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PubMed2026

Use of wearable technologies for physical activity promotion in older adults: A systematic review.

This systematic review, conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251055299), examined the use of wearable technologies for promoting physical activity (PA) in adults aged 60 years and older. Searches across five databases (PubMed, Scopus, Web of Science, CINAHL, Cochrane) identified 2438 records, of which only six randomized controlled trials published between 2021 and 2025 met inclusion criteria, with sample sizes ranging from 36 to 551 participants and mean ages between 65 and 79 years. Given the small number of included studies, findings should be interpreted as preliminary. The studies ranged from the standalone use of commercial trackers (Fitbit, Polar, ActiGraph) to multicomponent interventions combining wearables with physiotherapist feedback, telephone counseling, web-based platforms, or interactive cognitive-motor training. Wearables used alone, as in the REACT trial, produced small or non-significant PA effects. In contrast, interventions integrating devices with personalized feedback, professional support, or digital platforms, such as PROMOTE and TASMANIA, were associated with more consistent improvements in PA, physical function, and cognitive outcomes. Multicomponent programs, such as PEER and ICMT, reported broader benefits, including cognition, balance, and reductions in sedentary behavior, though these findings derive from individual trials and require replication. Risk of bias, assessed with the Cochrane Risk of Bias tool version 2 (RoB 2.0), was rated as "some concerns" for five studies and low for only one, mainly due to gaps in randomization reporting, missing data, and lack of preregistration. Tentatively, and based on a very limited evidence base, wearables may have greater impact when embedded within broader behavioral systems, incorporating feedback, coaching, or interactive components, rather than when used in isolation as passive monitoring tools. Adherence and psychosocial outcomes appeared related to comfort and perceived usefulness among older adults, though larger and more robust trials are needed to confirm these patterns.

Humans↗
PubMed1999

The EARLY ALLIANCE prevention trial: an integrated set of interventions to promote competence and reduce risk for conduct disorder, substance abuse, and school failure.

Describes the EARLY ALLIANCE interventions, an integrated set of four programs designed to promote competence and reduce risk for early-onset conduct disorder, substance abuse, and school failure. These interventions are evaluated as part of a prevention trial that begins at school entry and targets child functioning and socializing practices across multiple contexts (school, peer group, family) and multiple domains (affective, social, and achievement coping-competence). The paper presents the conceptual foundation of the four interventions, including a synopsis of the risk and protective factors associated with conduct disorder and related outcomes, and of the coping-competence model driving EARLY ALLIANCE. The developmental rationale, intended impact, and procedures are described for each intervention: a universally administered classroom program and indicated, peer, reading-mentoring, and family programs. Interventions are currently being tested in a prevention trial, which is briefly summarized.

Adolescent↗
PubMed2004

Individual differences in language performance after cochlear implantation at one to three years of age: child, family, and linguistic factors.

Language skills were investigated in a multicultural sample of 13 prelingually deaf children (11 profoundly deaf from birth) who received cochlear implants between 14 and 38 months of age; average duration of implant use was 49 months. Individual postimplant language skills ranged from extremely delayed to age appropriate. On average, skills varied across domains: on vocabulary, several children functioned in the average range compared with hearing peers, but all were below that range on a test emphasizing syntax (CELF-P). Children with preimplant hearing experience had the highest scores on all language measures. Excluding these children, age of implantation (range 14 to 27 months) associated inversely and significantly with CELF-P scores, even when nonverbal IQ was controlled. Qualitative analyses indicated higher child language achievement associated with parents' reports of lengthy, in-depth processes to decide about cochlear implantation. Such reports may indicate high levels of ongoing parent involvement with child and programming.

Child Language↗
PubMed2001

How did Project Northland reduce alcohol use among young adolescents? Analysis of mediating variables.

