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Levinger P, Fearn M, Dreher B, Bauman A, Brusco NK, Gilbert A, Soh SE, Burton E, James L, Hill KD. The ENJOY Seniors Exercise Park IMP-ACT project: IMProving older people's health through physical ACTivity: a hybrid II implementation design study protocol. Arch Public Health 2024; 82:43. [PMID: 38532524 DOI: 10.1186/s13690-024-01262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION The health benefits of physical activity are well established; however, most older people are not sufficiently physically active. Despite the availability of various physical activity interventions and programs, implementation of effective prevention strategies to reduce older people's physical inactivity are lacking. The ENJOY IMP-ACT project is an implementation research project, based on a previous evidence-based physical and social activity program utilising specialised outdoor exercise equipment (the Seniors Exercise Park) for older people. The ENJOY IMP-ACT aims to increase participation in physical activity to improve health outcomes for older people in Victoria, Australia. METHOD The ENJOY IMP-ACT is a hybrid II implementation-effectiveness pre-post mixed method study design. Five local governments (6 public sites/parks) will undergo a 3-month control period followed by 9-months implementation intervention (TERM framework intervention: Training, Engagement, Resources development, Marketing and promotion), and a maintenance phase (3 months). Various methodologies will be employed throughout the project at each site and will include direct observations of park users, intercept surveys with park users, online access monitor platform (using an online app), interviews with stakeholders and exercise program leaders, a process evaluation of physical activity programs, a social return-on-investment analysis, and other related activities. DISCUSSION Through the implementation framework design, the ENJOY IMP-ACT is uniquely placed to translate an evidenced-based physical and social activity program into real world settings and increase physical activity among older people. If successful, this program will inform scale up across Australia with the goal of improving the health and wellbeing of older people. TRIAL REGISTRATION This registration trial is prospectively registered with the Australian New Zealand Clinical Trials Registry. Trial number ACTRN12622001256763 . Date registered 20/09/2022.
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Affiliation(s)
- Pazit Levinger
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Australia.
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
| | - Marcia Fearn
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
| | - Bronwyn Dreher
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
| | - Adrian Bauman
- School of Public Health, and the Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Natasha K Brusco
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Australia
| | - Andrew Gilbert
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
- Department of Social Inquiry, La Trobe University, Melbourne, Australia
| | - Sze-Ee Soh
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lisa James
- National Ageing Research Institute, Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Australia
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Major G, Bagnall AM, Bhar S, Bryant C, Dow B, Dunt D, Fearn M, Harper R, Leung WY, Mnatzaganian G, O'Bree B, Doyle C. A Scoping Review of the Measurement of Depression in Older Adults with Cognitive Impairment. Clin Gerontol 2022:1-13. [PMID: 36163627 DOI: 10.1080/07317115.2022.2126809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Depression and cognitive impairment are disabling conditions that commonly occur together in older adults. The interaction is challenging when choosing appropriate measurement scales. This review aimed to summarize the scales to measure depression symptoms in older people with cognitive impairment, investigating how cognitive impairment is related to the choice of measurement, and how the setting may affect the choice of measurement. METHODS A scoping review of literature published between 2015 and 2021. RESULTS After screening 1580 articles, 26 were included in the review with 11 different measures of depression symptoms identified. The measures mostly commonly used were the Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory (NPI-Q). Most studies did not report on the usability of depression scales used with people with cognitive impairment and only two scales (CSDD and NPI-Q, not GDS) have been validated for use with this population. CONCLUSIONS Severe cognitive impairment was under-represented in the identified studies, and no association was detected between study setting, cognitive impairment and type of measure used. CLINICAL IMPLICATIONS Clinicians and researchers should consider both the cognitive status of participants and the setting they live in when choosing a measure of depression symptoms.
