Effect of pulmonary rehabilitation duration on exercise capacity and health-related quality of life in people with chronic obstructive pulmonary disease (PuRe Duration Trial): A randomized controlled equivalence trial.

Background And Objective: There is no strong evidence on the optimal duration of pulmonary rehabilitation (PR) programmes. The aim of the study was to determine whether an 8-week PR programme was equivalent to a 12-week PR programme in improving endurance exercise capacity in people with chronic obstructive pulmonary disease (COPD).

Methods: Participants with COPD were randomized to either an 8-week (8-wk Group) or 12-week (12-wk Group), twice weekly, supervised PR programme consisting of endurance and strength training and individualized self-management education.

Patterns of physical activity of people with COPD during participation in a pulmonary rehabilitation program.

Introduction: Very few studies have examined patterns of physical activity (PA) during a pulmonary rehabilitation (PR) program in people with COPD.

Aims: To compare the patterns of PA in: 1) the week before commencing PR (pre-PR) with a week during PR (PR week); 2) PR days and non-PR days during a PR week; 3) pre-PR and the week following PR completion (post-PR).

Methods: This was a multicenter, prospective cohort study.

Effect of a 4-Week Telerehabilitation Program for People With Post-COVID Syndrome on Physical Function and Symptoms: Protocol for a Randomized Controlled Trial.

Objective: COVID-19 has led to significant morbidity and mortality globally. Post-COVID sequelae can persist beyond the acute and subacute phases of infection, often termed post-COVID syndrome (PCS). There is limited evidence on the appropriate rehabilitation for people with PCS.

Effect of High-Intensity Power Training on Cognitive Function in Older Adults With Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Study.

We sought to determine the effects of 12 months of power training on cognition, and whether improvements in body composition, muscle strength, and/or aerobic capacity (VO2peak) were associated with improvements in cognition in older adults with type 2 diabetes (T2D). Participants with T2D were randomized to power training or low-intensity sham exercise control condition, 3 days per week for 12 months. Cognitive outcomes included memory, attention/speed, executive function, and global cognition.

Changes in Exercise Capacity and Health-Related Quality of Life at Four and Eight Weeks of a Pulmonary Rehabilitation Program in People with COPD.

Pulmonary Rehabilitation (PR) is a key intervention in the management of people with chronic obstructive pulmonary disease (COPD), though few studies have assessed where changes in outcomes occur during a PR program. The aim of this study was to determine the changes in exercise capacity and health-related quality of life at four and eight weeks during a twice-weekly supervised PR program in people with COPD. Fifty participants with COPD were recruited and attended PR twice-weekly for eight weeks.

The Effect of High-Intensity Power Training on Habitual, Intervention and Total Physical Activity Levels in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Randomized Controlled Trial.

Background: We examined the effect of power training on habitual, intervention and total physical activity (PA) levels in older adults with type 2 diabetes and their relationship to metabolic control.

Materials And Methods: 103 adults with type 2 diabetes were randomized to receive supervised power training or sham exercise three times/week for 12 months. Habitual, intervention, and total PA, as well as insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c), were measured.

Chronic wound care delivery in wound clinics, community nursing and residential aged care settings: A qualitative analysis using Levine's Conservation Model.

Aims And Objectives: To explore patient experience of chronic wound care across diverse models of outpatient wound care delivery.

Background: Chronic wounds represent a significant personal, family and healthcare system burden. Evidence suggests specialist wound clinics are more effective and less expensive, however, most outpatient wound care is delivered by general community nurses.

Incontinence in frail elderly persons: Report of the 6th International Consultation on Incontinence.

Background: Evidence-based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management.

Aims: To summarize the available evidence relating to the management of urinary incontinence in frail older people published since the 5th International Consultation on Incontinence.

Effect of a pulmonary rehabilitation programme of 8 weeks compared to 12 weeks duration on exercise capacity in people with chronic obstructive pulmonary disease (PuRe Duration): protocol for a randomised controlled trial.

Introduction: Pulmonary rehabilitation (PR) is a key component in the management of chronic obstructive pulmonary disease (COPD). There is no strong evidence on the optimal duration of PR programmes. The aim of this study is to determine whether an 8-week PR programme is equivalent to a 12-week PR programme in people with COPD.

Increasing the delivery of upper limb constraint-induced movement therapy post-stroke: A feasibility implementation study.

Introduction: Few stroke survivors receive upper limb constraint-induced movement therapy (CIMT). The aims of this study were to evaluate whether a behaviour change program for occupational therapists increased the number of stroke survivors receiving CIMT, describe the time and process involved in delivering the first program, any adverse events, fidelity and dose of CIMT provided, and upper limb outcomes.

Methods: A feasibility pre-post implementation study design was used, with intervention and measures for therapists and stroke survivors.

Acute exercise decreases vaccine reactions following influenza vaccination among older adults.

Although valuable and effective in decreasing disease burden, influenza vaccination has low rates of efficacy, especially in those at most risk. Studies have shown that acute exercise can improve vaccine responses, most consistently with weaker antigens. Here we examined the effect of resistance exercise on the acute and longer-term responses to influenza vaccination among healthy older adults.

The oral health status, behaviours and knowledge of patients with cardiovascular disease in Sydney Australia: a cross-sectional survey.

