Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores.

INTRODUCTION: Different remote interventions, such as applications (apps), have been used to continue promoting healthy ageing and preventing disability during the COVID-19 pandemic. The growing trend of apps in health is exponential and may facilitate scaling up physical activity prescription. Numerous tools are available, but little is known regarding their appropriateness, validation and recommendation, especially for frail older adults. METHODS: In-house, we developed an application that makes both the Apple app Store and the Google Play Store searchable using topic-related keywords and facilitates the extraction of basic app-information of the search results. The study was aimed at apps available to an English-speaking market. The resulting apps were filtered using various inclusion and exclusion criteria. The resultant apps underwent a more in-depth characterisation and searches for scientific publications on each app website and PubMed. RESULTS: From an initial search result of >2,800 apps, 459 met the initial inclusion criteria. After a more in-depth review of their features, 39 apps remained for possible app in older frail patients. After testing them, 22 apps were excluded. Seventeen apps fit the inclusion and exclusion criteria and were deemed appropriate after peer review. Of these, only one app, Vivifrail, had any type of publication/published evidence. CONCLUSION: Apps can be valuable tool in prescribing exercise for frail older adults living in the community. However, few apps seem useful on a large scale, and there is limited evidence to support their effectiveness. It is important to invest in adapting Information and Communication Technologies to this population group.

Sustained improvement of intrinsic capacity in community-dwelling older adults: The +AGIL Barcelona multidomain program.

BACKGROUND: Different programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older adults' intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the integrated care for older people (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults' physical performance. METHODS: All +AGIL Barcelona consecutive participants since 2016 were enrolled. After a comprehensive geriatric assessment, a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10-week boost multicomponent exercise program, nutritional and sleep-hygiene counselling, revision and optimization of pharmacological treatments and screening for cognitive impairment, depression and loneliness. Changes in physical performance after 3 and 6 months were assessed using mixed models including baseline frailty degree, time and all potential significant confounders. RESULTS: We included 194 participants in the analysis (mean age = 81.6 [standard deviation = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Physical Performance Battery [SPPB] test, combining gait speed, strength and balance) was found at 3 months (SPPB mean change: 1.4; 95% CI: 1.1-1.6) and 6 months (SPPB mean change: 1.1; 95% CI 0.8-1.5). Equivalent results were observed for all the SPPB sub-tests. CONCLUSIONS: A coordinated, multidisciplinary and integrated program can benefit older adults' intrinsic capacity. The participants' empowerment and the connection with the available community resources are critical points for a successful intervention.

Co-designing implementation strategies to promote remote physical activity programs in frail older community-dwellers.

Background: The "AGIL Barcelona (AGILBcn)" community-based integrated care program is a multicomponent healthy aging intervention for frail older adults. In this context, the present study aimed to identify implementation strategies to optimize the accessibility, acceptability, and adaptability of mobile health (mhealth) interventions to enhance physical activity in frail older adults, and to prioritize action points according to their importance and feasibility, through a co-design process. Material and methods: A mixed methods approach was used. In the qualitative phase, a method adapted from the World Café was applied in 6 virtual groups to identify strategies to facilitate the virtual physical activity program. In the quantitative phase, prioritization and feasibility of the strategies was analyzed through surveys. Strategies were ranked based on priority vs. feasibility, revealing if strategies should either be: implemented first; if possible; taken into account for future consideration; or directly disregarded. The convenience sample included older adults (n = 7), community professionals (n = 9) and health professionals (n = 13). Qualitative data were analyzed by summative content analysis and quantitative data by nonparametric descriptive analyses. Results: A total of 27 strategies were identified and grouped into four categories: general strategies for reducing barriers; specific strategies for facilitating the use of a digital application; specific strategies for facilitating participation in virtual exercise groups; and specific strategies for facilitating external support. According to the ranking of strategies, the first ones to be implemented included: digital literacy, digital capability assessment, family technology support, weekly telephone follow-up by professionals, personalizing exercises, and virtual exercises in small groups. Conclusion: The active participation of all stakeholders enabled us to identify potential strategies for implementing person-oriented technology in physical activity programs and for engaging older adults.

[Perceptions and external factors of physical activity in adolescents using mixed methods]. / Percepciones y factores externos de la actividad física en adolescentes mediante métodos mixtos.

OBJECTIVE: Analyze the levels of physical activity in adolescents and their relationship with perceptions of physical activity and external factors. METHOD: Cross-sectional descriptive observational study. The participants were adolescents between the ages of 11 and 18. They were recruited in secondary schools in the municipality of Esplugues de Llobregat, Barcelona, Spain. The measurements were amount of physical activity (IPAQ-A questionnaire) and the relationship between level of physical activity and the perceptions of physical activity and external factors proposed by the health promotion model. RESULTS: Of the total sample, 60.34% participants were insufficiently active. The factors positively associated with physical activity were male gender (p<0.01), engaging in extracurricular sports (p<0.01), perceiving benefits (p<0.01), perceiving self-efficacy (p<0.01), interpersonal influences (p<0.01), having parents who engage in sports (p<0.01), social support (p<0.01) and social norms supporting exercise (p<0.01). The factors negatively associated with physical activity were female gender (p<0.01), body mass index (p=0.048) and perceiving obstacles (p<0.01). There was no relationship with social class (p=0.164). Situational influences were a conditioning factor for boys (p<0.01), but not girls (p=0.561). CONCLUSIONS: This study identifies factors that determinate the practice of physical activity in adolescents. Taking these factors into account in the design of health promotion interventions and policies could help increase levels of physical activity in this population. Even so, there are some variables, such as gender and socioeconomic status, that should be explored in depth through research that is more exploratory and discursive.