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Affiliation(s)
- Georgia Major
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Anne-Marie Bagnall
- School of Health and Community Studies, Leeds Beckett University Leeds, United Kingdom
| | - Sunil Bhar
- Psychology Department, Swinburne University, Melbourne, Victoria, Australia
| | - Christina Bryant
- Emeritus, The University of Melbourne, Melbourne, Victoria, Australia
| | - Briony Dow
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia.,Emeritus, The University of Melbourne, Melbourne, Victoria, Australia
| | - David Dunt
- Emeritus, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marcia Fearn
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Robin Harper
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Wing-Yin Leung
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - George Mnatzaganian
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Paramedicine, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Bridget O'Bree
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Colleen Doyle
- Aged Care Division, National Ageing Research Institute, Melbourne, Victoria, Australia.,Psychology Department, Swinburne University, Melbourne, Victoria, Australia
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Fearn M, Harper R, Major G, Bhar S, Bryant C, Dow B, Dunt D, Mnatzaganian G, O'Connor D, Ratcliffe J, Samuel S, Bagnall AM, Doyle C. Befriending Older Adults in Nursing Homes: Volunteer Perceptions of Switching to Remote Befriending in the COVID-19 Era. Clin Gerontol 2021; 44:430-438. [PMID: 33403935 DOI: 10.1080/07317115.2020.1868646] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Residents in nursing homes are being isolated to prevent exposure to COVID-19. Many are prone to depression, anxiety and loneliness, and extra isolation leaves them vulnerable to compromised mental health. In this study, trained volunteers providing befriending for residents with symptoms of depression, anxiety and loneliness switched to remote befriending during COVID-19. The purpose of this study was to gauge volunteer perceptions of the switch.Methods: A qualitative phenomenological approach was used to understand how switching to remote befriending impacted on volunteers and residents. A convenience sample of 18 participants responded to questions either in individual or group interviews.Results: Volunteers adapted their befriending visits, switching from face to face visits to remote options. The format was decided collaboratively. Hearing impairments hindered phone calls. Residents sometimes felt uncomfortable with digital technology but on the whole, the change to remote "visiting" was accepted.Conclusions: Further research is being conducted to gauge mental health outcomes for residents. Most volunteers and residents accepted the switch to remote befriending as better than no contact.Clinical implications: Volunteers can provide valuable support for residents living with social isolation during COVID-19. The format for social support needs to be decided collaboratively between volunteer and resident.
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Affiliation(s)
- Marcia Fearn
- Aged Care Division, National Ageing Research Institute, Melbourne, Australia
| | - Robin Harper
- Aged Care Division, National Ageing Research Institute, Melbourne, Australia
| | - Georgia Major
- Aged Care Division, National Ageing Research Institute, Melbourne, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University, Melbourne, Australia
| | - Christina Bryant
- School Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Briony Dow
- Aged Care Division, National Ageing Research Institute, Melbourne, Australia.,School Psychological Sciences, The University of Melbourne, Melbourne, Australia.,School Nursing, Deakin University, Melbourne, Australia
| | - David Dunt
- School Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | | | | | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Sarah Samuel
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Anne Marie Bagnall
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
| | - Colleen Doyle
- Aged Care Division, National Ageing Research Institute, Melbourne, Australia.,Department of Psychological Sciences, Swinburne University, Melbourne, Australia
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Doyle C, Bhar S, Bryant C, Dow B, Dunt D, Mnatzaganian G, O'Connor D, Ratcliffe J, You E, Bagnall AM, Major G, Harper R, Fearn M. BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol. BMC Geriatr 2021; 21:305. [PMID: 33980168 PMCID: PMC8115389 DOI: 10.1186/s12877-021-02233-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. METHODS AND ANALYSIS We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. DISCUSSION To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people's mental health. TRIAL REGISTRATION Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112 , registered 06/05/2019 - retrospectively registered.
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Affiliation(s)
- Colleen Doyle
- Aged Care Division, National Ageing Research Institute, Poplar Road, Parkville, 3052, Australia. .,Department of Psychological Sciences, Swinburne University, John Street, Hawthorn, 3122, Australia. .,School of Nursing and Midwifery, Deakin University, Burwood Highway, Burwood, 3125, Australia.