Background: Periodontal disease is a risk factor for atherosclerotic cardiovascular disease and it is recommended internationally that patients with cardiovascular disease should engage in preventative oral health practices and attend regular dental care visits. This study aimed to explore the oral health status, behaviours and knowledge of patients with cardiovascular disease.

Methods: A cross-sectional questionnaire containing 31 items was administered to patients with cardiovascular disease from cardiac rehabilitation and outpatient clinics in Sydney Australia in 2016-2017.

Systematic review and meta-analysis of the effect of protein and amino acid supplements in older adults with acute or chronic conditions.

The loss of lean body mass, muscle strength and physical function causes significant problems in older adults. Protein and amino acid supplements can preserve muscle strength but the effect on function is variable. We conducted a systematic literature review and meta-analysis to investigate the effect of protein and amino acid supplementation on fat-free mass, muscle strength and physical function in malnourished, frail, sarcopenic, dependent or elderly with acute or chronic conditions, with or without rehabilitation exercise.

Graded Resistance Exercise And Type 2 Diabetes in Older adults (The GREAT2DO study): methods and baseline cohort characteristics of a randomized controlled trial.

Background: Type 2 diabetes (T2D) is projected to affect 439 million people by 2030. Medical management focuses on controlling blood glucose levels pharmacologically in a disease that is closely related to lifestyle factors such as diet and inactivity. Physical activity guidelines include aerobic exercise at intensities or volumes potentially unreachable for older adults limited by many co-morbidities.

Effects of concomitant spinal cord injury and brain injury on medical and functional outcomes and community participation.

Background: There are limited data on the interactions between concomitant spinal cord injury (SCI) and traumatic brain injury (TBI) in terms of medical, psychological, functional, and community outcomes.

Objective: To investigate the hypothesis that in addition to SCI-associated sensory-motor impairments, people with dual diagnosis would experience additional TBI-associated cognitive impairments that would have a negative impact on community reintegration.

Methods: Cross-sectional, case-matched study comparing a consecutive sample of participants with dual diagnosis (n = 30) to an SCI group (n = 30) and TBI group (n = 30).

The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial.

Background: Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available.

Methods: The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up.

Nutrition as a part of healthy aging and reducing cardiovascular risk: improving functionality in later life using quality protein, with optimized timing and distribution.

Aging is associated with many physiological changes, which may in time lead to numerous pathophysiological outcomes, including adverse vascular events. For example, senescence of the immune system and cellular senescence both contribute to rising inflammation with age, potentially induced by the overall burden of comorbid illness, adipose tissue mass, diet, socioeconomic status, and physical activity. In turn, this chronic inflammation decreases physical and cognitive performance, and promotes sarcopenia and the syndrome of frailty.

Weight loss and malnutrition in the elderly--the shared role of GPs and APDs.

This article forms part of a series looking at the relationship between diet and good health, and the role of the dietician in the primary health care team. This review highlights some of the physical, social and medical factors that can indicate compromised nutritional status in the elderly, the screening tools available to detect malnutrition, and when to involve a dietician.

High rate of deficiency in the amino acids tryptophan and histidine in people with wounds: implication for nutrient targeting in wound management--a pilot study.

Background: Malnutrition resulting from inadequate protein, energy, or micronutrient intake has been identified as an independent risk factor for the development of pressure ulcers in older adult patients and is associated with increased morbidity and death.

Objective: To assess the relationship between albumin, the standard biochemical marker of nutritional adequacy, and amino acid status in people with wounds.

Methods: The authors performed tests for serum albumin, prealbumin, and amino acid profiles on 18 consecutive hospital patients with wounds and 7 patients without wounds.

Are general practitioners satisfied with electronic discharge summaries?

The aim of this study was to assess general practitioners' (GPs') satisfaction with the quality of information in electronic discharge summaries and the timeliness of their receipt of the summaries. The study was conducted in a 75-bed Australian public metropolitan hospital which uses an electronic discharge summary which is mailed to the patients' nominated GP. Eighty-five GPs were surveyed regarding their satisfaction with the content of the electronic discharge summary and the timeliness of receipt.

Diet and aging: bearing on thrombosis and hemostasis.

Diet is one of the environmental factors that influences thrombosis and hemostasis. Macronutrients, micronutrients, and other bioactive food components alter the predisposition to thrombosis. The type and amount of dietary fat has been shown to alter thromboxane A2 production and platelet aggregation, bleeding time, factor VII, fibrinogen, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1).

Collaborating to manage polypharmacy.

DiNCQUMGP (Divisions National Consortium for the Quality Use of Medicines in General Practice) reports on a collaboration between doctors, pharmaceutical companies, government agencies, and medicine users to manage polypharmacy (prescribing multiple medicines to a patient) amongst older people. We have reported the outcomes of our collaboration (improving the Quality Use of Medicines) elsewhere. Here we discuss how we worked together, opened up new opportunities, and learned from one another.

A relationship between computerisation and quality in general practice.

Aim: To explore whether there is an association between use of computers and compliance with The Royal Australian College of General Practitioners (RACGP) Entry Standards for General Practice.

Method: Participants in the RACGP Field Test of Standards were surveyed to determine their level of computerisation. These data were matched with the participants' compliance with selected standards.