Project Northland is a randomized trial designed to create, implement and evaluate multilevel, community-wide strategies to prevent alcohol use among adolescents. This paper will focus on the mediating outcomes of the early adolescent phase of Project Northland when the students in the study cohort were in Grades 6-8. The project was conducted in 24 school districts and adjacent communities in northeastern Minnesota. The intervention consisted of social-behavioral curricula in schools, peer leadership activities, parental involvement and education, and community-wide activities. At the end of 3 years of intervention, significantly fewer students in the intervention school districts reported alcohol use than students in the reference districts. Mediation analyses were conducted to investigate if the intervention's effects on mediating variables could explain the reduction in alcohol use. Important mediators of Project Northland's effect on alcohol use were: (1) peer influence to use, including normative estimates, (2) functional meanings of alcohol use, (3) attitudes and behaviors associated with alcohol and drug problems like stimulus seeking, rule violations and bad judgement, and (4) parent-child alcohol-related communication around alcohol use. In addition, among those who did not use alcohol at baseline, self-efficacy to refuse offers of alcohol was a significant mediator.

Adolescent↗
PubMed1995

Psychosocial adjustment in children with port-wine stains and prominent ears.

OBJECTIVE: To evaluate psychosocial adjustment in children with port-wine stain (PWS) and children with prominent ears (PE). METHOD: Thirty-two children aged 7 to 16 years with facial PWS and 42 children with PE were evaluated using the Harter Self-Perception Profile, the Revised Children's Manifest Anxiety Scale, the Children's Depression Inventory, the Disfigurement Perception Scale, and the Child Behavior Checklist. Results were compared with normative data for the local population or with a control group. Profile scores were correlated with severity of the PWS or prominence of the ears. RESULTS: Children with PE had poorer self-perception, higher concentration anxiety, and more internalizing and externalizing symptoms, and they were more withdrawn and had more social problems than children with PWS. The children with PWS functioned as well as or better than nondisfigured peers on measurements of psychosocial adjustment, while children with PE scored lower than nondisfigured peers on measures of self-perception and parent-rated social and attention problems. There was no correlation between degree of disfigurement and level of psychosocial adjustment. CONCLUSIONS: Psychosocial adjustment varied according to the nature of the disfigurement or deformity and was unrelated to the severity of the disfigurement.

Adaptation, Psychological↗
PubMed2000

Illnesses among United States veterans of the Gulf War: a population-based survey of 30,000 veterans.

Despite numerous studies on veterans of the 1990 to 1991 Gulf War, the fundamental questions of how healthy they are and how their health compares with that of their military peers who were not deployed to the Gulf have not been fully answered. We conducted a health survey in which the health outcomes of a population-based sample of 15,000 Gulf veterans representing various military branches and unit components (regular, reserve, National Guard) were compared with those of 15,000 non-Gulf veterans who were randomly sampled to mirror the number in the same military strata in the Gulf veteran group. In comparison with their peers, Gulf veterans had a higher prevalence of functional impairment, health care utilization, symptoms, and medical conditions and a higher rate of low general health perceptions. A longitudinal follow-up of the health of these veterans will be needed to detect changes in health status and to detect diseases with a long latency period.

Adult↗
PubMed1989

Agreement between parents' and teachers' ratings of behavioral/emotional problems of children aged 4-12.

Parents' and teachers' reports of behavioral/emotional problems in 1161 children aged 4-12 from the general population and assessed via the Achenbach Child Behavior Checklist were compared. Low to moderate agreement was found, with parents reporting more problems than teachers. Agreement was higher for externalizing problems than for internalizing problems and higher for children receiving special education than for those receiving regular education. Agreement was slightly higher for older than younger children. Sex of the child did not influence parent-teacher agreement. Teachers scored children higher on problems related to peer relations and on problems interfering with academic functioning, whereas parents scored their children higher on problems associated more strongly with externalizing than with internalizing syndromes.

Affective Symptoms↗
PubMed1985

Atherosclerosis precursors in Finnish children and adolescents. XII. Smoking behaviour and its determinants in 12-18-year-old subjects.

The cross-sectional study of 1980 for atherosclerosis precursors in Finnish children and adolescents aimed at a wide coverage of the relevant relationships of the smoking behaviour to socioeconomic and psychosocial factors. The initiation and establishment of the smoking habits were primarily viewed as a function of the youngsters' main socializing agents: the peer group and the family. A subpopulation comprising 1,790 children and adolescents aged 12, 15 and 18 years of the total sample was included in the study on smoking behaviour. The information on smoking habits was collected in connection with the medical examination in a solitary room where the youngsters could respond undisturbed. Data on the children's families were obtained by means of a general questionnaire filled out by the parents. The prevalence of daily smoking was 1% in the 12-year-old, 10% in the 15-year-old, and 30% in the 18-year-old subjects. The best friend's behaviour was the best predictor of an adolescent's smoking behaviour, although the family had retained its role as an important model as regards the learning of smoking behaviour. Quitting school turned out to be a major event leading to an increased risk of becoming a habitual smoker. No clear associations between socioeconomic status of the family and daily smoking were found, except that farmers' children had generally lower rates of daily smoking than children from other socioeconomic groups. First contacts with tobacco formed part of a normal behaviour pattern at a certain age, and this experimentation was unrelated to a later regular habit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Why do teens smoke? American Indian and Hispanic adolescents' perspectives on functional values and addiction.

