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Cette étude visait à documenter comment un programme de familiarisation à l'utilisation du transport en commun influence l'expérience de mobilité des aînés. Ce programme a été co-construit avec des partenaires clés afin d'y inclure l'usage d'outils de planification technologiques et un accompagnement personnalisé tenant compte des incapacités des participants. Une étude de cas multiples (n = 7) a été menée selon une approche mixte convergente, combinant des méthodes qualitatives (p. ex., entrevues) et quantitatives (p. ex., cartes à puces). Les participants qui ont bénéficié davantage de la formation ont rapporté une meilleure connaissance du transport en commun et une plus grande confiance à utiliser l'autobus. Ils ont aussi effectué plus de sorties. Nos résultats suggèrent d'intégrer une destination « signifiante » et l'apprentissage d'outils de planification non technologiques à la formation pour en assurer la compatibilité avec les besoins et le niveau de littératie numérique des aînés. De futures études aideront à favoriser cette option de transport en amont de la perte du permis de conduire.

Previous research documented a dramatic decline in the residential mobility of elderly Canadians (65 years and older) since 1961. We examine more recent data from the 2011 and 2016 censuses to update findings and extend previous research. We first found that elderly residential mobility has continued to decline. There were substantial declines of 20 per cent and more for all types of residential mobility. Second, descriptive analysis of changes over time in the proportion of the population that lives in a different province than their province of birth for 1871 to the present suggests that the 1906-1925 birth cohorts experienced migration rates that were slightly higher than comparable later cohorts. Third, multivariate analysis of 1971-2016 interprovincial migration data shows that the 1906-1925 birth cohort who entered early adult years during World War II had higher migration rates than earlier or later birth cohorts. The cohort explanation accounted for 10 per cent of the decrease in elderly migration between 1981 and 2016. A cohort explanation can therefore contribute to understanding decreased elderly migration, but many questions remain for future study.

The cessation of driving is a difficult transition for the elderly, but it can be facilitated through interventions. The purpose of this study was to explore the satisfaction, usefulness and applicability of the CarFreeMe intervention in the French-Canadian context. A qualitative clinical research device was used on ten older adults aged between 61 and 90 years. The participants had stopped driving within the last twelve months or were planning to stop driving in the near future and did not have cognitive impairments. After the intervention, the participants were generally satisfied and reported on its usefulness and applicability in a French-Canadian context. In addition, they identified the positive impacts related to their social involvement as they re-engaged in or pursued their significant activities. Further research is required to assess the intervention's effects and the practicability of implementing it in Canada.

No one has validated measuring the wrist's active range of motion (ROM) using smartphone images in patients. It is not known whether pathological factors affect the accuracy of this measurement technique. The purpose of this study was to assess if smartphone photography is as reliable and valid as manual goniometry for measuring wrist joint ROM. We reviewed 38 wrists in 38 patients (21 women and 17 men) with a mean age of 45 years (range, 26-60). Smartphones were used to take digital photos of injured wrists at extremes of wrist motion, including flexion, extension, radial and ulnar deviation. The mean difference in measured ROM between the two measurement methods (digital photos and handheld goniometer) was compared using Student's t test and the relationship determined using Pearson correlation coefficients. Bland-Altman analysis was used to define the limits of agreement (LOA). No significant difference was found when comparing the wrist ROM in the four positions using manual goniometry and digital measurements from photos taken by a surgeon. Between the goniometer measurements and digital photos taken by a surgeon, the Pearson coefficients were high, with most being above 0.8 for the four positions. The Pearson coefficients also show the smartphone measurements were highly precise. There was high reliability between the photographs taken by surgeons and by patients, as well as high interobserver reliability. Smartphone photography is a reliable and valid method to measure wrist joint ROM in patients. This measurement method can be used to measure outcomes., (Copyright © 2020 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

More attention is being focused on the consequences of climate change on migration and public health, but they are still poorly understood. While the health risks caused by climate change can contribute to an increase in migration, migrating and displaced people are also more exposed, due to the difficulties they face in accessing health services. The still unknown relationship between climate change, disasters, migration and health needs to be exposed., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

ABSTRACTExercise has potential to mitigate morbidity in knee osteoarthritis (OA). Participants with knee OA were randomized to a Square-stepping Exercise (SSE) group (2x/week for 24 weeks) or a control group. We assessed the feasibility of SSE and its effectiveness on symptoms (WOMAC), balance (Fullerton), mobility, and walking speed at 12 and 24 weeks. The SSE group had a 49.3% attendance rate and trended toward improvement in the 30-second chair stand at 12 (F = 1.8, p = .12, ηp2 = 0.16), and 24 weeks, (F = 3.4, p = .09, ηp2 = 0.18), and walking speed at 24 weeks, compared to controls. There were no differences in symptoms or balance. The low attendance and recruitment demonstrated limited feasibility of SSE in adults with knee OA. Trends suggest the potential for SSE to improve lower extremity functional fitness and walking speed. SSE should be further studied for effectiveness on symptoms and balance, in addition to improving feasibility.

ABSTRACTCauses of falls in older adults are common, multifactorial, and can lead to significant injury. This before-and-after study evaluated the benefits of a Fall Prevention Mobile Clinic (FPMC) in reducing the risk of falling in older adults in British Columbia, Canada. Four hundred seventy-six participants (average age of 83.6 years) enrolled in the study and were followed for 12 months after attending the FPMC. At 12-month follow-up, the mean percentage uptake of fall prevention recommendations was 48.8 per cent (SD = 25.7%), the Timed Up and Go mobility measure improved from a median of 19.04 seconds to 17.45 seconds and the number of participants falling decreased from 64.8 per cent (in the 12 months before attending the clinic) to 55.6 per cent (in the 12 months after attending the clinic) (p = .012). After attending the FPMC, participants acted on recommendations, improved mobility and decreased their risk of future falls.

