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Results 31 - 40 of 660

Social prescribing evidence map: summary report


Summary findings from an evidence mapping to share evidence on the effectiveness and practice of social prescribing to improve the health and well-being of individuals with social, emotional or practical needs. Sixty-two sources met the inclusion criteria for the evidence map. Two main types of social prescribing were identified. Those targeting psychosocial needs and those intended for people who are sedentary and/or overweight or obese. In total six types of social prescribing initiative are described: link worker programmes (schemes linking people to a facilitator who assessed them and referred them on to community support); community arts programmes; a horticultural programme; exercise referral schemes; commercial weight loss programmes and referral to welfare rights advice. The evidence mapping aims to support professionals looking to implement social prescribing interventions within primary and community care settings across Wales

Quality and cost-effectiveness in long-term care and dependency prevention: the English policy landscape. CEQUA report


This report summarises policy developments in England in relation to quality and cost-effectiveness and dependency prevention in long-term care. These policy aims focus on maximising the cost-effectiveness of the social care system, so that service users’ and carers’ quality of life is maximised within available resources. The report provides an overview of the long-term care system in England. It then reviews key recent policy developments in four areas: reducing dependency cost-effectively; strategies for maximising care coordination; supporting unpaid carers; and use of innovative care models, with a focus on technological solutions and personalisation. An appendix lists key features of the Care Act 2014 and the Better Care Fund relevant to prevention.

Psychological benefits of attending the theatre associated with positive affect and well-being for subscribers over age 60


Objectives: Although late adulthood may be a time of greater well-being, optimal aging still characterizes a minority of older adults. Understanding how individuals achieve well-being across adulthood is important for intervention and social policy. This study focused on how attending live theatre might enhance the well-being of a sample of 53 season ticket holders aged 60 and older. Based on a previously tested conceptual framework, we hypothesized that post-performance reports of social-cognitive experience while at the play would predict post-performance positive affect, which in turn would predict well-being. Method: The sample was a subset of volunteers from a large survey study of theatre ticket purchasers. They completed baseline and two-year follow-up measures of well-being, and questionnaires immediately after attending seven plays across two seasons: measures of social engagement, belonging, flow, positive affect, and their reactions to the plays. Results: This study found that sense of belonging, social engagement, and flow were associated with positive affect after performances, as hypothesized. This study also found that the cumulative positive affect experienced after plays in the two seasons predicted change in well-being between baseline and follow-up. Conclusion: The findings suggest that attending performances is a combined social, cognitive, and affective experience that transcends entertainment. Future research might investigate whether the psychological benefit model assessed in this study will generalize to other leisure activities that create similar engagement. The findings have implications for individuals seeking to promote their own well-being, and, possibly more importantly, for policies that support enriching cultural opportunities, particularly in the arts.

The contribution of community singing groups to the well-being of older people: participant perspectives from the United Kingdom


Current evidence suggests that participatory arts activities, and particularly group singing, may contribute to the well-being of older people. However, there is currently a paucity of prospective research from the participant perspective. This qualitative study nested within a randomized controlled trial aimed to assess participants’ perspectives of the acceptability and effect on health and well-being of a community singing program for older people. Volunteers recruited to the intervention arm (n = 131) were invited to write comments on their experiences over three data collection points of a 14-week singing program. A subsample (n = 19) participated in a retrospective semi-structured interview. Data were subjected to content and thematic analysis. Comments and interviews from 128 individuals suggested that the singing groups led to specific, incremental benefits to physical, psychological, social, and community well-being. Benefits tended to tail off after the program ended. Suggestions were made for the future running of such groups.

Impact of community care in enabling older people with complex needs to remain at home

RYAN Assumpta Ann, et al

Aim. This aim of the study was to explore the impact of community care in enabling older people with complex needs to remain at home. Background. Changing demographic trends and successive government policies have led to an increase in the number of older people with complex needs residing in the community. Design. A qualitative approach using semi‐structured interviews was used to collect data from older people (n=17) and carers (n=14). Method. Social workers were asked to identify community dwelling older people (65+years) with multiple needs requiring interventions from a range of health and social care practitioners. Results. Community care enabled older people with complex needs who would otherwise have required residential or nursing home care to remain in their own homes. This was the expressed wish of both the older people and carers interviewed. Conclusions. The provision of high‐quality community care for older people is a globally significant challenge and one that requires creative solutions, both at a local and strategic level. Relevance to clinical practice. Nurses and other health and social care professionals need to understand the significance of ‘home’ for older people and take steps to ensure that additional and appropriate resources are targeted towards community care.

Home modifications to reduce injuries from falls in the Home Injury Prevention Intervention (HIPI) study: a cluster-randomised controlled trial

