ORCID Profile
0000-0001-8041-1835
Current Organisations
University of Western Australia
,
Centro Hospitalar do Porto
,
Remedy Health Care Inc.
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Hindawi Limited
Date: 26-04-2020
DOI: 10.1111/HSC.12996
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2018
DOI: 10.11124/JBISRIR-2017-003485
Abstract: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I 2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26 95% CI [−3.72, −0.80]). Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.
Publisher: Frontiers Media SA
Date: 03-08-2021
DOI: 10.3389/FPUBH.2021.683723
Abstract: Recently hospitalized older people are at risk of falls and face barriers to undertaking fall prevention strategies after they return home from hospital. The authors examined the effects of tailored education delivered by physiotherapists on the knowledge (capability) and the motivation of older people to engage in fall prevention after hospital discharge. Utilizing data gathered from a recent trial, data was analyzed from 390 people who were 60 years and over without impaired cognition (& /10 abbreviated mental test score) and discharged from three Australian hospitals. Motivation and capability were measured at baseline in the hospital and at 6-months after hospital discharge by blinded assistants using structured surveys. Bivariate analysis using generalized linear modeling explored the impact of education on the capability and motivation. Engagement in fall prevention strategies was entered as an independent variable during analysis to determine associations with capability and motivation. The education significantly improved capability [−0.4, 95% CI (−0.7, −0.2), p & 0.01] and motivation [−0.8, 95% CI (−1.1, −0.5), p & 0.01] compared with social-control at the time of hospital discharge. In contrast, social-control participants gained capability and motivation over the 6-months, and no significant differences were found between groups in capability [0.001, 95% CI (−0.2, 0.2), p = 0.9] and motivation [−0.01, 95% CI (−0.3, 0.3), p = 0.9] at follow-up. Tailored fall prevention education is recommended around hospital discharge. Participants still needed to overcome barriers to falls prevention engagement post hospitalization. Thus, tailored education along with direct clinical services such as physiotherapy and social supports is warranted for older people to avoid falls and regain function following hospitalization.
Publisher: Project MUSE
Date: 06-2023
Publisher: Wiley
Date: 28-07-2021
DOI: 10.1111/OPN.12408
Abstract: Although Transition Care Programmes (TCP) are designed to assist older adults to regain functional ability after hospitalisation, it is unclear whether TCP improve older adults’ health‐related outcomes. The objective of the review was to synthesise the best available evidence for the effectiveness of TCP on health‐related outcomes for older adults admitted to a transition care facility after hospitalisation. Searches were conducted using the databases PubMed, AMED (Ovid), Embase (Ovid), PscyINFO (Ovid) and CINAHL (Full text) and grey literature from January 2000 to May 2020 in English only. Studies that reported health‐related outcomes of older adults (aged 65 and above) who received TCP in a facility setting were deemed eligible for inclusion following critical appraisal by two reviewers. Data were pooled in meta‐analysis where possible, or reported narratively. A total of 21 studies from seven countries [( n = 5 RCT, n = 16 observational cohort studies) participants’ mean age 80.2 (±8.3)] were included. Pooled analysis (2069 participants, 7 studies) demonstrated that 80% of older adults undertaking TCP were discharged home [95% CI (0.78–0.82, p 0.001), I 2 = 21.99%, very low GRADE evidence]. Proportions of older adults discharged home varied widely between countries (33.3%–86.4%). There was a significant improvement in ability to perform activities of daily living (2001 participants, 7 studies) as measured by the Modified Barthel Index [17.65 points (95% CI 5.68–29.62, p = 0.004), I 2 = 0.00%, very low GRADE evidence]. The proportion of older adults discharged home from TCP compared to other discharge destinations differs between countries. This could be due to the intensity of the rehabilitation delivered and the maximum length of stay allowed prior to discharge. Future studies that comprehensively evaluate the efficacy of TCP on health‐related outcomes including quality of life are required. Further investigation is required to identify which aspects of TCP affect successful discharge home.
Publisher: Project MUSE
Date: 06-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
DOI: 10.11124/JBISRIR-2016-002952
Abstract: The objective of this review is to synthesize the best available evidence on the effectiveness of falls prevention interventions provided just prior or immediately after discharge from hospital on falls rates and falls injuries among older adults living in the community in the first 6 months after discharge from hospital.
