Physical activity and exercise appear to improve psychological health. However, the quantitative effects of Tai Chi on psychological well-being have rarely been examined. We systematically reviewed the effects of Tai Chi on stress, anxiety, depression and mood disturbance in eastern and western populations. Eight English and 3 Chinese databases were searched through March 2009. Randomized controlled trials, non-randomized controlled studies and observational studies reporting at least 1 psychological health outcome were examined. Data were extracted and verified by 2 reviewers. The randomized trials in each subcategory of health outcomes were meta-analyzed using a random-effects model. The quality of each study was assessed. Forty studies totaling 3817 subjects were identified. Approximately 29 psychological measurements were assessed. Twenty-one of 33 randomized and nonrandomized trials reported that 1 hour to 1 year of regular Tai Chi significantly increased psychological well-being including reduction of stress (effect size [ES], 0.66; 95% confidence interval [CI], 0.23 to 1.09), anxiety (ES, 0.66; 95% CI, 0.29 to 1.03), and depression (ES, 0.56; 95% CI, 0.31 to 0.80), and enhanced mood (ES, 0.45; 95% CI, 0.20 to 0.69) in community-dwelling healthy participants and in patients with chronic conditions. Seven observational studies with relatively large sample sizes reinforced the beneficial association between Tai Chi practice and psychological health. Tai Chi appears to be associated with improvements in psychological well-being including reduced stress, anxiety, depression and mood disturbance, and increased self-esteem. Definitive conclusions were limited due to variation in designs, comparisons, heterogeneous outcomes and inadequate controls. High-quality, well-controlled, longer randomized trials are needed to better inform clinical decisions.

/pdf/tai-chi-on-psychological-well-being-systematic-review-and-57vytvju0v.pdf

Tai Chi on psychological well-being: systematic review and meta-analysis

Background: The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed.Objectives: To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years).Data sources: We searched: MEDLINE (1966—May 2008); EMBASE (1980—May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982—May 2008); PsycINFO (1966—May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008).Review methods: Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores o...

/pdf/how-effective-are-physical-activity-interventions-for-zj85wn9jt9.pdf

How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review

Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B-level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults' lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.

Physical Benefits of Dancing for Healthy Older Adults: A Review

Objectives
During the past decade, several studies have systematically reviewed interprofessional education (IPE), but few have inclusively reviewed this literature. None has focused primarily on IPE in allied health, despite differences in recruitment and socialisation across the health professions. This systematic review seeks to uncover the best approach to pre-licensure, university-based allied health IPE to determine which aspects require modification in which contexts to provide optimal learning experiences.

Methods
A systematic search of 10 databases was conducted for articles published in English, between January 1998 and January 2013. Studies were included if they used quantitative or qualitative methodologies to report on the outcomes associated with IPE in allied health. Two independent reviewers identified studies that met the inclusion criteria, critically appraised the included studies and extracted data relating to the effectiveness of IPE in allied health. Data were synthesised narratively to address the study aims.

Results
Large gaps – relating to methods, theory and context – remain within this body of literature. Studies measured students' attitudes and understanding of other health professional roles, teamwork and knowledge in response to IPE interventions using patient scenarios, lectures and small-group work. Differences in power and curriculum placement were described as factors affecting IPE effectiveness.

Conclusions
Evaluation remains the primary aim within this literature. Few studies use theory, take an inductive approach to understanding the processes behind IPE or include detailed participant descriptions. Therefore, we suggest that IPE research is currently caught in an epistemological struggle, between assumptions underpinning biomedical and health science research, and those underpinning education studies. As part of a systems approach to understanding interprofessional socialisation, we call for researchers to take a realistic approach to evaluation that is inclusive of, and responsive to, contextual factors to explore how IPE leads to improved long-term outcomes in differing circumstances.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/medu.12290

Interprofessional education in allied health: a systematic review.

Engaging in reflection is a vital part of learning for university students and its practice should be embedded in course design. Feedback on written work can be used as a vehicle for reflection. Both the gift and receipt of feedback and the habit of reflection require practice and capturing this experiential learning can be achieved in a class environment. This paper outlines how reflection on written feedback may be used formatively by teachers in a university context. The paper reports on the use of a simple tool, a self‐copying sheet, given to management undergraduates on the return of coursework, which engages students and captures their reflection on their feedback. The teaching model presented outlines an approach to reflective learning that recognises the need for students to engage with feedback in the classroom, to reflect on it and to feed forward to the next assessment, thus completing the learning cycle.

Feeding forward: using feedback to promote student reflection and learning – a teaching model

This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postintervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.

Physical and psychological outcomes of a supported physical activity program for older carers.

A search was made of relevant databases and the reference lists of key textbooks and reviews. Of 420 potentially relevant articles, 25 were included in the review. Medicine, nursing, physiotherapy, occupational therapy and social work were the professions most often included. Aims and activities of interprofessional clinical education (IPCE) programs were varied, and there was inconsistency in outcome evaluation approach and tools. The models of IPCE described in the literature are diverse. The major barriers to IPCE were logistical, and the careful planning and negotiation required to overcome these barriers was time consuming. Detailed planning, stakeholder enthusiasm and commitment appear to be essential to the success of IPCE. The literature provides guiding principles for establishing a program; however, there is limited evidence to support a particular approach.

/pdf/interprofessional-pre-qualification-clinical-education-a-f44cp32phf.pdf

Interprofessional pre-qualification clinical education: a systematic review

The transition from student to professional is challenging. Training programs provide discipline specific skills but do not adequately develop the interprofessional, team focused and work ready clinicians needed for the current workplace. In Australia, a formal graduate year is common in nursing; however, structured programs to support the student to professional transition are uncommon in allied health. This paper reports on the first year of an innovative program designed to address this gap. Fourteen new graduates at Northern Health in Melbourne, Australia from the disciplines of occupational therapy, physical education, physiotherapy, podiatry, social work and speech pathology participated in twelve, 2-hour sessions over a ten-month period during their first year of professional practice. These facilitated sessions aimed to foster reflective practice, peer support, to develop professional characteristics and provide an interdisciplinary forum for sharing experiences and learning. The paper outlines graduates and facilitators experience, together with the impacts for the health service.

Allied health graduate program - supporting the transition from student to professional in an interdisciplinary program.

Background: Residential aged care staff play a significant role in the day- to-day lives of residents yet are faced with many barriers to providing care that promotes resident wellbeing. Approach: Action research is a useful approach for clarifying issues, identifying education and training needs, and identifying, and in some cases overcoming, organizational barriers to change. The Well for Life project aimed to enhance the social and physical health and well being of residents of aged care settings by empowering the staff of facilities to make change. The project had a particular focus on nutrition and physical activity. This paper reports on the action research group process undertaken during Phase I of the Well for Life project. Five residential aged care settings participated in the action research process facilitated by project staff independent of the facilities. The action plan and outcomes from one of these settings is used to illustrate the process and outcomes. Findings: The main findings of the project indicate that using a process that encourages staff involvement in identification of issues and actions can facilitate change in the practice of resident care. The action research groups identified specific gaps in knowledge and skill leading to targeted education that addressed areas of need. The importance of presenting information and learning opportunities for staff in a variety of formats was also recognized, as was the importance of organizational context, management support and empowerment of staff to make change.

Robyn Smith

Papers

Physical and psychological outcomes of a supported physical activity program for older carers.

Interprofessional pre-qualification clinical education: a systematic review

Allied health graduate program - supporting the transition from student to professional in an interdisciplinary program.

Changing practice in residential aged care using participatory methods.

Older peoples’ experience of accessing emergency care