The purpose of this study is to assess the effects of different strategies of health on the levels of physical activity (PA), physical fitness (PF), cardiovascular disease (CVD) risk factors and quality of life (QoL) of the institutionalized elderly. Concurrently studies were made of the effect of detraining on these same variables. In this investigation we carried out a prospective longitudinal study with an experimental design, with 1 year plus 3 months of a detraining period. Methodology. (a) A questionnaire with socio-demographic characteristics and a QoL scale (MOS SF-36); (b) Functional Fitness Test to assess PF; (c) An MTI Actigraph to evaluate the PA; (d) Biochemical analysis of blood, blood pressure and bio-impedance. The Main Results Indicated That: (i) ST significantly improved strength and body flexibility and AT the aerobic endurance, agility/dynamic balance and lower strength and flexibility; (ii) Implications of detraining were more evident on the PA groups in the lower body flexibility, which is associated with agility/dynamic balance and lower strength in the AT group; (iii) Cardiovascular variables improved significantly especially blood pressure, cholesterol and glucose in the ST and HDL in the AT group; not having undergone significant changes with the detraining. The results of this thesis contribute positively to highlight the importance of PA in the promotion of health, prevention and reduction of CVD risk factors and the improvement of the PF and QoL.

Alexandrina Lobo

Joana Carvalho

Paula Santos

Effects of Training and Detraining on Physical Fitness, Physical Activity Patterns, Cardiovascular Variables, and HRQoL after 3 Health-Promotion Interventions in Institutionalized Elders

Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. 
 Methods. A 7-page cross-sectional survey. 
 Results. Of the entire study sample (<svg style="vertical-align:-0.1575pt" id="M1" height="9.7875004" version="1.1" viewBox="0 0 50.4375 9.7875004" width="50.4375" xmlns="http://www.w3.org/2000/svg" >
 <g transform="matrix(1.25,0,0,-1.25,0,9.7875)">
 <g transform="translate(72,-64.17)">
 <text transform="matrix(1,0,0,-1,-71.95,64.37)">
 <tspan style="font-size: 11.21px; " x="0" y="0">𝑁</tspan>
 <tspan style="font-size: 11.21px; " x="12.642624" y="0">=</tspan>
 <tspan style="font-size: 11.21px; " x="23.435928" y="0">7</tspan>
 <tspan style="font-size: 11.21px; " x="29.039928" y="0">2</tspan>
 <tspan style="font-size: 11.21px; " x="34.643929" y="0">0</tspan>
 </text>

 </g>
 </g>
</svg>), 29&#x25; of the physicians reported having experienced an abusive event in the last month by a patient or patient family member. Abusive incidents were classified as minor, major, or severe. Of the physician participants who reported having been abused, all reported having experienced a minor event, 26&#x25; a major, and 8&#x25; a severe event. Of the physicians who experienced an abusive event, 55&#x25; were not aware of any policies to protect them, 76&#x25; did not seek help, and 64&#x25; did not report the abusive event. 
Conclusion. Family physicians are subjected to significant amounts of abuse in their day-to-day practices. Few physicians are aware of workplace policies that could protect them, and fewer report abusive encounters. Physicians would benefit from increased awareness of institutional policies that can protect them against abusive patients and their families and from the development of a national policy.

Baukje (Bo) Miedema

Ryan Hamilton

Sue Tatemichi

Anita Lambert-Lanning

Francine Lemire

Donna Manca

Vivian R. Ramsden

Monthly Incidence Rates of Abusive Encounters for Canadian Family Physicians by Patients and Their Families

Aim. Heart murmur is common in children, and it is one of the main reasons for referral among children in primary care. The aim of this study is to evaluate agreement and consistency of normal, innocent, and pathologic murmur decision between academic family physicians and academic pediatric cardiologist. Methods. Seven hundred fifteen primary school children were examined by family physicians and paediatric cardiologist. Auscultatory examination was performed. Intensity, frequency, duration, quality, location, and radiation of the murmur were described if present. Agreement of normal, innocent, and pathologic murmur classification decision between family physician and paediatric cardiologist was analyzed by using kappa statistic. Results. Normal, innocent and pathologic murmurs were reported for 419, 228, and 54 children in family physicians' reports, respectively. Paediatric cardiologist agreed on 383 (91.4&#x25;) children as normal, 191 (83.7&#x25;) children having innocent murmur, and 19 (35.2&#x25;) children having pathologic murmur among family physician's reports. There was good consistency between family physicians and paediatric cardiologist (<svg style="vertical-align:-0.0pt;width:9.4125004px;" id="M1" height="7.0124998" version="1.1" viewBox="0 0 9.4125004 7.0124998" width="9.4125004" xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,7.0125)">
		<g transform="translate(72,-66.39)">
			<text transform="matrix(1,0,0,-1,-71.95,66.44)">
				<tspan style="font-size: 12.50px; " x="0" y="0">𝜅</tspan>
			</text>