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University, John Street, Hawthorn, 3122, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville, 3010, Australia
| | - Briony Dow
- Aged Care Division, National Ageing Research Institute, Poplar Road, Parkville, 3052, Australia.,School of Nursing and Midwifery, Deakin University, Burwood Highway, Burwood, 3125, Australia.,School of Population and Global Health, The University of Melbourne, Grattan Street, Parkville, 3010, Australia
| | - David Dunt
- School of Population and Global Health, The University of Melbourne, Grattan Street, Parkville, 3010, Australia
| | | | - Daniel O'Connor
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, 3800, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Sturt Road, Bedford Park, 5042, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, The University of Melbourne, Poplar Road, Parkville, 3052, Australia
| | | | - Georgia Major
- Aged Care Division, National Ageing Research Institute, Poplar Road, Parkville, 3052, Australia
| | - Robin Harper
- Aged Care Division, National Ageing Research Institute, Poplar Road, Parkville, 3052, Australia
| | - Marcia Fearn
- Aged Care Division, National Ageing Research Institute, Poplar Road, Parkville, 3052, Australia
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Haralambous B, Mackell P, Lin X, Fearn M, Dow B. Improving health literacy about dementia among older Chinese and Vietnamese Australians. AUST HEALTH REV 2019; 42:5-9. [PMID: 28877842 DOI: 10.1071/ah17056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/22/2017] [Indexed: 11/23/2022]
Abstract
The number of older people in the population is increasing faster than for any other age group. This population growth, while positive, is associated with increasing incidence of chronic and progressive diseases such as dementia. This requires older people to navigate services that may not be designed to meet their needs. This issue can be further amplified in culturally and linguistically diverse populations who often have limited English language proficiency and limited knowledge of diseases such as dementia. Health literacy, a person's ability to access, understand, appraise and apply information about their health and health care, including navigating health services, is low among older people and even lower among older people born overseas. This paper describes findings from a recent research study which developed and used the Cultural Exchange Model. The model is based on a process of collaboration, whereby researchers, service providers and community members work together to build evidence about a particular topic, in this case dementia. The study demonstrated that the Cultural Exchange Model facilitates opportunities for researchers, health professionals, community workers and carers to improve their knowledge of conditions such as dementia and rapidly translate evidence into practice. It also showed that it is possible to recruit, engage and generate new knowledge within populations that are traditionally excluded from research but have high prevalence of dementia. This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration.
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Affiliation(s)
- Betty Haralambous
- National Ageing Research Institute, 34 Poplar Road, Parkville, Vic. 3010, Australia. ;
| | - Paulene Mackell
- National Ageing Research Institute, 34 Poplar Road, Parkville, Vic. 3010, Australia. ;
| | - Xiaoping Lin
- National Ageing Research Institute, 34 Poplar Road, Parkville, Vic. 3010, Australia. ;
| | - Marcia Fearn
- National Ageing Research Institute, 34 Poplar Road, Parkville, Vic. 3010, Australia. ;
| | - Briony Dow
- National Ageing Research Institute, 34 Poplar Road, Parkville, Vic. 3010, Australia. ;
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Batchelor F, Hwang K, Haralambous B, Fearn M, Mackell P, Nolte L, Detering K. Facilitators and barriers to advance care planning implementation in Australian aged care settings: A systematic review and thematic analysis. Australas J Ageing 2019; 38:173-181. [PMID: 30873713 DOI: 10.1111/ajag.12639] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/07/2019] [Accepted: 02/17/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There are many studies investigating implementation of advance care planning (ACP) in aged care around the world, but few studies have investigated Australian settings. The objective of this study was to determine facilitators and barriers to implementation of ACP in Australian residential and community aged care. METHODS Evidence from Australian studies published between 2007 and September 2017 of ACP in residential and community aged care was sourced from electronic databases using predetermined search strategies. Data were extracted and synthesised using thematic analysis, and summarised according to themes. RESULTS Nine studies described facilitators and barriers of ACP implementation. Six themes were identified: "Education and Knowledge," "Skills and Training," "Procedures and Resources," "Perceptions and Culture," "Legislation" and "Systems." CONCLUSIONS A whole of systems approach is necessary to facilitate uptake of ACP in residential aged care settings. More research is needed to understand facilitators and barriers to ACP in community aged care.