Publisher: Oxford University Press (OUP)
Date: 23-03-2018
Abstract: older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® sixteen studies (total s le size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. We found home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-07-2020
Publisher: Frontiers Media SA
Date: 28-06-2021
DOI: 10.3389/FPUBH.2021.688640
Abstract: Introduction: Continued evaluation of Transition Care Programs (TCP) is essential to improving older adults' outcomes and can guide which older adults may benefit from undertaking TCP. The aim of this study was to audit a transition care service to identify the association between the characteristics of older adults undertaking a facility-based TCP and (i) discharge destination and (ii) functional improvement. Materials and methods: An audit ( n = 169) of older adults aged 60 years and above who completed a facility-based TCP in Australia was conducted. Outcomes audited were performance of activities of daily living (ADL) measured using the Modified Barthel Index (MBI) and discharge destination. Data were analyzed using logistic regression and linear mixed modeling. Results: Older adults [mean age 84.2 (±8.3) years] had a median TCP stay of 38 days. Fifty-four older adults (32.0%) were discharged home, 20 (11.8%) were readmitted to hospital and 93 (55%) were admitted to permanent residential aged care. Having no cognitive impairment [OR = 0.41 (95% CI 0.18-0.93)], being independent with ADL at admission [OR = 0.41 (95% CI 0.16-1.00)] and a pre-planned team goal of home discharge [OR = 24.98 (95% CI 5.47-114.15)] was significantly associated with discharge home. Cases discharged home showed greater improvement in functional ability [MBI 21.3 points (95% CI 17.0-25.6)] compared to cases discharged to other destinations [MBI 9.6 points (95% CI 6.5-12.7)]. Conclusion: Auditing a facility-based TCP identified that older adults who were independent in ADL and had good cognitive levels were more likely to be discharged home. Older adults with cognitive impairment also made clinically significant functional improvements.
Publisher: Wiley
Date: 02-07-2019
DOI: 10.1111/JGS.16053
Publisher: BMJ
Date: 04-2018
Publisher: Springer Science and Business Media LLC
Date: 24-01-2014
DOI: 10.1038/NCOMMS4180
Abstract: The attractive optoelectronic properties of conducting polymers depend sensitively upon intra- and inter-polymer chain interactions, and therefore new methods to manipulate these interactions are continually being pursued. Here, we report a study of the isotopic effects of deuterium substitution on the structure, morphology and optoelectronic properties of regioregular poly(3-hexylthiophene)s with an approach that combines the synthesis of deuterated materials, optoelectronic properties measurements, theoretical simulation and neutron scattering. Selective substitutions of deuterium on the backbone or side-chains of poly(3-hexylthiophene)s result in distinct optoelectronic responses in poly(3-hexylthiophene)/[6,6]-phenyl-C61-butyric acid methyl ester (PCBM) photovoltaics. Specifically, the weak non-covalent intermolecular interactions induced by the main-chain deuteration are shown to change the film crystallinity and morphology of the active layer, consequently reducing the short-circuit current. However, side-chain deuteration does not significantly modify the film morphology but causes a decreased electronic coupling, the formation of a charge transfer state, and increased electron-phonon coupling, leading to a remarkable reduction in the open circuit voltage.
Publisher: Informa UK Limited
Date: 12-05-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 27-07-2022
Publisher: CSIRO Publishing
Date: 03-11-2022
DOI: 10.1071/PY22153
Abstract: Background Being physically active and socially connected is positively associated with healthy aging. Older adults living in the community may be at risk of social isolation and reduced physical activity, especially in recent times due to COVID-19. There are many programs that offer opportunities for evidence-based physical activity or social connection however, there is a lack of programs that include both. The objective of this study was to explore the lived experience of older adults who participated in Connect 60+ – a program that promoted exercise and social activities – delivered from a community hub that could be attended either in person or online. Methods A qualitative study that used descriptive phenomenology was conducted. A purposive s le of 13 older adults (age ≥65 years) was recruited to take part in semistructured telephone interviews to discuss barriers and enablers to program engagement. Data were analysed using thematic analysis. Results The overarching theme was that participating in Connect 60+ was an enjoyable and encouraging experience for participants. The program enabled them to increase their physical activity and build social connections within their community. The main themes that enabled engagement were: (1) an enabling program design, (2) developing new connections in the community, and (3) experiencing motivation to engage. A few barriers were identified, including difficulties connecting online and lack of male attendance. Conclusions Wellness programs delivered in community hubs may facilitate older adults to increase their engagement in both physical and social activity. The program appeared to impact positively on participants’ motivation, with some participants reporting that they had sustained their behaviour changes since program completion. To address identified barriers, easy to use online technology is recommended, and strategies to promote male attendance.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2017
DOI: 10.11124/JBISRIR-2016-002938
Abstract: The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident. Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?
No related grants have been discovered for Chiara Naseri.