A Healthy Conversation Skills intervention to support changes to physical activity and dietary behaviours in community-dwelling older adults during the COVID-19 pandemic

AIMS

Physical activity (PA) and nutrition are important determinants of health in late adulthood. However, low levels of PA and poor nutrition are common in older adults and have become more prevalent during the COVID-19 pandemic. We hypothesised that Healthy Conversation Skills could be used to support health behaviour changes beneficial for health in older adults and thus conducted a study nested within the UK Hertfordshire Cohort Study.

METHODS

Between November 2019 and March 2020, 176 participants were visited at home. A trained researcher administered a questionnaire and undertook anthropometric and physical performance tests. A total of 89 participants were randomised to the control group and received a healthy living leaflet; 87 participants in the intervention group were interviewed using Healthy Conversation Skills at the initial visit with follow-up telephone calls at 1, 3, 6 and 9 months. Follow-up at 1 year by postal questionnaire assessed change in PA and diet. In total, 155 participants (79 control and 76 intervention) completed the baseline and 1-year follow-up.

RESULTS

At baseline, median (lower quartile, upper quartile) age (years) was 83.1 (81.5, 85.5) and median PA time (min/day) from walking, cycling and sports was 30.0 (15.0, 60.0). In total, 95% of participants completed the intervention; the total response rate for postal questionnaires was 94%. There were no statistically significant differences in outcomes between the trial arms. In women, there was a tendency for greater increases in diet quality in the intervention group compared to the control group (p = 0.075), while among men, there was a tendency for reduced decline in self-reported physical function in the intervention group compared to the control group (p = 0.081).

CONCLUSION

We have shown that it is viable to utilise Healthy Conversation Skills via telephone to promote healthier lifestyles in older adults. Larger appropriately powered studies to determine the efficacy of such an intervention are now warranted.

Work and Retirement Among Women: The Health and Employment After Fifty Study

BACKGROUND

Women increasingly work beyond age 50+ but their occupational health is under-researched.

AIMS

To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit.

METHODS

Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit.

RESULTS

At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands).

CONCLUSIONS

Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.

From farm to fork… and beyond! UV enhances Aryl hydrocarbon receptor-mediated activity of cruciferous vegetables in human intestinal cells upon colonic fermentation

While the "farm to fork" strategy ticks many boxes in the sustainability agenda, it does not go far enough in addressing how we can improve crop nutraceutical quality. Here, we explored whether supplementary ultraviolet (UV) radiation exposure during growth of broccoli and Chinese cabbage can induce bioactive tryptophan- and glucosinolate-specific metabolite accumulation thereby enhancing Aryl hydrocarbon receptor (AhR) activation in human intestinal cells. By combining metabolomics analysis of both plant extracts and in vitro human colonic fermentation extracts with AhR reporter cell assay, we reveal that human colonic fermentation of UVB-exposed Chinese cabbage led to enhanced AhR activation in human intestinal cells by 23% compared to plants grown without supplementary UV. Thus, by exploring aspects beyond "from farm to fork", our study highlights a new strategy to enhance nutraceutical quality of Brassicaceae, while also providing new insights into the effects of cruciferous vegetables on human intestinal health.

Variational analysis of inextensible elastic curves

We minimize elastic energies on framed curves which penalize both curvature and torsion. We also discuss critical points using the infinite dimensional version of the Lagrange multipliers’ method. Finally, some examples arising from the applications are discussed and also numerical experiments are presented.

778 THE IMPACT OF MUSCULOSKELETAL CONDITIONS AND FRAILTY ON THE ABILITY TO SELF-CARE OR BE IN RECEIPT OF CARE: A STUDY OF COMMUNITY-

Introduction

Musculoskeletal conditions (MSC) and frailty lead to a significant burden of disease in later life. Living independently remains the aim of older adults but ability to self-care or access care at home may hamper this. Our aim was to consider whether MSC (osteoporosis, sarcopenia, osteoarthritis) and frailty were associated with ability to self-care or influence access to formal/informal care among community-dwelling older adults.

Methods

Participants were recruited from an established cohort study of community-dwelling adults in the UK. Osteoporosis was assessed using Dual-energy X-ray Absorptiometry. Sarcopenia was assessed using EWSGOP2 criteria. Osteoarthritis of the hand, hip or knee was defined by clinical examination. Frailty was assessed using Fried criteria. Ability to self-care and access to formal/informal care were self-reported.

Results

443 men and women (median age 75.5 [IQR 73.5–77.9] years) participated. Osteoporosis affected (n = 74) 21.4% of participants, (n = 115) 26.8% had osteoarthritis, (n = 30) 8.6% had sarcopenia, and (n = 33) 7.6% were identified as frail. Most participants (n = 402 [90.7%]) reported no problems with self-care. Identical proportions of participants received informal (n = 53 [12%]) and formal (n = 53 [12%]) care at home in the previous year. Reporting difficulties with self-care was associated with clinical osteoarthritis (OR 3.48, 95% CI 1.63–7.43, p = 0.001) and frailty (5.29, 2.12–13.2, p < 0.001), but not with osteoporosis or sarcopenia. Receiving informal care at home in the past year was associated with osteoarthritis (2.56, 1.28–5.14, p = 0.008), the coexistence of two or more MSC (6.50, 1.66–25.39, p = 0.007), and frailty (6.25, 2.59–15.08, p < 0.001), but not with osteoporosis or sarcopenia alone. None of the conditions were associated with receiving formal care.