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Affiliation(s)
| | - Kerry Hwang
- National Ageing Research Institute, Parkville, Victoria, Australia
| | | | - Marcia Fearn
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Paulene Mackell
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Karen Detering
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
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Doyle C, Bhar S, Fearn M, Ames D, Osborne D, You E, Gorelik A, Dunt D. The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: A randomized controlled trial. Br J Health Psychol 2017; 22:542-556. [PMID: 28544504 DOI: 10.1111/bjhp.12245] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 04/10/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The main objectives of this pragmatic randomized controlled trial were to investigate the impact of cognitive behaviour therapy (CBT) and an active social control (befriending) on depression and anxiety symptoms in people with chronic obstructive pulmonary disease (COPD). METHODS Eligible participants were randomly allocated to receive eight weekly telephone interventions of CBT (n = 54) or befriending (n = 56). Repeated-measures ANOVA was used to assess changes in scores and Cohen's d was used to assess effect sizes. RESULTS Significant improvement was observed in anxiety symptoms for the befriending group from baseline (T1) to post-intervention assessment (T2) and to 8-week follow-up assessment (T3), with a small to medium effect size (Cohen's d = 0.3). Significant improvement was noted in depression symptoms from T1 to T2 for both groups, but only the CBT group had a significant difference at T3, with a small to medium effect size (Cohen's d = 0.4). For secondary outcomes, there was a significant change in COPD symptoms from T1 to T2 for the befriending group; however, at T3 this change was no longer significant. Finally, there was a significant change in general self-efficacy for both groups between T1 and T2, and T1 and T3. CONCLUSION Cognitive behaviour therapy reduced depression symptoms but not anxiety. Befriending reduced depression symptoms in the short term and anxiety symptoms in both the short term and long term. Further research is needed to demonstrate non-inferiority of telephone delivery compared with other formats, and to understand the impact of befriending which has the potential to be a cost-effective support for people with COPD. Statement of contribution What is already known on this subject? Depression and anxiety are common comorbidities in people with chronic obstructive pulmonary disease. Mood disorders are not commonly routinely treated in people with chronic obstructive pulmonary disease. Telephone-administered CBT has been shown to be as effective as face-to-face CBT in reducing depression and anxiety. What does this study add? Telephone-administered CBT can reduce depression symptoms in people with COPD. Telephone-administered befriending can reduce anxiety and depression symptoms in people with COPD. People with COPD who have mood disorders would prefer to have CBT than befriending.
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Affiliation(s)
- Colleen Doyle
- National Ageing Research Institute, Melbourne, Victoria, Australia.,Australian Catholic University, Melbourne, Victoria, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Marcia Fearn
- National Ageing Research Institute, Melbourne, Victoria, Australia
| | - David Ames
- National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Debra Osborne
- National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Melbourne, Victoria, Australia
| | - Alex Gorelik
- Melbourne Epicentre, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
| | - David Dunt
- Centre for Health Policy, The University of Melbourne, Victoria, Australia
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Fearn M, Bhar S, Dunt D, Ames D, You E, Doyle C. Befriending to Relieve Anxiety and Depression Associated with Chronic Obstructive Pulmonary Disease (COPD): A Case Report. Clin Gerontol 2017; 40:207-212. [PMID: 28452661 DOI: 10.1080/07317115.2017.1292417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by airflow obstruction and shortness of breath, which as a result can severely limit activities of daily living. COPD sufferers are 85% more likely to develop anxiety disorders than healthy matched controls. Some of the factors that have been suggested to be associated with high anxiety in people with COPD include dyspnoea, the inability to perform daily activities or fulfil social roles, rehospitalisation and some COPD treatments. There is substantial evidence that cognitive behaviour therapy (CBT) is effective in managing mood disorders, but there is also some evidence that befriending can assist people. Befriending is an intervention that focuses on everyday conversation topics and can be delivered by volunteers with training and supervision. The case presented here illustrates the use of befriending provided over the phone for a participant with severe anxiety and depression. It was part of a larger RCT comparing CBT and befriending for the management of anxiety and depression in people with COPD. Symptoms were alleviated after a course of 8 weeks of befriending telephone calls from a volunteer. While befriending is not a substitute for CBT it may be useful in circumstances where CBT is not easily accessible.