Tobacco use by the young is one of the greatest public health concerns in the United States and is targeted by a number of prevention and control programs. A fuller understanding of the social and cultural values that youths attach to smoking is important in achieving focused, effective prevention strategies. Drawing on data collected through individual and focus group interviews, this article examines reasons that Hispanic and American Indian youths give to explain their smoking. The analysis presented here focuses on two interrelated sets of reasons: the functional values of tobacco use (including mood management, peer influences, and image maintenance) and addiction. This article concludes with a discussion of the implications these data may have for prevention and cessation programs aimed at youth and outlines ideas for an anthropological research agenda on youth and tobacco.

Adolescent↗
PubMed2000

Reducing substance dependence in elderly people: the side effects program.

OBJECTIVES: To reduce benzodiazepine, narcotic and total prescription medication use in community-dwelling elderly people with suspected substance dependence. METHODS: A community-based substance dependence program for seniors was established, and referrals were accepted from a wide variety of sources (self-referral, families, emergency departments, family physicians, community agencies, etc). The service typically included several home visits by a nurse and/or social worker trained in recognizing and treating substance dependence in the elderly, medical assessment by a geriatrician and generation of a client-directed treatment plan. Treatment plans included individual and family counselling, recommendations regarding medication changes and involvement in a peer support/education group. Medication use, health care utilization, functional status, cognition and depression scales were collected before and six months after intervention. RESULTS: Of the 95 elderly patients with substance dependence that were seen over a period of 12 months, 55 agreed to participate in the program. Substance dependence included alcohol dependence in 23 participants, benzodiazepine dependence in 20 participants, narcotic dependence in six participants and mixed dependence in six participants. Involvement in the program was associated with significant reductions in depression scale scores (P=0.02), number of daily prescription medications (P=0.002), benzodiazepine use (P=0.01), narcotic use (P=0.04) and number of acute hospitalizations (P=0.001). No significant changes were noted in cognition, functional status, total prescription costs, office visits or emergency room visits. CONCLUSIONS: A community-based sub- stance dependence program for elderly people may significantly reduce narcotic, benzodiazepine and prescription medication use in this population. Further studies are needed to determine the cost effectiveness of such programs.

Activities of Daily Living↗
PubMedDate not supplied

An integrated architecture for deploying a virtual private medical network over the web.

In this paper we describe a pilot architecture aiming at protecting Web-based medical applications through the development of a virtual private medical network. The basic technology, which is utilized by this integrated architecture, is the Trusted Third Party (TTP). In specific, a TTP is used to generate, distribute, and revoke digital certificates to/from medical practitioners and healthcare organizations wishing to communicate in a secure way. Digital certificates and digital signatures are, in particular, used to provide peer and data origin authentication and access control functionalities. We also propose a logical Public Key Infrastructure (PKI) architecture, which is robust, scalable, and based on standards. This architecture aims at supporting large-scale healthcare applications. It supports openness, scalability, flexibility and extensibility, and can be integrated with existing TTP schemes and infrastructures offering transparency and adequate security. Finally, it is demonstrated that the proposed architecture enjoys all desirable usability characteristics, and meets the set of criteria, which constitutes an applicable framework for the development of trusted medical services over the Web.

Certification↗
PubMed2002

Chronically ill but still adolescent.

Most children with chronic conditions survive to, at least, age twenty. This increased survival means that primary care providers will have to deal with chronically ill adolescents. In this paper, we review the existing literature and we analyze whether or not there are differences with their healthy peers regarding their pubertal development, family structure and functioning, friends, academic achievement, and risky behaviors, using a non-categorical approach.

Adolescent↗
PubMed1987

A professional recognition system using peer review.