KEALL Michael D, et al

Background: Despite the considerable injury burden attributable to falls at home among the general population, few effective safety interventions have been identified. This study tested the safety benefits of home modifications, including handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, edging for outside steps, and slip-resistant surfacing for outside areas such as decks and porches. Methods: This study is a single-blind, cluster-randomised controlled trial of households from the Taranaki region of New Zealand. To be eligible, participants had to live in an owner-occupied dwelling constructed before 1980 and at least one member of every household had to be in receipt of state benefits or subsidies. This study randomly assigned households by electronic coin toss to either immediate home modifications (treatment group) or a 3-year wait before modifications (control group). Household members in the treatment group could not be masked to their assigned status because modifications were made to their homes. The primary outcome was the rate of falls at home per person per year that needed medical treatment, which was derived from administrative data for insurance claims. Coders who were unaware of the random allocation analysed text descriptions of injuries and coded injuries as all falls and injuries most likely to be affected by the home modifications tested. To account for clustering at the household level, this stanalysed all injuries from falls at home per person-year with a negative binomial generalised linear model with generalised estimating equations. Analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000779279. Findings: Of 842 households recruited, 436 (n=950 individual occupants) were randomly assigned to the treatment group and 406 (n=898 occupants) were allocated to the control group. After a median observation period of 1148 days (IQR 1085–1263), the crude rate of fall injuries per person per year was 0·061 in the treatment group and 0·072 in the control group (relative rate 0·86, 95% CI 0·66–1·12). The crude rate of injuries specific to the intervention per person per year was 0·018 in the treatment group and 0·028 in the control group (0·66, 0·43–1·00). A 26% reduction in the rate of injuries caused by falls at home per year exposed to the intervention was estimated in people allocated to the treatment group compared with those assigned to the control group, after adjustment for age, previous falls, sex, and ethnic origin (relative rate 0·74, 95% CI 0·58–0·94). Injuries specific to the home-modification intervention were cut by 39% per year exposed (0·61, 0·41–0·91). Interpretation: The findings suggest that low-cost home modifications and repairs can be a means to reduce injury in the general population. Further research is needed to identify the effectiveness of particular modifications from the package tested.

Cost-effectiveness of telecare for people with social care needs: the Whole Systems Demonstrator cluster randomised trial

HENDERSON Catherine, et al

Purpose of the study: to examine the costs and cost-effectiveness of ‘second-generation’ telecare, in addition to standard support and care that could include ‘first-generation’ forms of telecare, compared with standard support and care that could include ‘first-generation’ forms of telecare. Design and methods: a pragmatic cluster-randomised controlled trial with nested economic evaluation. A total of 2,600 people with social care needs participated in a trial of community-based telecare in three English local authority areas. In the Whole Systems Demonstrator Telecare Questionnaire Study, 550 participants were randomised to intervention and 639 to control. Participants who were offered the telecare intervention received a package of equipment and monitoring services for 12 months, additional to their standard health and social care services. The control group received usual health and social care. Primary outcome measure: incremental cost per quality-adjusted life year (QALY) gained. The analyses took a health and social care perspective. Results: cost per additional QALY was £297,000. Cost-effectiveness acceptability curves indicated that the probability of cost-effectiveness at a willingness-to-pay of £30,000 per QALY gained was only 16%. Sensitivity analyses combining variations in equipment price and support cost parameters yielded a cost-effectiveness ratio of £161,000 per QALY. Implications: while QALY gain in the intervention group was similar to that for controls, social and health services costs were higher. Second-generation telecare did not appear to be a cost-effective addition to usual care, assuming a commonly accepted willingness to pay for QALYs.

Interventions for preventing falls in older people living in the community (review)

GILLESPIE Lesley D., et al

Background: Approximately 30 per cent of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.Objective: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. Search methods: this review searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Selection criteria: Randomised trials of interventions to reduce falls in community-dwelling older people. Main results: this review included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Findings: Group and home‐based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow‐up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti‐slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community‐dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

Nostalgia as a psychological resource for people with dementia: a systematic review and meta-analysis of evidence of effectiveness from experimental studies

ISMAIL Sanda Umar, et al

Objective: This review systematically examines evidence relating to the effect of nostalgia on psychological well-being through a meta-analysis of measures of social connectedness, self-esteem, meaning in life, self-continuity, optimism and positive and negative affect. Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results: Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminiscence to be included in the meta-analysis. Nostalgic reminiscence had moderate effects on positive affect (0.51 (0.37, 0.65), p= 0.001), social connectedness (0.72 (0.57, 0.87), p= 0.001), self-esteem (0.50 (0.30, 0.70), p= 0.001), meaning in life (0.77 (0.47, 1.08), p= 0.001) and optimism (0.38 (0.28, 0.47), p= 0.001) and a large effect on self-continuity (0.81 (0.55, 1.07), p= 0.001). There was, however, no difference between the effect of nostalgic reminiscence and non-nostalgic reminiscence for negative affect (−0.06 (−0.20, 0.09), p= 0.443). Conclusion: This systematic review and meta-analysis provides an overview of the evidence base for nostalgia. This is an important stage in developing nostalgia as a clinical intervention for people with dementia which might be achieved, for instance, by adapting current reminiscence and life review techniques. This meta-analysis will therefore also serve as a valuable reference point for the continued exploration of nostalgia as an intervention.

Wellbeing evidence at the heart of policy

HARDOON Deborah, HEY Nancy, BRUNETTI Silvia

Improving wellbeing is widely recognised as a goal of policy and practice. This report sets out the state of the evidence and next steps for applying a wellbeing approach to decision making in the UK. It looks at what is meant by wellbeing and how it is currently measured in the UK and Internationally. It considers how wellbeing can be improved, including a review evidence of what works and tools those working in a policy context need to implement these findings. It also considers the challenges of implementing a wellbeing approach and the role businesses, communities and individuals can play. The final section outlines some of the issues which have yet to be tackled in order for wellbeing to become the dominant narrative which underpins the decisions taken.

Results 31 - 40 of 660


Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation


KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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