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Affiliation(s)
- Marcia Fearn
- a National Ageing Research Institute , Melbourne , Victoria , Australia
| | - Sunil Bhar
- b Swinburne University of Technology , Melbourne , Victoria , Australia
| | - David Dunt
- c The University of Melbourne , Melbourne , Victoria , Australia
| | - David Ames
- a National Ageing Research Institute , Melbourne , Victoria , Australia
| | - Emily You
- c The University of Melbourne , Melbourne , Victoria , Australia
| | - Colleen Doyle
- a National Ageing Research Institute , Melbourne , Victoria , Australia.,c The University of Melbourne , Melbourne , Victoria , Australia.,d Australian Catholic University , Melbourne , Victoria , Australia
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Doyle C, Dunt D, Ames D, Fearn M, You E(C, Bhar S. Study protocol for a randomized controlled trial of telephone-delivered cognitive behavior therapy compared with befriending for treating depression and anxiety in older adults with COPD. Int J Chron Obstruct Pulmon Dis 2016; 11:327-34. [PMID: 26929616 PMCID: PMC4760208 DOI: 10.2147/copd.s100859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT) for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety. METHODS The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants' satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention. CONCLUSION People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for face-to-face psychological treatment. The results of this study should identify the relative efficacy of CBT delivered over the telephone to this population, which, if successful, may be a cost-effective and more palatable alternative to face-to-face treatment of depression or anxiety for this population.
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Affiliation(s)
- Colleen Doyle
- Australian Catholic University, Melbourne, VIC, Australia
| | - David Dunt
- Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia
| | - Marcia Fearn
- National Ageing Research Institute, Melbourne, VIC, Australia
| | | | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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Nitz J, Cyarto E, Andrews S, Fearn M, Fu S, Haines T, Haralambous B, Hill K, Hunt S, Lea E, Moore K, Renehan E, Robinson A. Outcomes from the Implementation of a Facility-Specific Evidence-Based Falls Prevention Intervention Program in Residential Aged Care. Geriatr Nurs 2012; 33:41-50. [DOI: 10.1016/j.gerinurse.2011.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 10/31/2011] [Accepted: 11/07/2011] [Indexed: 10/14/2022]
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Gilbertson AM, Kormányos A, Buckle PD, Fearn M, Ashley T, Lambert CJ, Solin SA, Cohen LF. Room temperature ballistic transport in InSb quantum well nanodevices. Appl Phys Lett 2011; 99:242101-2421013. [PMID: 22275771 PMCID: PMC3261050 DOI: 10.1063/1.3668107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 11/18/2011] [Indexed: 05/31/2023]
Abstract
We report the room temperature observation of significant ballistic electron transport in shallow etched four-terminal mesoscopic devices fabricated on an InSb/AlInSb quantum well (QW) heterostructure with a crucial partitioned growth-buffer scheme. Ballistic electron transport is evidenced by a negative bend resistance signature which is quite clearly observed at 295 K and at current densities in excess of 10(6) A/cm(2). This demonstrates unequivocally that by using effective growth and processing strategies, room temperature ballistic effects can be exploited in InSb/AlInSb QWs at practical device dimensions.
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Gilbertson AM, Benstock D, Fearn M, Kormányos A, Ladak S, Emeny MT, Lambert CJ, Ashley T, Solin SA, Cohen LF. Sub-100-nm negative bend resistance ballistic sensors for high spatial resolution magnetic field detection. Appl Phys Lett 2011; 98:62106. [PMID: 21383870 PMCID: PMC3048882 DOI: 10.1063/1.3554427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 01/24/2011] [Indexed: 05/30/2023]
Abstract
We report the magnetic field detection properties of ballistic sensors utilizing the negative bend resistance of InSb∕In(1-x)Al(x)Sb quantum well cross junctions as a function of temperature and geometric size. We demonstrate that the maximum responsivity to magnetic field and its linearity increase as the critical device dimension is reduced. This observation deviates from the predictions of the classical billiard ball model unless significant diffuse boundary scattering is included. The smallest device studied has an active sensor area of 35×35 nm(2), with a maximum responsivity of 20 kΩ∕T, and a noise-equivalent field of 0.87μT∕Hz at 100 K.
