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"Hill, Keith"
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Neural mechanisms underlying state mental fatigue: a systematic review and activation likelihood estimation meta-analysis
Sustained performance of cognitive tasks could lead to the development of state mental fatigue characterized by subjective sensation of mental weariness and decrease in cognitive performance. In addition to the occupational hazards associated with mental fatigue, it can also affect physical performance reducing endurance, balance, and sport-specific technical skills. Similarly, mental fatigue is a common symptom in certain chronic health conditions such as multiple sclerosis affecting quality of life of the patients. Despite its widely acknowledged negative impact, the neural mechanisms underlining this phenomenon are still not fully understood. We conducted a systematic review and activation likelihood estimation (ALE) meta-analysis of functional neuroimaging studies investigating the effect of mental fatigue due to time-on-task (TOT) on brain activity to elucidate the possible underlying mechanisms. Studies were included if they examined change in brain activity induced by experimental mental fatigue (TOT effect) or investigated the relationship between brain activity and subjective mental fatigue due to TOT. A total of 33 studies met the review’s inclusion criteria, 13 of which were included in meta-analyses. Results of the meta-analyses revealed a decrease in activity with TOT in brain areas that constitute the cognitive control network. Additionally, an increased activity with TOT, as well as negative relationship with subjective mental fatigue was found in parts of the default mode network of the brain. The changes in cognitive control and the default mode networks of the brain due to state mental fatigue observed in this study were discussed in relation to the existing theories of mental fatigue.
Journal Article
Never lead alone : 10 shifts from leadership to teamship
\"In this guide on maximizing teams to achieve outstanding business success, the author of Who's Got Your Back and Never Eat Alone distills his years of experience coaching teams at Fortune 500 companies and startup unicorns to optimize team performance\"-- Provided by publisher.
BOOK
Effect of cognitive task complexity on dual task postural stability: a systematic review and meta-analysis
The dual task experimental paradigm is used to probe the attentional requirements of postural control. However, findings of dual task postural studies have been inconsistent with many studies even reporting improvement in postural stability during dual tasking and thus raising questions about cognitive involvement in postural control. A U-shaped non-linear relationship has been hypothesized between cognitive task complexity and dual task postural stability suggesting that the inconsistent results might have arisen from the use of cognitive tasks of varying complexities. To systematically review experimental studies that compared the effect of simple and complex cognitive tasks on postural stability during dual tasking, we searched seven electronic databases for relevant studies published between 1980 to September 2020. 33 studies involving a total of 1068 participants met the review’s inclusion criteria, 17 of which were included in meta-analysis (healthy young adults: 15 studies, 281 participants; Stroke patients: 2 studies, 52 participants). Narrative synthesis of the findings in studies involving healthy old adults was carried out. Our result suggests that in healthy population, cognitive task complexity may not determine whether postural stability increases or decreases during dual tasking (effect of cognitive task complexity was not statistically significant; P > 0.1), and thus the U-shaped non-linear hypothesis is not supported. Rather, differential effect of dual tasking on postural stability was observed mainly based on the age of the participants and postural task challenge, implying that the involvement of cognitive resources or higher cortical functions in the control of postural stability may largely depends on these two factors.
Journal Article
A study protocol for a pragmatic pre-post trial to determine the feasibility and effectiveness of a novel co-designed service to support health and wellbeing of older carers of older people
Older carers (≥50 years) of older people (≥65 years) are an important sub-group of carers performing valuable roles in providing informal care but often do not have the time or give priority to supporting their own health and wellbeing. Current services supporting older carers’ health and wellbeing are fragmented and inadequate. Through previous research and co-design activity by our team, an innovative multidisciplinary Carer Health and Wellbeing Service (CHWS) has been developed. The purpose of this protocol paper is to describe the rationale for the CHWS and the methods proposed to evaluate its effectiveness and implementation outcomes. The CHWS commenced in March 2024 at Peninsula Health, Melbourne, Australia. Older carers of older people can be referred from multiple sources, including self-referral. A pre-post mixed methods study design is being utilised. Initial assessments include the Carer Support Assessment Needs Tool (CSNAT) and carer prioritisation of their needs, which guides further assessment and interventions. Assessments will occur at Service intake and 6 months later. The primary effectiveness outcome is the Preparedness for Caregiving Scale, and primary implementation outcomes are reach and adoption. Interviews of carers, referrers and staff, and a cost-utility analysis will be undertaken. The target sample size is 137 carers undertaking assessment and intervention over the 15 months data collection. Generalised linear regression will be used to compare pre- and post-continuous outcome measures. Qualitative data will be thematically analysed. Results will inform future scaling up of this innovative approach to optimising health and wellbeing of older carers of older people. Trial registration number: Australian New Zealand Clinical Trials Registry (ANZCTR) – ACTRN: 12625000245493.
Journal Article
نابليون في نوتنج هيل : رواية
في لندن المستقبل-1984-تآكلت الروح الإنسانية بفعل وطأة الرأسمالية والبيروقراطية، حتى تحولت إلى ريشة في مهب الريح. بعد أن يتم اختيار موظف ضئيل الحجم، أوبيرون كوين، بشكل عشوائي تماما، كرئيس للدولة، يقرر أن يحول لندن إلى كرنڤال على أسلوب القرون الوسطى ؛ من أجل متعته الخاصة. لكن رجلا واحدا، آدم واين، ينظر إلى وضع الأشياء الجديد بجدية شديدة، وينظم جيشا لنوتنج هيل لمحاربة الغزاة من الأحياء الأخرى. في البداية يربك مشروعه الجميع، لكن سرعان ما يصاب الجميع بعدوى إخلاصه، مع نتائج مبهجة.
