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Results for 'environmental factors'

Results 1 - 6 of 6

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

GILLESPIE Lesley D., et al
2012

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.

Dementia-friendly Brent: a model of community

TILKI Mary
2018

Report on the London borough of Brent's dynamic social movement helping to make the borough dementia friendly. Community Action on Dementia Brent (CADBrent) is a dynamic social movement that aims to make the London borough dementia friendly, accessible and inclusive of black and minority ethnic (BME) communities. Much has been achieved since the movement began five years ago. Some of the schemes discussed in the article include: Dementia peer support project; dementia friendly Mapesbury; The De-Cafe - memory cafe; Whole street of support; The Shed and Parnerships in Innovative Education.

What is the impact on health and wellbeing of interventions that foster respect and social inclusion in community-residing older adults? A systematic review of quantitative and qualitative studies

RONZI S., et al
2018

Background: Many interventions have been developed to promote respect and social inclusion among older people, but the evidence on their impacts on health has not been synthesised. This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature. Methods: Eligible studies published between 1990 and 2015 were identified by scanning seven bibliographic databases using a pre-piloted strategy, searching grey literature and contacting experts. Studies were included if they assessed the impact (quantitatively) and/or perceived impact (qualitatively) of an intervention promoting respect and social inclusion on the physical or mental health of community-residing people aged 60 years and older. Titles and abstracts were screened for eligibility by one reviewer. A second reviewer independently screened a 10% random sample. Full texts were screened for eligibility by one reviewer, with verification by another reviewer. Risk of bias was assessed using standardised tools. Findings were summarised using narrative synthesis, harvest plots and logic models to depict the potential pathways to health outcomes. Results: Of the 27,354 records retrieved, 40 studies (23 quantitative, 6 qualitative, 11 mixed methods) were included. All studies were conducted in high and upper middle-income countries. Interventions involved mentoring, intergenerational and multi-activity programmes, dancing, music and singing, art and culture and information-communication technology. Most studies (n = 24) were at high or moderate risk of bias. Music and singing, intergenerational interventions, art and culture and multi-activity interventions were associated with an overall positive impact on health outcomes. This included depression (n = 3), wellbeing (n = 3), subjective health (n = 2), quality of life (n = 2), perceived stress and mental health (n = 2) and physical health (n = 2). Qualitative studies offered explanations for mediating factors (e.g. improved self-esteem) that may lead to improved health outcomes and contributed to the assessment of causation. Conclusions: Whilst this review suggests that some interventions may positively impact on the health outcomes of older people, and identified mediating factors to health outcomes, the evidence is based on studies with heterogeneous methodologies. Many of the interventions were delivered as projects to selected groups, raising important questions about the feasibility of wider implementation and the potential for population-wide benefits.

Effects of forest therapy on depressive symptoms among adults: a systematic review

LEE Insook, et al
2017

This study systematically reviewed forest therapy programs designed to decrease the level of depression among adults and assessed the methodological rigor and scientific evidence quality of existing research studies to guide future studies. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors independently screened full-text articles from various databases using the following criteria: (1) intervention studies assessing the effects of forest therapy on depressive symptoms in adults aged 18 years and older; (2) studies including at least one control group or condition; (3) peer-reviewed studies; and (4) been published either in English or Korean before July 2016. The Scottish Intercollegiate Guideline Network measurement tool was used to assess the risk of bias in each trial. In the final sample, 28 articles (English: 13, Korean: 15) were included in the systematic review. We concluded that forest therapy is an emerging and effective intervention for decreasing adults' depression levels. However, the included studies lacked methodological rigor. Future studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.

Evaluation of a web-based app to assist home-hazard modification in falls prevention

WARD Gillian, WALKER-CLARKE Aimee, HOLLIDAY Nikki
2017

Introduction: Given the impact falls can have on older people and their families, many health and social care services are focused on preventing falls and implementing interventions to reduce future falls. FallCheck is a web app that supports identification of home-hazards and directs users towards self-management strategies to reduce risk of falling. Method: A survey by clinical experts of a beta version of FallCheck was conducted, producing quantitative and qualitative data including issues and attributes identified by respondents. Thirty-six individuals signed up to take part in the study, and 27 respondents took part in the final evaluation survey. Findings: Testing by health and social care professionals found there is scope for using the app as a digital self-assessment tool by people at risk of falls. It has further potential as an effective tool to support environmental/behavioural change to reduce risk of falls. Conclusion: FallCheck was developed from a sound evidence-base to support home-hazard modification as an effective intervention component within a multifactorial intervention to prevent falls. Health and social care professionals found it had good acceptability for use in practice, justifying further testing of the usability and effectiveness of the app in supporting behavioural changes and environmental modifications with people at risk of falling and carers.

Well-being through design: transferability of design concepts for healthcare environments to ordinary community settings

BOEX Will, BOEX Sam
2012

The concept of well-being is now well established, both in ordinary language and in UK Government policy. There is now a growing interest in looking at the effects on environmental design on well-being. The aim of this paper is to explore current interest in the concept of well-being, and to trace the growing use of design ideas in healthcare settings to reduce stress and maximise efficiency. The potential in this approach is illustrated with some examples of design approaches applied in healthcare. The patient journey through the healthcare setting is considered in terms of ‘touch points’ such as the car park, the entrance, corridors, and the work area. These design concepts and approaches seem also to promise similar benefits in community settings where issues in managing the health and well-being of vulnerable individuals are equally relevant. They may be especially useful in current efforts towards creating dementia-friendly homes and communities, or ‘psychologically informed environments’ in services for marginalised and excluded individuals.

Results 1 - 6 of 6

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News

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

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
View more: News
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