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Leontiadou MA, Litvinenko KL, Gilbertson AM, Pidgeon CR, Branford WR, Cohen LF, Fearn M, Ashley T, Emeny MT, Murdin BN, Clowes SK. Experimental determination of the Rashba coefficient in InSb/InAlSb quantum wells at zero magnetic field and elevated temperatures. J Phys Condens Matter 2011; 23:035801. [PMID: 21406869 DOI: 10.1088/0953-8984/23/3/035801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report the optical measurement of the spin dynamics at elevated temperatures and in zero magnetic field for two types of degenerately doped n-InSb quantum wells (QWs), one asymmetric (sample A) and one symmetric (sample B) with regards to the electrostatic potential across the QW. Making use of three directly determined experimental parameters: the spin lifetime, τ(s), the sheet carrier concentration, n, and the electron mobility, μ, we directly extract the zero-field spin splitting. For the asymmetric sample where the Rashba interaction is the dominant source of spin splitting, we deduce a room temperature Rashba parameter of α = 0.09 ± 0.1 eV Å which is in good agreement with calculations and we estimate the Rashba coefficient α(0) (a figure of merit for the ease with which electron spins can be modulated via an electric field). We review the merits/limitations of this approach and the implications of our findings for spintronic devices.
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Affiliation(s)
- M A Leontiadou
- Advanced Technology Institute, University of Surrey, Guildford GU2 7XH, UK
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Abstract
The main focus of lower limb physical performance assessment in people with haemophilia (PWH) has usually been on function, muscle strength and joint flexibility. The impact of haemophilic arthropathy on balance and falls risk is relatively under-explored. The aim of this study was to evaluate balance and related performance in PWH compared with age and gender matched healthy controls. It involved a comprehensive suite of clinical and laboratory measures of static and dynamic balance, mobility, strength, physical activity and falls efficacy completed in 20 PWH (mean age 39.4, 100% male) and 20 controls. Fifty percent of PWH reported falls in the past 12 months. Moderate impairment of balance and related measures were identified in PWH compared with the controls, with an average 35% difference between groups. Significant differences were evident between groups on both clinical and laboratory measures, including measures of dynamic bilateral stance balance [limits of stability measures on the laboratory test, functional reach; (P < 0.001); dynamic single leg balance (Step Test, P < 0.001)], gait and mobility (gait speed, step width and turning measures on the laboratory test, timed up and go test; P < 0.001); muscle strength (timed sit to stand, P = 0.002; quadriceps strength, P < 0.001); and activity level and falls efficacy, (P < 0.004). The dynamic clinical and laboratory measures testing similar domains of balance, gait and mobility had moderate correlations (0.310 < r < 0.531, P < 0.01). Moderate impairments in balance, mobility and related measures were identified in PWH, compared with the control group. Clinicians should include assessments of balance and related measures when reviewing adults with haemophilia.
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Affiliation(s)
- M Fearn
- Preventive and Public Health Division, National Ageing Research Institute, Parkville, Vic., Australia.
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Abstract
PURPOSE This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH). METHOD Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers. RESULTS The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment. CONCLUSIONS Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.
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Affiliation(s)
- Briony Dow
- National Ageing Research Institute, Victoria, Australia.
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Hill K, Smith R, Fearn M, Rydberg M, Oliphant R. Physical and Psychological Outcomes of a Supported Physical Activity Program for Older Carers. J Aging Phys Act 2007; 15:257-71. [PMID: 17724393 DOI: 10.1123/japa.15.3.257] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postint-ervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p < .05). There was no change in the Zarit Carer Burden Scale (p > .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.
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Affiliation(s)
- Keith Hill
- National Ageing Research Institute, Parkville, Victgoria, Australia
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Horsfield AP, Bratkovsky AM, Fearn M, Pettifor DG, Aoki M. Bond-order potentials: Theory and implementation. Phys Rev B Condens Matter 1996; 53:12694-12712. [PMID: 9982941 DOI: 10.1103/physrevb.53.12694] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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