Engaging older adults in an online physical activity programme to improve cognition: A qualitative study.

OBJECTIVES: Maintaining physical activity is a modifiable risk factor for dementia. However, older adults do not routinely meet activity guidelines. Online interventions offer a means of engaging with this group and overcoming barriers to physical activity, particularly in the context of a global pandemic where people have become accustomed to at-home and digital living. This study explored the factors which maximise engagement in an online programme to promote physical activity. METHODS: A qualitative study was conducted with adults aged 50 and over, recruited through the online UK PROTECT study cohort. Four focus groups (n = 21) examined key contributors to engagement with a digital programme to promote physical activity. Iterative Categorisation was utilised to identify categories and themes of the focus group data. Semi-structured interviews were also conducted (n = 5) in which participants were asked to comment on a concept-stage online intervention. RESULTS: Four key themes emerged from focus group data: interaction at the fore, incentives as foundations, fitting around me and identity is critical. The semi-structured interviews identified key areas of programme acceptability and specific needs for enhancing engagement. CONCLUSIONS: Older adults are open to using online physical activity programmes. Any intervention must be tailored to individual usability preferences and encompass fitness, health and lifestyle needs of older adults. The conceptual-stage intervention used in this study was found to be acceptable, with key changes needed to maximise engagement.

Cardiovascular preventive care for patients with serious mental illness.

OBJECTIVE: To determine whether patients with serious mental illness (SMI) are receiving preventive care for cardiovascular disease at the same rate as those without SMI in an interprofessional practice with a mandate to care for persons with barriers to access to the health care system. DESIGN: Quality improvement exercise using a case-matched retrospective chart review. SETTING: Somerset West Community Health Centre in downtown Ottawa, Ont. PARTICIPANTS: All patients with SMI were adult, current primary care patients from the Somerset West Community Health Centre with a recorded diagnosis of SMI (bipolar affective disorder, schizophrenia, or other psychosis) during the 2-year period from June 1, 2013, to May 31, 2015. Two control patients (current primary care patients without SMI and matched for age and sex) were randomly chosen for each patient with SMI. MAIN OUTCOME MEASURES: They had at least 1 record in their electronic chart during the 2-year study period of measurement of blood pressure, weight, body mass index, smoking status, lipid screening results, or diabetes screening results. Prevention score was calculated as the number of preventive tests documented out of the possible 6. Secondary measures included age, sex, comorbidities (diabetes, hypertension, or hyperlipidemia), mental illness diagnosis, involvement of a psychiatrist, and involvement of a mental health case worker. RESULTS: Patients with SMI had higher rates of diabetes, hypertension, and dyslipidemia. Screening rates for the 6 outcome measures were very similar between patients with and without SMI. Patients with SMI who were under the care of a psychiatrist or who had a case worker had more complete screening results than those who had neither provider. CONCLUSION: As expected, patients with SMI had higher rates of metabolic comorbidities than control patients had. Screening rates for cardiovascular risk factors were similar in the 2 groups. Involvement of mental health case workers and psychiatrists in the patients' care might be linked to more complete preventive screening.

No Dose Response Effect of Carbohydrate Mouth Rinse on Cycling Time-Trial Performance.

The aim of the current study was to investigate the influence of mouth rinsing carbohydrate at increasing concentrations on ~1 hr cycle time trial performance. Eleven male cyclists completed three experimental trials, following an overnight fast. Cyclists performed a ~1 hr time trial on a cycle ergometer, while rinsing their mouth for 5 s with either a 7% maltodextrin solution (CHO), 14% CHO or a taste-matched placebo (PLA) after every 12.5% of the set amount of work. Heart rate was recorded every 12.5% of the time trial, while RPE and GI comfort were determined every 25% of the time trial. The mouth rinse protocol influenced the time to complete the time trial (p < .001), with cyclists completing the time trial faster during 7% CHO (57.3 ± 4.5 min; p = .004) and 14% CHO (57.4 ± 4.1 min; p = .007), compared with PLA (59.5 ± 4.9 min). There was no difference between the two carbohydrate trials (p = .737). There was a main effect of time (P<0.001) for both heart rate and RPE, but no main effect of trial (p = .107 and p = .849, respectively). Scores for GI comfort ranged from 0-2 during trials, indicating very little GI discomfort during exercise. In conclusion, mouth rinsing and expectorating a 7% maltodextrin solution, for 5 s routinely during exercise was associated with improved cycle time trial performance approximately 1 h in duration. Increasing the carbohydrate concentration of the rinsed solution from 7% to 14% resulted in no further performance improvement.

Acute anxiogenic-like effects of selective serotonin reuptake inhibitors are attenuated by the benzodiazepine diazepam in BALB/c mice.

Selective serotonin re-uptake inhibitors (SSRIs), which are used commonly to treat anxiety disorders, have characteristic anxiogenic effects following acute administration. Treatment with anxiolytic benzodiazepines (BZs) may reduce these effects, although little is known about potential drug interactions. Our study evaluated acute anxiogenic-like effects of SSRIs, alone and combined with a BZ. Adult male BALB/c mice received fluoxetine (3.0-30.0mg/kg, i.p.) or citalopram (3.0-30.0mg/kg, i.p.) alone or in combination with diazepam (0.3-10.0mg/kg, i.p.), after which they were evaluated with the light/dark and open-field tests for anxiogenesis/anxiolysis. In addition, release of the stress hormone corticosterone was assessed following combined SSRI/BZ administration. In the light/dark and open-field tests, acute SSRIs produced a behavioral profile consistent with anxiogenesis, while diazepam produced an anxiolytic-like profile. Pre-treatment with diazepam (0.3-10mg/kg) reversed the effects of an anxiogenic-like dose of an SSRI (18mg/kg fluoxetine, 30mg/kg citalopram) in both light/dark and open-field tests. Diazepam, fluoxetine or citalopram, and their combination all significantly increased plasma corticosterone levels to the same degree. These findings suggest that a BZ-type drug can attenuate acute anxiogenic-like effects of an SSRI via a mechanism independent of corticosterone regulation.