processes with those employed by their sexual-minority counterparts. Participants included 333 female college students (ages 18–23; M = 19.2): 228 participants primarily identified as “exclusively straight/heterosexual,” and 105 participants indicated a sexual-minority identity. Sixty-seven percent of exclusively heterosexual respondents (n = 154) indicated having thought about or questioned their sexual orientation. The processes by which heterosexual participants described questioning their sexual orientation were coded for the presence of five emergent categories using an inductive thematic coding methodology. These five categories included unelaborated questioning (19%), other-sex experiences (16%), exposure to sexual minorities (26%), assessment of same-sex attraction (48%), and evaluations of same-sex behavior (26%). Several unifying and differentiating themes emerged between sexual orientation groups. Results from this study suggest that contemporary young women's heterosexuality is not necessarily an unexamined identity; indeed, the large majority of young women in this sample were deliberately identifying as heterosexual after contemplating alternative possibilities.     

Perceptions of participants and staff of implementing a physical activity program in rural primary care

Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.     

To Refer or Not to Refer: Exploring Family Therapists' Beliefs and Practices Related to the Referral of Lesbian,Gay, and Bisexual Clients

This study explored how negative beliefs toward lesbian, gay, and bisexual (LGB) individuals and LGB clinical competence influenced family therapists' beliefs and practices regarding referring based on the sexual orientation of the client. The sample consisted of 741 experienced clinicians. The results of this study indicated that the majority of the participants believe it is ethical to refer LGB clients; however, most had never made such a referral. Furthermore, participants who had referred based solely on the client's sexual orientation reported higher levels of negative beliefs toward LGB individuals and lower levels of LGB clinical competence. Finally, negative beliefs toward LGB persons not only predicted the practice of referring, but also the belief that it is ethical to refer an LGB client.     

Gambling-related problems across life domains: an exploratory study of non-treatment-seeking weekly gamblers

This study uses content analysis to provide a qualitative exploration of how life roles are affected by frequent (i.e. at least weekly) gambling, based on in-depth interviews with a community sample of 161 non-treatment-seeking frequent gamblers. Over half (51.6%) of the participants indicated problems associated with gambling and 131 examples were identified. The majority of problems were relational (50.4%), followed by financial (19.8%), work (13.7%), and school related (8.4%). Slightly less than half of participants (41.7%) reported losses due to gambling and 92 examples were provided. The most frequently reported loss was identity related (54.3%), which included self-esteem/shame (38.0%), estrangement from family (34.0%), estrangement from friends (16.0%), and estrangement from work colleagues (6.0%). Additional losses included health (29.3%) and financial (8.7%). Almost two-thirds of participants (64.6%) reported difficulty concentrating in family (18.4%), work (16.8%), and school (9.6%) activities, whereas general concentration problems comprised an additional 48.8% of the examples provided. Half of participants (49.1%) discussed behavioral withdrawal due to gambling, which included withdrawal from work (44.3%), relationships (24.5%), school (15.1%), and personal (6.6%) activities. These findings paint a complex picture of how gambling interferes with different life roles for some frequent gamblers, identifying important areas for future research and practice.     

Alcohol involvement and the Five-Factor model of personality: a meta-analysis

The purpose of this meta-analysis was to quantify the relationship between the Five-Factor Model of personality and alcohol involvement and to identify moderators of the relationship. The meta-analysis included 20 studies, 119 effect sizes, and 7,886 participants. Possible moderators examined included: five-factor rating type (self vs. other); study time-frame (cross sectional vs. longitudinal); sample type (treatment vs. non-treatment); type of alcohol involvement measure used; gender of the participants; and age of the participants. The meta-analysis showed alcohol involvement was associated with low conscientiousness, low agreeableness, and high neuroticism, a personality profile that: a) fits on the low end of a superordinate personality dimension that has been called self-control; and b) makes treatment difficult. Several significant moderators of effect size were found, including the following: studies of individuals in treatment for alcohol problems showed a more negative pattern of personality traits than did other studies; cross-sectional studies, but not longitudinal studies, showed a significant effect for agreeableness, perhaps suggesting that low agreeableness may have a different causal link to alcohol involvement from the other factors; mixed-sex samples tended to have lower effect sizes than single-sex samples, suggesting that mixing sexes in data analysis may obscure effects.     

