Shanthi Johnson

Recommendations for action on the social determinants of health: a Canadian perspective

we are now well positioned to understand and address health disparities at the global, national, and local levels. The global resurgence of interest in addressing health disparities in the 1990s and 2000s through various movements, such as the WHO Commission on the Social Determinants of Health and their fi nal report with evidence-based recommendations,

Comparison of Creatine Supplementation Before Versus After Supervised Resistance Training in Healthy Older Adults

This study was performed to compare the effects of creatine supplementation (CR) before vs. after supervised resistance training (RT) in healthy older adults. Participants were randomized to one of two groups: CR-Before (0.1g•kg−1 creatine before + 0.1g•kg−1 placebo [rice flour] after RT, n = 11) or CR-After (placebo before + creatine after RT, n = 11). Resistance training (RT) was performed 3 days/week, on nonconsecutive days, for 12 weeks. Prior to and following the study, measures were taken for body composition, maximum strength, muscle protein catabolism, and kidney function. Over the 12-week training period, both groups experienced a significant increase in whole-body lean tissue mass, limb muscle thickness, and upper and lower body strength and a decrease in muscle protein catabolism (p < 0.001), with no differences between groups. There was no change in kidney function over time. Changes in muscle mass or strength are similar when creatine is ingested before or after supervised resistance training in older adults.

Healthy Life Expectancy in the Context of Population Health and Ageing in India

This study examines life expectancy (LE) and healthy life expectancy (HLE) in India longitudinally over the period 2007 to 2020, providing projections into the future. Specifically, the Indian Healthy Life Expectancy Projection model was developed based on epidemiological data (mortality, disability rates) obtained from the World Health Organization and the Government of India. The current model contributed to 4 key findings: decreases in mortality but not in all age and gender groups; increasing disability in the Indian population over time; increase in LE and HLE into the future in all age and gender groups; and the largest gains in LE and HLE are in the older age bands starting from the 70+ age band in women and 65+ age band in men. This study sheds some light on the population health measures needed to improve the understanding of the determinants of health for the efficient allocation of resources and to inform policy in the planning of health and social services.

Policy, Community and Kin: Interventions That Support Rural Healthy Aging

This study examines the interventions that enable rural seniors to remain within their homes and communities as they age. Through semi-structured interviews with 40 rural seniors, the findings reveal a number of actions that facilitate rural aging. This study has important implications for a range of stakeholders from policy makers to community leaders by identifying policy, community, and kin-level interventions that support rural healthy aging in place. In identifying interventions that support rural seniors’ needs, this study provides a fundamental basis to better allocate resources, plan programs, and develop policies that reflect the needs of an aging population.

The effects of dietary fasting on physical balance among healthy young women

BackgroundThe study examined the effects of dietary fasting on physical balance among young healthy women.MethodsThis study undertaken involving 22 young healthy women (age = 22 ± 1.5) using a within subject counterbalanced 2-week crossover study design. Participants were asked to refrain from consuming any food or beverage for 12 hours prior to the fasting trial and to maintain their regular diet for the non-fasting trial. Measures included: a background questionnaire, 24-hour dietary recall, and functional reach and timed single-limb stances.ResultsFasting resulted in significant declines in functional reach (p < 0.01), and ability to balance in a single limb stance with eyes open, on both the dominant and non-dominant legs (p < 0.01 and p < 0.01, respectively), and with eyes closed on the dominant leg (p < 0.01).ConclusionsThe findings have implications for athletic performance in younger individuals as well as emphasizing the need for health education for young women to avoid skipping meals.

Use of oral nutrition supplements: in long-term care facilities.

PURPOSE Practices related to oral nutrition supplement (ONS) use were examined in elderly people living in long-term care (LTC) facilities. METHODS Thirteen LTC facilities within a large regional health authority participated, and 17 people responsible for prescribing ONS in their facilities were interviewed, using a key informant telephone survey. A survey on ONS practice was modified, pilot tested, and used. RESULTS Oral nutrition supplements were primarily prescribed by nursing staff (59%), followed by physicians, registered dietitians, or other staff; ONS use was prescribed for decreased intake, unintentional weight loss, or wound healing. Various ONS products (e.g., Ensure, Boost, or Resource 2.0) were prescribed. Only 18% of respondents reported using alternative food options first to supplement nutritional intake, before introducing ONS. In terms of follow-up and evaluation, the measures of improvement included weight gain, wound healing, or improved well-being; reasons for discontinuation included weight gain, increased intake, or death. CONCLUSIONS Within LTC settings, the prescription and monitoring of ONS vary considerably. Evidence-based guidelines for the prescription and monitoring of ONS and for the use of a food-first strategy should be developed, implemented, and evaluated to optimize the nutritional health of the elderly in LTC facilities.

The future of health care: students' perceptions, education, and training in aging and health in India.

This study examined the students’ perceptions on the care of the older persons and their education and training in geriatrics and gerontology in India. Students (n = 229) from medicine, nursing, and social work programs completed a survey. Three key findings emerged: (a) strong family ties and filial piety in aging care, (b) acknowledging the importance of social, economic, and religious factors in the care of the older persons while not recognizing the age-related health needs, and (c) although participants described their education and training as being adequate, lack of awareness of aging policies highlight the need for formalized educational and training opportunities.

Review of Nutrition Screening and Assessment Practices for Long-Term Care Residents

Abstract The older adult population in Canada is growing, creating a greater demand for long-term care (LTC) facilities. Seniors living in LTC are more vulnerable to malnutrition, making it important to implement nutrition screening tools on a routine basis. The purpose of this study was to explore the practices of Registered Dietitians (RDs) related to nutritional screening, nutritional assessment, and follow-ups conducted within LTC facilities. This study also explored possible barriers hindering the application of these practices. Nine RDs from two health regions in Southern Saskatchewan completed a phone interview to address nutrition care practices/policies and barriers in LTC facilities. Results showed a considerable amount of variability in nutrition care practices for screening and assessment with lack of time identified as the greatest barrier. These findings highlight the importance of having consistent policies and a sufficient amount of RDs available in LTC facilities to provide the expected level of nutrition care for residents.

Understanding complex care for older adults within Canadian home care: a systematic literature review

ABSTRACT In the context of an aging population, both the need for home care services and its complexity of care have increased in many high-income countries. Yet, the definition of what constitutes complex care is largely elusive. This systematic review examined the conceptual definition of complex care within the home care environment using several social and health science databases for research published from 2000 to 2017. Of the 25 articles and reports identified, only 16 addressed complex care specifically and included older adults, aging, and/or home care. The results showed that complex care for older adults is primarily defined from a biomedical approach focusing on chronic disease and management and less commonly from the perspective of the social determinants of health. Future studies should consider the importance of the continuum of care needs from both the biomedical and the social determinants to adequately plan and provide care for older adults.

The Effects Of Home Based Nutrition And Exercise Intervention In Improving Functional Capacity Associated With Falls Among Older Adults: 440 Board #277 June 1, 9: 30 AM - 11: 00 AM.

Effects of a Group-based Behavioral Intervention On Dietary Behaviors in Older Adults Rebecca A. Schlaff, Meghan Baruth, Valerie J. Adams, Tatum Goldufsky, Nathan A. Peters, Graceson C. Kerr, Ashley Boggs, Ashley Ewald. Saginaw Valley State University, University Center, MI. Duke University, Durham, NC. Michigan State University, East Lansing, MI. University of South Carolina, Columbia, SC. Email: raschlaf@svsu.edu