IRIS Tipologia:
https://hdl.handle.net/10807/83122
2024-03-28T12:59:07ZLow adherence to physical activity is associated with incident mobility in older adults with physical frailty and sarcopenia: results from the SPRINTT randomized clinical trial
https://hdl.handle.net/10807/268527
Titolo: Low adherence to physical activity is associated with incident mobility in older adults with physical frailty and sarcopenia: results from the SPRINTT randomized clinical trial
Autori: Alejandro Álvarez-Bustos; Riccardo Calvani; Leocadio Rodriguez-Mañas; Francesco Landi; Matteo Cesari; Helio José Coelho-Junior; Emanuele Marzetti
Abstract: Background: Physical activity (PA) and nutrition are the most effective strategies to prevent mobility disability and other negative outcomes in older adults. However, considerable heterogeneity was observed in response to PA across interventional studies. This may be explained by different levels of adherence to PA interventions among participants. Objectives: To examine the effects of adherence to a PA intervention on the risk of developing mobility disability in older adults with Physical Frailty and Sarcopenia (PF&S). Methods: Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalized as having a total score from 3 to 9 at the Short Physical Performance Battery (SPPB), low appendicular lean muscle mass, and the ability to complete the 400 m walk test in <15 minutes. For the present investigation, data from participants allocated to the multicomponent intervention (PA plus nutrition) were analyzed. Adherence to PA was defined based on the number of weekly sessions attended and agreement with recommendations of the American College of Sports Medicine. Adherence was categorized as low (<2 sessions/week, LA), meeting recommendations (2–3 sessions/week, MR), and high recommendations (>3 sessions/week, AR). The primary outcome was incident mobility disability, operationalized as incident inability to complete the 400-m walk test in <15 minutes at follow-up. Results: 689 participants (mean age 79.3 years, 72.6% women) were included. In those with SPPB 3–7, MR [OR (95%CI): 0.56 (0.34, 0.93), p-value 0.025] and AR [OR (95%CI): 0.26 (0.16, 0.42), p-value <0.001] groups had lower risk of mobility disability compared to the LA group. In participants with SPPB 8–9, AR group had a significant lower likelihood of mobility disability comparing with the LA group [OR (95%CI): 0.18 (0.06, 0.57), p-value 0.004]. No significant differences were observed between MR and AR groups. Conclusion: In older adults with PF&S, a high adherence to PA recommendations is associated with reduced incidence of mobility disability.2024-01-01T00:00:00ZPhysical performance and incidence of negative events in very old adults: results from the IlSIRENTE study
https://hdl.handle.net/10807/268525
Titolo: Physical performance and incidence of negative events in very old adults: results from the IlSIRENTE study
Autori: Hélio José Coelho-Júnior; Andrea Russo; Francesco Landi; Emanuele Marzetti
Abstract: Background: Declining physical performance in old age is associated with a wide range of negative health related outcomes, including disability, poor quality of life, admission to hospital, admission to residential care, and death (1 3). However, it is unclear which physical capabilities should be prioritized to obtain prognostic information in older adults. Methods: ilSIRENTE was a prospective cohort study of older adults residing in the mountain community of the Sirente geographic area in Central Italy. The study was designed by the Department of Geriatrics of the Università Cattolica del Sacro Cuore (Rome, Italy) an d the teaching nursing home Opera Santa Maria della Pace (Fontecchio, L’Aquila, Italy) in partnership with local administrators and primary care physicians of the Sirente Mountain Community Municipalities. The protocol was approved by the Ethics Committee of the Université Cattolica del Sacro Cuore. Prior to enrollment, all participants or their proxies, when appropriate, provided signed informed consent. Baseline assessments began in December 2003 and were completed in September 2004. Follow up visits took place after 24 months of baseline assessment. Information about medical history, medications, and lifestyle habits (e.g., smoking, alcohol consumption, physical activity) was collected using validated questionnaires. Physical performance was assessed usin g isometric handgrip strength, walking speed at usual and fast pace, 5 time sit to stand test, and sit to stand power measures. Absolute, relative, allometric, and specific muscle power values of lower extremities were calculated using the equations validated by Alcazar et al. (5). Appendicular skeletal muscle mass was estimated from calf circumfe rence using a validated equation (6). History of falls, incident falls, and disability status according to basic Activities of Daily Living (ADLs) were recorded over two years. Survival status was obtained from the participants’ general practitioners and w as confirmed by the National Death Registry over 10 years from enrolment. Linear, binary, and Cox regressions were used to evaluate the association between physical