Intersensory Redundancy Enhances Memory in Bobwhite Quail Embryos

Information presented concurrently and redundantly to 2 or more senses (intersensory redundancy) has been shown to recruit attention and promote perceptual learning of amodal stimulus properties in animal embryos and human infants. This study examined whether the facilitative effect of intersensory redundancy also extends to the domain of memory. We assessed bobwhite quail chicks' ability to remember and prefer an individual maternal call presented either unimodally or redundantly and synchronously with patterned light during the period prior to hatching. Embryos provided with unimodal auditory exposure failed to prefer the familiar call over a novel maternal call postnatally at 48 hr and 72 hr following exposure. In contrast, embryos provided with redundant, synchronous audiovisual stimulation significantly preferred the familiar call at 48 hr following exposure, but not at 72 hr. A second experiment provided chicks with a single 10‐min refamiliarization with the familiar call at either 48 hr or 72 hr following hatching. Chicks given only unimodal auditory exposure prior to hatching did not appear to benefit from this brief postnatal refamiliarization, showing no preference for the familiar call at either 72 or 96 hr. Chicks that received redundant audiovisual stimulation prenatally showed a significant preference for the familiar call (following the brief reexpo sure 24 hr earlier) at both 72 and 96 hr of age. These results are the first to demonstrate that redundantly specified information is remembered longer and reactivated more easily than the same information presented unimodally. These findings provide further evidence of the salience of intersensory redundancy in guiding selective attention and perceptual learning during early development.     

Emotional Empathy as Related to Mimicry Reactions at Different Levels of Information Processing

The hypotheses of this investigation were based on conceiving of facial mimicry reactions in face-to-face interactions as an early automatic component in the process of emotional empathy. Differences between individuals high and low in emotional empathy were investigated. The parameters compared were facial mimicry reactions, as represented by electromyographic (EMG) activity, when individuals were exposed to pictures of angry or happy faces. The present study distinguished between spontaneous facial reactions and facial expressions associated with more controlled or modulated emotions at different information processing levels, first at a preattentive level and then consecutively at more consciously controlled levels: 61 participants were exposed to pictures at three different exposure times (17, 56, and 2350 ms). A significant difference in facial mimicry reactions between high- and low-empathy participants emerged at short exposure times (56 ms), representing automatic, spontaneous reactions, with high-empathy participants showing a significant mimicking reaction. The low-empathy participants did not display mimicking at any exposure time. On the contrary, the low-empathy participants showed, in response to angry faces, a tendency to an elevated activation in the cheek region, which often is associated with smiling.     

Oxygen consumption, heart rate, rating of perceived exertion, and systolic blood pressure with water treadmill walking

The purpose of this study was to examine the cardiovascular responses to water treadmill walking at 2.0 mph (3.2 km/hr), 2.5 mph (4.0 km/hr), and 3.0 mph (4.8 km/hr) in older adults. Responses to water treadmill walking in 92 degrees F (33 degrees C) water were compared with responses to land treadmill walking at 70 degrees F (21 degrees C) ambient temperature. After an accommodation period, participants performed 5-min bouts of walking at each speed on 2 occasions. Oxygen consumption (VO2), heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE) were significantly higher during therapeutic water treadmill walking than during land treadmill walking. Furthermore, VO2, HR, and RPE measures significantly increased with each speed increase during both land and water treadmill walking. SBP significantly increased with each speed during water treadmill walking but not land treadmill walking. Thus, it is imperative to monitor HR and blood pressure for safety during this mode of activity for older adults.     

Implementation and evaluation of an Exercise is Medicine™ on campus week

Exercise is Medicine™ (EiM) on campus targets physical activity (PA) participation on college campuses. Limited research has addressed how PA initiatives can be operationalized on college campuses.PurposeTo describe the implementation of EiM on a large U.S. university campus and present preliminary outcomes on participation and awareness.MethodsEiM week was implemented on a large university campus. Exercise stations were set-up at campus locations to encourage brief bouts of PA and educate about the benefits of PA. Evaluation included observations of participation, surveys, and intercept surveys to assess awareness and reach.ResultsEiM week was implemented during Fall 2013. Exercise stations elicited 1771 exercise bouts from participants. Surveys indicated widespread reach across the university (13 of 17 colleges); most students (50.8%) became aware of the EiM campaign by passing by the exercise stations. Campus intercept surveys 1-week post-event indicated 54% students had heard about EiM, of which 39% had heard/seen the event through messages encouraging exercise.ConclusionThe current study was successful in engaging a large, diverse population on a college campus. Lessons learned from the development, implementation, and evaluation of EiM on campus activities provide insight for university campuses looking to target student health and PA participation.     

Promoting walking among older adults living in retirement communities

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.