Basics of qualitative research: Grounded theory procedures and techniques

Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S2

The goals of the …

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2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.

Exercise and physical activity for older adults

Established in 2006, TATA Africa Services (Nigeria) Limited operates as the nodal point for Tata businesses in West Africa. TATA Africa Services (Nigeria) Limited has a strong presence in Nigeria with investments exceeding USD 10 million. The company was established in Lagos, Nigeria as a subsidiary of TATA Africa Holdings (SA) (Pty) Limited, South Africa and serves as the hub of Tata’s operations in Nigeria and the rest of West Africa.

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A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. The results are discussed in terms of recent neuroscientific and psychological data that indicate cognitive and neural plasticity is maintained throughout the life span.

https://www.jstor.org/stable/pdfplus/40063782.pdf

Fitness Effects on the Cognitive Function of Older Adults: A Meta-Analytic Study

Background Previous observational and interventional studies have suggested that regular physical exercise may be associated with reduced symptoms of depression. However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated. Objective To assess the effectiveness of an aerobic exercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial. Methods One hundred fifty-six men and women with MDD (age, > or = 50 years) were assigned randomly to a program of aerobic exercise, antidepressants (sertraline hydrochloride), or combined exercise and medication. Subjects underwent comprehensive evaluations of depression, including the presence and severity of MDD using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) scores before and after treatment. Secondary outcome measures included aerobic capacity, life satisfaction, self-esteem, anxiety, and dysfunctional cognitions. Results After 16 weeks of treatment, the groups did not differ statistically on HAM-D or BDI scores (P = .67); adjustment for baseline levels of depression yielded an essentially identical result. Growth curve models revealed that all groups exhibited statistically and clinically significant reductions on HAM-D and BDI scores. However, patients receiving medication alone exhibited the fastest initial response; among patients receiving combination therapy, those with less severe depressive symptoms initially showed a more rapid response than those with initially more severe depressive symptoms. Conclusions An exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons. Although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD.

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Effects of Exercise Training on Older Patients With Major Depression

Objective: The purpose of this study was to assess the status of 156 adult volunteers with major depressive disorder (MDD) 6 months after completion of a study in which they were randomly assigned to a 4-month course of aerobic exercise, sertraline therapy, or a combination of exercise and sertraline. 

Methods: The presence and severity of depression were assessed by clinical interview using the Diagnostic Interview Schedule and the Hamilton Rating Scale for Depression (HRSD) and by self-report using the Beck Depression Inventory. Assessments were performed at baseline, after 4 months of treatment, and 6 months after treatment was concluded (ie, after 10 months). 

Results: After 4 months patients in all three groups exhibited significant improvement; the proportion of remitted participants (ie, those who no longer met diagnostic criteria for MDD and had an HRSD score <8) was comparable across the three treatment conditions. After 10 months, however, remitted subjects in the exercise group had significantly lower relapse rates (p = .01) than subjects in the medication group. Exercising on one's own during the follow-up period was associated with a reduced probability of depression diagnosis at the end of that period (odds ratio = 0.49, p = .0009). 

Conclusions: Among individuals with MDD, exercise therapy is feasible and is associated with significant therapeutic benefit, especially if exercise is continued over time.

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Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months

This paper reports on an investigation of the variables that may be predictive of intentions to leave a job, and tests a model that includes mediating variables. A total of 173 retail salespeople completed questionnaires measuring commitment to the organization for which they worked, job satisfaction, stress, supervisor support, locus of control, self‐esteem, the perceived stressors in the job and their intention to quit. Path analysis was used to test the relationships hypothesized in the model. The majority of hypotheses were supported, with the variables included accounting for 52 per cent of the variance in intention to quit. Emotional support from supervisors and self‐esteem mediated the impact of stressors on stress reactions, job satisfaction, commitment to the organization and intention to quit. It is suggested that to ameliorate intention to quit and in turn reduce turnover, managers need to actively monitor workloads, and the relationships between supervisors and subordinates in order to reduce and manage stress. Managers also need to monitor both the extrinsic and intrinsic sources of job satisfaction available to employees. These activities could assist in maintaining and increasing job satisfaction and commitment to the organization.

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How can managers reduce employee intention to quit

Physical fitness and cognitive functioning in aging.

Objective We investigated elementary school children's ability to use a variety of Likert response formats to respond to concrete and abstract items. Methods 111 children, aged 6-13 years, responded to 2 physical tasks that required them to make objectively verifiable judgments, using a 5-point response format. Then, using 25 items, we ascertained the consistency between responses using a "gold standard" yes/no format and responses using 5-point Likert formats including numeric values, as well as word-based frequencies, similarities to self, and agreeability. Results All groups responded similarly to the physical tasks. For the 25 items, the use of numbers to signify agreement yielded low concordance with the yes/no answer format across age-groups. Formats based on words provided higher, but not perfect, concordance for all groups. Conclusions Researchers and clinicians need to be aware of the limited understanding that children have of Likert response formats.

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Kathleen A. Moore

Papers

Effects of Exercise Training on Older Patients With Major Depression

Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months

How can managers reduce employee intention to quit

Physical fitness and cognitive functioning in aging.

The Use of Likert Scales With Children