Qualitative evaluation of a community-based intervention to reduce social isolation among older people in disadvantaged urban areas of Barcelona.

This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community-based intervention to reduce social isolation among older adults. The 'School of Health for Older People' is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi-structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community-dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in-depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community.

Evaluación de una intervención de promoción de la salud para personas mayores de barrios desfavorecidos / Evaluation of a health promotion intervention for elderly persons in underprivileged areas

Objetivo: evaluar la efectividad de una intervención de promoción de la salud para personas de edad avanzada, con el objetivo de promover la adopción de hábitos saludables y de mejorar la calidad de vida relacionada con la salud (CVRS), la salud mental y el apoyo social. Método: se llevó a cabo un estudio de evaluación con diseño pre/post, no-experimental. Se trataba de captar a mayores de 65 años, residentes en la comunidad, de dos barrios de nivel socioeconómico desfavorecido de la ciudad de Barcelona. La intervención consistió en un taller estructurado en ocho sesiones cuyo objetivo era la adopción de hábitos saludables. Se obtuvo información sobre la actividad física, CVRS, hábitos dietéticos, salud mental y apoyo social a partir de cuestionarios validados (IPAQ, SF-36, PREDIMED, GHQ-12, MOS y NSHAP, respectivamente). Se analizaron diferencias antes y después de la intervención mediante los test de McNemar, t de Student y de Wilcoxon para datos apareados según correspondiese. Resultados: la muestra se compuso de 22 adultos. Tras la intervención, la mediana de actividad física se incrementó en 842,5 MET/semana. La CVRS también mejoró: las puntuaciones para dimensión mental se incrementaron en un 30% y las de la dimensión física un 22%. No se observaron cambios en la dieta o en la salud mental. Conclusiones: las intervenciones de promoción de la salud, orientadas a personas mayores pueden jugar un papel clave en la mejora de la calidad de vida y el bienestar

Objective: to assess the efficacy of a health promotion intervention for persons of advanced age, with the objective of promoting the adoption of healthy habits and improving health-related quality of life (HRQoL), mental health, and social support. Methods: an evaluation study was conducted with pre/post, non-experimental design. The objective was to recruit >65-year-old persons living in the community, from two areas in the city of Barcelona with underprivileged socioeconomic levels. The intervention consisted in a workshop structured into eight sessions, with the objective of adopting healthy habits. Information was collected about physical activity, HRQoL, diet habits, mental health, and social support, through validated questionnaires (IPAQ, SF-36, PREDIMED, GHQ-12, MOS and NSHAP, respectively). Any differences before and after the intervention were analyzed through the McNemar, Student's t and Wilcoxon tests for paired data, as relevant. Results: the sample included 22 adults. After the intervention, there was an increase in the median physical activity of 842.5 MET/week. There was also an improvement in HRQoL: the scores for the mental dimension increased by 30% and the physical dimension by 22%. No changes were observed in diet or mental health. Conclusions: health promotion interventions, oriented to elderly persons, can play a key role in the improvement of QoL and wellbeing

Relationship between Smoking and Acute Mountain Sickness: A Meta-Analysis of Observational Studies.

AIMS: Previous epidemiological investigations of the relationship between smoking and acute mountain sickness (AMS) risk yielded inconsistent findings. Therefore, a meta-analysis of observational studies was performed to determine whether smoking is related to the development of AMS. METHODS: Searches were performed on PubMed, Scopus, Embase, and Web of Science for relevant studies that were published before November 2016 reporting smoking prevalence and AMS. Two evaluators independently selected studies, extracted data, and assessed study quality. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were obtained using random-effects models. Subgroup analyses were performed according to the type of participant, altitude, and study design. RESULTS: A total of 11 observational studies involving 7,106 participants, 2,408 of which had AMS, were eligible for inclusion in this meta-analysis. The summary RR for AMS comparing smokers to nonsmokers was 1.02 (95% CI: 0.83 to 1.26). Specific analyses for altitude, type of participant, and study design yielded similar results. There was significant heterogeneity for all studies (Q = 37.43; P < 0.001; I2 = 73%, 95% CI: 51% to 85%). No publication bias was observed (Egger's test: P = 0.548, Begg's test: P = 0.418). CONCLUSIONS: The meta-analysis indicates that no difference was found in AMS risk with regard to smoking status.

Relationship of altitude mountain sickness and smoking: a Catalan traveller's cohort study.

OBJECTIVES: The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING: Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS: A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES: The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS: AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS: These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.