Association between subjects with newly Diagnosed rheumatoid arthritis and dental caries / Asociación entre sujetos con artritis reumatoide recientemente diagnosticada y caries dental

Abstract Alterations in saliva, temporomandibular joint disorders, dysphagia, Sjogrens syndrome, dental caries, periodontal disease, and tooth loss have been identified in patients with Rheumatoid Arthritis. The aims of this research were 1) to study the association between newly diagnosed rheumatoid arthritis and dental caries and 2) to identify most frequent teeth with caries in study groups. A descriptive pilot study was performed. A total of 620 participants were evaluated, 29 met the selection criteria. The subjects were divided into 2 groups: 13 subjects with newly diagnosed rheumatoid arthritis and 16 subjects without rheumatoid arthritis. Salivary parameters, DMFT index, care index, FS-T index and Treatment Needs Index were evaluated in all participants. The Fishers Exact test and Mann-Whitney U test we used to establish the differences between groups. Low mean in all salivary parameters and a high caries frequency were observed in subjects with newly diagnosed rheumatoid arthritis compared to a control group (p<0.01). The right maxillary second premolar (n=6, 46%, p=0.0100); right mandibular second premolar (n=7,54%, p=0.0462) and left mandibular second molar (n=10,77%, p=0.0001) were the most frequent teeth with caries. Early diagnosis and early treatment of rheumatoid arthritis can improve the prognosis in most of patients. The development of new public health policies and care based on the prevention are necessary to improve the quality of patients lives.

Resumen Alteraciones en la saliva, trastornos de la articulación temporomandibular, disfagia, síndrome de Sjogren, caries dental, enfermedad periodontal y pérdida de dientes son algunas patologías que se han identificado en pacientes con artritis reumatoide. Los objetivos de este estudio fueron (1) Asociar la artritis reumatoide recientemente diagnosticada con la caries dentales e (2) Identificar los dientes más frecuentes con caries en los grupos de estudio. Se realizó un estudio piloto descriptivo. 620 participantes fueron evaluados, 29 sujetos cumplieron con los criterios de selección. Los sujetos se dividieron en 2 grupos: 13 sujetos con artritis reumatoide recién diagnosticados y 16 sujetos sin artritis reumatoide. En todos los participantes se evaluaron parámetros salivales, el índice CPOD, el índice IC, el índice FS-T y el índice INT. La prueba exacta de Fisher y U de Mann-Whitney se utilizaron para establecer diferencias entre grupos. En los resultados se observó un bajo promedio de los parámetros salivales y una alta frecuencia de caries en sujetos con artritis reumatoide recién diagnosticados comparados con un grupo control (p<0.01). El segundo premolar superior derecho (n=6,46%, p=0,0100); el segundo premolar mandibular derecho (n=7,54%, p=0.0462) y el segundo molar mandibular izquierdo (n=10,77%, p=0.0001) fueron los dientes más frecuentes con caries dental. El diagnóstico y el tratamiento temprano de la artritis reumatoide pueden mejorar el pronóstico en la mayoría de los pacientes. El desarrollo de nuevas políticas de salud pública basadas en la prevención de la cavidad bucal son necesarias para mejorar la calidad de vida de los pacientes.

Comment on Blancafort Alias et al. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. Int. J. Environ. Res. Public Health 2021, 18, 5979.

We read with interest the article by Blancafort et al. [...].

Antimicrobial effect of gold nanoparticles in the formation of the Staphylococcus aureus biofilm on a polyethylene surface.

The main of this study was to evaluate the inhibitory effect on the in vitro formation of the Staphylococcus aureus biofilm formed on a polyethylene (PE) surface with a nanostructured Gold (Au) coating for medical devices. An experimental in vitro study was carried out using PE discs with an Au nanoparticle coating (AuNPs) on one side (experimental group) and without coating on the other (control group); the discs were mounted in the CDC biofilm reactor adding broth of yeast-dextrose-peptone (YPD) sterile culture inoculated with S. aureus in a cell suspension (5 × 108 cells/ml). The specimens were evaluated at different times (6, 12, 24, 48, 72 h) and stained with the Live/Dead Bacterial Viability Kit (Invitrogen) for observation, analysis, and quantification with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). The results showed that as evaluation time passed an increasing of S. aureus biofilm formation was observed in the control group, in the experimental group, a statistically significant biofilm inhibition was observed with respect to the AuNPs uncoated specimens (p ≤ 0.05) and showed a ratio of almost 4:1 viable/nonviable in the biofilm of the uncoated surfaces, with a difference > 5 Log10 in the CFU counts. The PE with AuNP coating showed an inhibitory effect on the biofilm formation of S. aureus.