Linear, binary, and Cox regressions were used to evaluate the association between physical performance measures and health outcomes. performance measures and health outcomes. Results: Mean age of the 255 participants was 84.2 ± 5.1 years, and 161 (63.1%) were women. Mean age of the 255 participants was 84.2 ± 5.1 years, and 161 (63.1%) were women. Logistic regression indicated that hanLogistic regression indicated that handdgrip strength was significantly associated with incident ADL grip strength was significantly associated with incident ADL disability, whereas specific muscle power was an independent predictor of death. No significant disability, whereas specific muscle power was an independent predictor of death. No significant associations were observed between any physical performance measure and incident falls.associations were observed between any physical performance measure and incident falls. Conclusion: Our findings indicate selective associations between physical performance tests and Our findings indicate selective associations between physical performance tests and the occurrence of negative events in very old adults, with poor handgrip strength predicting the occurrence of negative events in very old adults, with poor handgrip strength predicting disability and specific muscle power being longitudinally associated with deathdisability and specific muscle power being longitudinally associated with death.2024-01-01T00:00:00ZSELF-DETERMINED SENSE OF HOPELESSNESS IN COPD – A GROUNDED THEORY
STUDY
https://hdl.handle.net/10807/266857
Titolo: SELF-DETERMINED SENSE OF HOPELESSNESS IN COPD – A GROUNDED THEORY
STUDY
Autori: Poletti Valentina
Abstract: Self-determined sense of hopelessness in COPD – a Grounded Theory study
Introduction: Living with Chronic Obstructive Pulmonary Disease (COPD) is a struggling experience, with a negative impact both on the physical and psychological well-being of those affected.
Aim: The main aim was to develop a theoretical account of the perception and expectation patterns of COPD patients, considering their severity levels.
Methods: This Grounded Theory study, conducted at the U.O.C. Cardio Respiratory Rehabilitation Unit of the IRCCS Fondazione Don Carlo Gnocchi in Milan (Italy), involved 20 participants with COPD who underwent semi-structured face-to-face interviews about their experience and expectations of the disease. Interviews were audio-recorded, transcribed, and analyzed using a grounded theory approach. Moreover, a visual tool exploring their symptoms and the Pictorial Representation of Illness and Self-measure (PRISM) were administered. Clinical data have been also considered. Analysis was conducted through NVivo (version 12).
Results: Theoretical saturation of substantive codes was achieved with 20 interviews [Males=13 (65%)]. The participants’ mean age and the forced expiratory volume in 1 second were 68,18 (SD=7,17) years and 66 (SD=6,14) percent of predicted, respectively.
The core category was “hopelessness”. COPD was perceived as a serious threat to one’s daily activities, and interests. The most described symptoms were shortness of breath, sleep disturbances, and fatigue, resulting in depressive symptoms often linked to avoidance and a reduction in the motivation to undertake more challenging activities. In general, patients demonstrated some difficulties to project themselves into the future; negative illness expectations, linked to the sense of responsibility due to cigarette smoking, emerged in most cases, especially in patients with severe COPD. Feeling supported and hopeful about the effectiveness of treatment seems to have a positive influence on patients’ coping styles.
Discussion: This study confirmed how COPD limits patients' quality of life, increasing their general rejection of life. Investigating perceptions of their condition and focusing on their expectations might be useful to introduce personalized therapeutic interventions, where patients are the real experts of their disease.2023-01-01T00:00:00ZDialoghi sulla morfologia delle fonti
https://hdl.handle.net/10807/258900
Titolo: Dialoghi sulla morfologia delle fonti
Autori: Giovanni Bombelli; Paolo Heritier; Michele Massa
Abstract: Introduzione alla sezione speciale del fascicolo della Rivista che raccoglie gli atti di un ciclo di seminari dal titolo Dialoghi sulla morfologia delle fonti, tenutosi presso l’Università Cattolica del Sacro Cuore di Milano nella primavera del 2022. Gli incontri si sono strutturati come veri e propri dialoghi. Gli ospiti sono
stati invitati a discutere, tra loro e con gli organizzatori, attorno ad alcune domande, da una varietà di prospettive: dal diritto pubblico alla filosofia del diritto, sino ad altri settori delle scienze giuridiche, nonché ad aree afferenti altre scienze sociali (segnatamente la sociologia). Questa la domanda essenziale: come cambia il diritto per effetto del rifluire su di esso dei processi di mutamento sociale, in particolare in momenti segnati da situazioni di emergenza e orizzonti di incertezza conoscitiva (o, meglio, cognitiva). L'introduzione ripercorre i diversi seminari, inquadrandoli in un percorso teoretico unitario.2023-01-01T00:00:00Z