Type 2 diabetes mellitus is highly prevalent in older adults (≥65 years of age) and increases fall risk. Fear of falling and low balance confidence are reported in both fallers and nonfallers and can potentially be more debilitating than a fall itself. Therefore, the objective of this scoping review was to examine and map the current research evidence of balance confidence and fear of falling in older adults with type 2 diabetes. A search of CINAHL, EMBASE and PubMed was conducted. The search included MeSH terms and the key terms diabet* AND fear OR falls AND self-efficacy OR balance confidence. Inclusion criteria were 1) population: older adults (≥65 years of age) with type 2 diabetes; and 2) outcome measure: balance confidence or fear of falling. We included 21 studies: fear of falling (n=14); balance confidence (n=7). We categorized them into 4 themes: prevalence, severity, determinants and interventions. Determinants were further categorized into physical, psychosocial and health-related domains. Fear of falling and low balance confidence were highly prevalent and more severe in older adults with type 2 diabetes. Determinants of fear of falling and balance confidence occurred beyond the physical domain and the presence of diabetic peripheral neuropathy. Targeted group-based interventions (e.g. gait and balance training, tai chi, yoga) appear to be beneficial in reducing fear of falling and improving balance confidence. Future work is needed to generate best practices related to fear of falling and low balance confidence in older adults with type 2 diabetes., (Copyright © 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved.)

In functional rehabilitation service, the dietician, as educator, contributes to preventing recidivism and return to independence. A hospital team demonstrates the benefits of collaboration with dietitians in coordinated care for patients with various pathologies causing functional impairment., (Copyright © 2018. Publié par Elsevier Masson SAS.)

Falls in the elderly are frequent. A study carried out over 6 months in a university hospital's acute geriatric unit highlighted the real walking capacities of hospitalised elderly people. It also changed the perception of caregivers, doctors and nurses with regard to the real physical aptitudes of these patients enabling the risk of falls to be reduced in preparation for their return home or to a residential care home., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

We investigated the role of miR-301b in the modulation of the proliferation, migration, and invasion of bladder cancer (BLCA) cells. The expression of miR-301b and EGR1 (early growth response gene 1) mRNA were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). A dual-luciferase reporter gene system was used to identify the target relationship between miR-301b and EGR1. Cell proliferation, cell cycle, and apoptosis were analyzed by MTT assay, colony-forming assay, and flow cytometry, respectively. Cell motility and invasiveness were assessed by wound healing and Transwell assays. The expression of proteins involved in epithelial-to-mesenchymal transition (EMT) and EGR1 were determined by Western blot. Our results showed that miR-301b was up-regulated while EGR1 was down-regulated in BLCA tissues compared with adjacent normal tissues. The proliferation, migration, and invasiveness of T24 cells (a kind of human BLCA cell) were suppressed by decreasing miR-301b expression or increasing EGR1 expression. In addition, miR-301b promoted EMT signaling by influencing the expression of related proteins. In conclusion, miR-301b promotes the proliferation, migration, and aggressiveness of human BLCA cells by inhibiting the expression of EGR1.

We provide an in-depth description of the mobility (capacity and enacted function, i.e., physical activity and travel behaviour) of community-dwelling older adults of low socioeconomic status. Participants [n = 161, mean age (range) = 74 (65-96) years] completed interviewer-administered questionnaires and objective measures of mobility. Our findings did not generally indicate that older adults of low socioeconomic status have a reduced capacity to be mobile. Participants presented with positive profiles across physical, psychosocial, and social environment domains that influence the capacity to be mobile. They also made a high proportion of trips by foot, although these did not together serve to meet physical activity guidelines for most. We challenge future researchers to focus on innovative strategies to recruit this difficult-to-access population, to consider the influence of socioeconomic status across the lifespan, and the role of behaviour-driven agency when investigating the association between the person, environment, and older adult mobility.

The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.

This project was based on the premise that decisions concerning the ballistic protection provided to defence personnel should derive from an evaluation of the balance between protection level and its impact on physiological function, mobility, and operational capability. Civilians and soldiers participated in laboratory- and field-based studies in which ensembles providing five levels of ballistic protection were evaluated, each with progressive increases in protection, mass (3.4-11.0 kg), and surface-area coverage (0.25-0.52 m(2)). Physiological trials were conducted on volunteers (N = 8) in a laboratory, under hot-dry conditions simulating an urban patrol: walking at 4 km·h(-1) (90 min) and 6 km·h(-1) (30 min or to fatigue). Field-based trials were used to evaluate tactical battlefield movements (mobility) of soldiers (N = 31) under tropical conditions, and across functional tests of power, speed, agility, endurance, and balance. Finally, trials were conducted at a jungle training centre, with soldiers (N = 32) patrolling under tropical conditions (averaging 5 h). In the laboratory, work tolerance was reduced as protection increased, with deep-body temperature climbing relentlessly. However, the protective ensembles could be grouped into two equally stressful categories, each providing a different level of ballistic protection. This outcome was supported during the mobility trials, with the greatest performance decrement evident during fire and movement simulations, as the ensemble mass was increased (-2.12%·kg(-1)). The jungle patrol trials similarly supported this outcome. Therefore, although ballistic protection does increase physiological strain, this research has provided a basis on which to determine how that strain can be balanced against the mission-specific level of required personal protection.