Conclusion

MSC are associated with informal receipt of care. Presence of two or more MSC convey similar informal care requirements to those living with frailty. Early assessment and management of MSC and frailty in clinical practice may reduce need for care and preserve independence.

Shift work amongst older UK workers and job exit

BACKGROUND

Night/shift work may be increasing but there are few data about the prevalence amongst older workers. With governments encouraging people to work to older ages, it is important to know how feasible night/shift work is for them and whether there are any adverse health consequences.

AIMS

Amongst current older workers (aged 50-64 years), to explore the prevalence of night/shift working and evaluate its health impacts and sustainability over 4 years of follow-up.

METHODS

Data from the Health and Employment After Fifty cohort were used to describe the demographic, job and health characteristics of men and women undertaking night/shift work. Longitudinal data were used to examine the number and nature of exits annually thereafter.

RESULTS

Amongst the 5409 working at baseline, 32% reported night/shift work in sectors which differed by sex. Night/shift workers were more likely to be: current smokers; doing physically demanding work; struggling to cope at work; dissatisfied with their hours; depressed; sleeping poorly; rating their health poorly. Women whose job involves night work were more likely to exit the workforce over 4 years.

CONCLUSIONS

Almost one in three contemporary UK older workers report night/shift work. We found some evidence of adverse impacts on health, sleep and well-being and higher rates of job exit amongst women. More research is needed but night/shift work may be challenging to sustain for older workers and could have health consequences.

Experimental observation of Faraday waves in soft gels

We report the experimental observation of Faraday waves on soft gels. These were obtained using agarose in a mechanically vibrated cylindrical container. Low driving frequencies induce subharmonic standing waves with spatial structure that conforms to the geometry of the container. We report the experimental observation of the first 15 resonant Faraday wave modes that can be defined by the mode number (n,ℓ) pair. We also characterize the shape of the instability tongue and show the complex dependence upon material properties can be understood as an elastocapillary effect.

Applied health communication training as active methodologies in undergraduate medical

Background

Health education plays a fundamental role in the formation of critical and reflective health professionals, preparing them to transcend theories and experience challenging practices. For the educator, it is unique to guide the way that can transform a gap in the undergraduate medical education into a possibility of positive action. It was in this sense that the health communication training was developed, supported by theory of neurolinguistics and techniques of emotional intelligence. Teachers of the Communication, Leadership and Management Skills (speech therapist, psychologist, nurse, doctor, dentist) programmed a training to work with students, all from the second year of the undergraduate medical course, to stimulate verbal communication. and nonverbal. Six experiential activities were used in the classroom, detailing: Activity 1 - Assertive Communication;. Activity 2 - Consensus Groups. Activity 3 - Nonverbal Communication. Activity 4 - Body Shapes. Activity 5 - Perception of the Other.

Objective

This qualitative descriptive study aimed to report the experience of a trainning on the topic of health communication held in an institution of the public higher education system in Brazil with the purpose of promoting innovation in the education of medical students.

Results

Faced with activities like this, we realize that students go through a process of breaking paradigms, which significantly influences their way of thinking. Initial training should provide adequate support to students from the perspective of the knowledge spiral. From the generalist content, with the evolution of the undergraduate years, the student perfects and deepens his reflections, in a continuous process of meanings.

Conclusions

The training of verbal and nonverbal communication with medical students satisfactorily developed skills in personal interaction, behavioral, empathy, self-perception.

Key messages

This work represents a breakthrough in the field of health education towards producing technology for health professionals. Among the challenges of the 21st century is the use of new teaching methodologies that address the demands of world health problems.

Parametric Amplification and Noise Squeezing in Room Temperature Atomic Vapors

We report on the use of parametric excitation to coherently manipulate the collective spin state of an atomic vapor at room temperature. Signatures of the parametric excitation are detected in the ground-state spin evolution. These include the excitation spectrum of the atomic coherences, which contains resonances at frequencies characteristic of the parametric process. The amplitudes of the signal quadratures show amplification and attenuation, and their noise distribution is characterized by a strong asymmetry, similar to those observed in mechanical oscillators. The parametric excitation is produced by periodic modulation of the pumping beam, exploiting a Bell-Bloom-like technique widely used in atomic magnetometry. Notably, we find that the noise squeezing obtained by this technique enhances the signal-to-noise ratio of the measurements up to a factor of 10, and improves the performance of a Bell-Bloom magnetometer by a factor of 3.

A Case of Cavernous Haemangioma of the Spleen

The clinical and pathological data of a case of cavernous haemangioma of the spleen are reported. The diagnostic value of scanning in the present case is discussed.

Breast Carcinoma with Osteoclast-Like Giant Cells: Immunohistochemical and Ultrastructural Study of a Case and Review of the Literature

We describe an unusual case of infiltrating ductal carcinoma, not otherwise specified, containing numerous benign stromal osteoclast giant cells (OGCs). Macroscopically, the tumor appeared as a well-outlined dark brown mass and was initially interpreted as a benign lesion on the mammograms. OGCs were uniformly distributed in the tumor and were found in vascularized, hemorrhagic stroma often abutted on the nests of tumor cells. Electron microscopy supported a histiocytic origin of the OGCs, but immunohistochemistry failed to confirm the observation. The patient was alive and well 30 months following the operation. A review of the literature concerning breast carcinoma with OGCs is also presented.