		</g>
	</g>
</svg> value <svg style="vertical-align:-0.27588pt;width:50.337502px;" id="M2" height="11.1625" version="1.1" viewBox="0 0 50.337502 11.1625" width="50.337502" xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,11.1625)">
		<g transform="translate(72,-63.07)">
			<text transform="matrix(1,0,0,-1,-71.95,63.4)">
				<tspan style="font-size: 12.50px; " x="0" y="0">=</tspan>
				<tspan style="font-size: 12.50px; " x="12.027886" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="18.279387" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="21.405136" y="0">6</tspan>
				<tspan style="font-size: 12.50px; " x="27.656635" y="0">7</tspan>
				<tspan style="font-size: 12.50px; " x="33.908134" y="0">9</tspan>
			</text>

		</g>
	</g>
</svg>, 95&#x25; CI 0.630&#x2013;0.727, <svg style="vertical-align:-0.30096pt;width:56.150002px;" id="M3" height="11.0625" version="1.1" viewBox="0 0 56.150002 11.0625" width="56.150002" xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
		<g transform="translate(72,-63.15)">
			<text transform="matrix(1,0,0,-1,-71.95,63.5)">
				<tspan style="font-size: 12.50px; " x="0" y="0">𝑃</tspan>
				<tspan style="font-size: 12.50px; " x="10.890113" y="0">&lt;</tspan>
				<tspan style="font-size: 12.50px; " x="22.930502" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="26.056252" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="32.307751" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="38.559254" y="0">1</tspan>
			</text>

		</g>
	</g>
</svg>). They agreed on the majority of normal and innocent murmur decisions. However family physicians reported pathologic murmur more frequently. Conclusion. Cardiac auscultatory skills of academic family physicians may be concordant with paediatric cardiologist.

Guzel Discigil

Ayvaz Aydogdu

Ayfer Gemalmaz

F. Serdar Gurel

Okay Basak

Cardiac Auscultatory Skills of Academic Family Physicians: Strength of Association with an Academic Pediatric Cardiologist

Background. Dementia was affecting 855.000 patients in France in 2007. Lanmeur's rural hospital population was representative of the French nursing home&#39;s population. The followup was assumed by local GPs, which is also usual care in France for nursing homes. The study looked at clinical and paraclinical data transmitted at the institutionalization time of patients suffering from dementia. 
Aim. showing that admission letters did allow establishing a diagnosis of dementia for the GPs.
Method. we included all patients with dementia at the time of institutionalization between July 2000 and July 2007. We searched in the admission letters for 25 criteria extracted from the French guidelines for dementia and Alzheimer disease diagnosis (multiple cross-sectional analysis per year). 
Results. 293 patients were included. The median number of diagnostic criteria present in the letters of admission is 1 (first quartile: zero, third quartile: 4, and maximum: 12).
Conclusions. the data in admission letters did not allow the diagnosis of dementia according to the French guidelines. We know that dementia is underchecked and undertreated in France according to the same guidelines. What consequences did this lack of basic data give on motivation for treatment and recurrent diagnosis process for GPs? This has to be evaluated.

Cadier S&#233;bastien

Hummers-Pradier Eva

Barais Marie

Barraine Pierre

Chiron Benoit

Le Floch Bernard

Nabbe Patrice

Le Reste Jean-Yves

Audit about Medical Decision: Data Transmission Concerning Patients with Dementia Entering French Nursing Homes Does Not Confirm the Diagnosis

Objective. Caring for a patient with cognitive decline has an important impact on the general well-being of family caregivers. Although highly appreciated, interventions in dementia home care remain mainly ineffective in terms of well-being. Consequently, in spite of an extensive support system, abrupt ending of home care remains more rule than exception. Method. The hypothesis was that the intervention of a care counselor, coordinating care in quasi-unstructured way during one year, will alleviate caregivers' feelings of depression. The study population was composed of community-dwelling patients with cognitive decline. A care counselor was at the exclusive disposal of the intervention group. Primary outcome measure was caregiver depression. Results. Finally, depression was 6.25 times less frequent in the intervention group. The actual intervention appeared minimal with only ten applications for more support followed by only three interventions effectively carried out. Although caregivers felt burdened and depressed, formal support remained stable. On the other hand, the availability of the care counselor made caregivers feel less depressed with the same amount of support. Conclusion. Carers do not always need to be surrounded with more professionals, but they want to feel more supported. In terms of policy, this could have some important implications.

Birgitte Schoenmakers

Frank Buntinx

Jan Delepeleire

Supporting Family Carers of Community-Dwelling Elder with Cognitive Decline: A Randomized Controlled Trial

About this journal

Journal profile

Meet the editorial board

Editor spotlight

Submit your proposal

Do you think there is an emerging area of research that really needs to be highlighted? Or an existing research area that has been overlooked or would benefit from deeper investigation? Raise the profile of a research area by leading a Special Issue.

International Journal of Family Medicine