Book
A battery-less and wireless wearable sensor system for identifying bed and chair exits in a pilot trial in hospitalized older people
Falls in hospitals are common, therefore strategies to minimize the impact of these events in older patients and needs to be examined. In this pilot study, we investigate a movement monitoring sensor system for identifying bed and chair exits using a wireless wearable sensor worn by hospitalized older patients. We developed a movement monitoring sensor system that recognizes bed and chair exits. The system consists of a machine learning based activity classifier and a bed and chair exit recognition process based on an activity score function. Twenty-six patients, aged 71 to 93 years old, hospitalized in the Geriatric Evaluation and Management Unit participated in the supervised trials. They wore over their attire a battery-less, lightweight and wireless sensor and performed scripted activities such as getting off the bed and chair. We investigated the system performance in recognizing bed and chair exits in hospital rooms where RFID antennas and readers were in place. The system's acceptability was measured using two surveys with 0-10 likert scales. The first survey measured the change in user perception of the system before and after a trial; the second survey, conducted only at the end of each trial, measured user acceptance of the system based on a multifactor sensor acceptance model. The performance of the system indicated an overall recall of 81.4%, precision of 66.8% and F-score of 72.4% for joint bed and chair exit recognition. Patients demonstrated improved perception of the system after use with overall score change from 7.8 to 9.0 and high acceptance of the system with score ≥ 6.7 for all acceptance factors. The present pilot study suggests the use of wireless wearable sensors is feasible for detecting bed and chair exits in a hospital environment.
Journal Article
Caregivers’ experiences of a home support program after the hospital discharge of an older family member: a qualitative analysis
Background
The ageing global population has seen increasing numbers of older people living with chronic health problems, declining function, and frailty. As older people seek to live out their years at home, family members, friends and neighbours (informal caregivers) are increasingly relied upon for support. Moreover, pressured health systems and shorter hospital length of stay mean that informal caregivers can find themselves supporting the older person who is still unwell after discharge. The Further Enabling Care at Home (FECH) program was developed as a nursing outreach intervention designed to systematically address support needs of family caregivers of older people after hospital discharge to sustain their home-based caregiving. The objective of this study was to explore the experiences of informal caregivers who participated in the FECH program after an older family member’s discharge from hospital.
Methods
The study employed a qualitative descriptive design. Caregivers of older people discharged home from a Medical Assessment Unit in an Australian hospital who were included in the program were interviewed to explore their experiences and perceptions of the FECH program. Data were audio-recorded, transcribed, and subjected to thematic analysis.
Results
Twenty-one family caregivers (81% female, aged 25–89 years) participated in the interviews. Themes emerging were ‘The experience of caregiving’; ‘The experience of receiving FECH program support’; and ‘Caregivers’ suggestions for improvement’. Caregivers indicated that reflective discussions with the FECH nurse enabled them to recognise the complexity of the caregiving role and determine aspects where they needed support. Caregivers valued guidance from the FECH nurse in accessing information and resources, which helped them to feel more connected to support, more prepared to care for the older person and themselves, and more secure in the caregiving role.
Conclusions
Caregivers’ experiences indicated that the structured reflective FECH discussions prompted thought and provided guidance in navigating health and care systems. The FECH program appears to offer a means to address the practical, physical and psychosocial needs of informal caregivers as partners in person-centred health and social care.
Trial registration
ANZCTR Trial ID:
ACTRN126140011746773
.
Journal Article
Results from the ENJOY MAP for HEALTH: a quasi experiment evaluating the impact of age-friendly outdoor exercise equipment to increase older people’s park visitations and physical activity
Background
Recreational parks can play a significant role in older people’s health, with emerging evidence suggesting that changes in the physical environment, such as refurbishments of local parks, can increase park visitations and physical activity engagement. The ENJOY MAP for HEALTH aimed to evaluate the impact of Seniors Exercise Park installations and associated capacity building activities on older people’s park visitation, and park-based physical activity.
Method
The ENJOY MAP for HEALTH was a quasi-experiment study design that involved the installation of specialised Seniors Exercise Park equipment as part of park refurbishment, supported by promotion and community capacity building activities in six municipalities in Victoria, Australia. Direct observations of park users took place prior to park upgrades, one-month post upgrade and 12-months from baseline. The overall number and characteristics of park visitors, and the type and level of physical activity undertaken, were summarised descriptively. Generalised linear models were used to examine the impact of park refurbishment (equipment installation and site activation) on the total number of older people observed in the park, and their engagement in physical activity, accounting for site and seasonal effects.
Results
Overall number of visits increased following park upgrades, with the largest number of visitors observed one-month post upgrade (
n
= 12,501). The proportion of older people observed at the parks remained relatively low prior to and one-month post upgrade compared to other age groups. However, after adjusting for site and seasonal effects, the number of older people observed in the parks increased significantly post upgrade and site activation compared to prior to the refurbishment (incidence rate ratios (IRR) 3.55; 95% CI 2.68, 4.70). The number of older people observed to be exercising at the Seniors Exercise Park also increased by 100% at 12-months post-installation relative to one-month post upgrade (IRR 2.00; 95% CI 1.26, 3.17).
Conclusion
Installation of the Seniors Exercise Parks and the supportive programs and activities following six park upgrades resulted in an increase in older people’s park visitation and engagement in physical activity. Community engagement and training of volunteers with the support of local governments are likely to contribute to the increased park usage by older people.
Trial registration
This trial was registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808.
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380745&isReview=true
.
Journal Article