The concept of a Professional Recognition System or a Clinical Ladder is not new. In fact, many models appear in the literature and have been implemented in hospitals across the country. However, few models contain the element of peer review. This article describes the development process, structure, and function of a Clinical Ladder program at a pediatric tertiary level hospital. The program grew out of a desire and recognized need on the part of the professional nursing staff to reward outstanding nursing care. Based on the concept of peer review, it underwent many revisions and revealed many lessons that can be put to use by other persons attempting to implement such a program.

California↗
PubMed1992

Five- to fifteen-year follow-up after Fontan operation.

BACKGROUND: The purpose of this study was to estimate survival and quality of outcome and assess factors associated with outcome for patients out 5 to 15 years from their Fontan operation. METHODS AND RESULTS: We studied 352 patients who had the Fontan operation prior to 1985. The overall 1-, 5-, and 10-year survival was 77%, 70%, and 60%, respectively. The following factors were significantly associated with lower survival: univentricular heart or complex congenital anomalies other than tricuspid atresia, early calendar year of operation, heterotaxia syndromes, early age at operation, increased pulmonary artery pressure, atrioventricular valve dysfunction, and higher (worse) New York Heart Association class. Reoperations were necessary for 103 of the 352 patients. At least 20% of the survivors have or have had cardiac arrhythmias requiring antiarrhythmic medication or mechanical pacemaker insertion. Between 7% and 10% of the patients have had or had protein-losing enteropathy/hypoproteinemia. At 5 years postoperatively, 122 patients (34.7%) were alive with a better New York Heart Association functional classification than preoperatively. Fifty-eight patients (16.5%) were alive and in the same functional classification, but 126 (35.8%) died within the first 5 years or were in a worse functional classification. Thirty-nine patients were doing excellently and 29 patients poorly 5 years after the operation. Of the surviving patients, 43% can do as much exercise as their peers, whereas 3% are incapable of exercise. CONCLUSIONS: To assure good functional long-term outcome in addition to survival, clinicians must exclude from selection for Fontan operation patients known to be at high risk for death or poor outcome.

Adolescent↗
PubMed1980

Effects of the labels "mentally retarded" and "retard" on the social acceptability of mentally retarded children.

Effects of the labels "mentally retarded" and "retard" on fifth- and sixth-grade children's attitudes toward peers were studied. Results indicated that children's attitudes (feelings and behavioral intentions) were more positive toward the target child labeled "mentally retarded" than labeled "retard." The data also showed that children's reactions to the two labels were, in part, a function of the physical appearance and academic competence of the peer being rated. Children had the most negative attitudes toward a child labeled "retard" who appeared to be "normal." In contrast, children reacted favorably to the target child labeled "mentally retarded," even when he or she was academically incompetent. Finally, boys were more negative than were girls toward the target child, especially when the child was labeled "retard." Implications for the movement to abandon the use of labels were discussed.

Attitude↗
PubMed2004

Psychosocial functioning of young children with learning problems.

BACKGROUND: In this study, psychosocial functioning of different groups of young children with learning problems was investigated using a diverse set of psychosocial variables (including behaviour problems, academic motivation, social preference, and self-concept). METHODS: For this purpose, children with low academic achievement, with a specific learning disability based on an IQ-achievement discrepancy, and with a specific learning disability based on an achievement discrepancy, were selected out of 276 children of the first grade of regular primary schools. By means of multivariate analyses, their psychosocial functioning was compared to the functioning of children without learning problems. RESULTS: The total set of psychosocial variables was able to discriminate between children with and without learning problems, with medium effect size. Attention problems as reported by the teachers turned out to be the most important single psychosocial predictor for group discrimination. However, results varied according to the type of learning problem and the type of psychosocial problem. Children with a specific reading/spelling disability and children with low general academic achievement differed most from their peers without learning problems with regard to their psychosocial functioning. Poor cognitive self-concept was related primarily to low academic achievement, poor learning motivation might be specific for math problems, and a low social preference score seemed most characteristic of children with a specific learning disability. CONCLUSIONS: Studying several psychosocial variables simultaneously in different groups of children with learning problems leads to a further refinement of the current knowledge.

Child↗
PubMed1990

LD status and achievement: confounding variables in the study of children's social status, self-esteem, and behavioral functioning.

The purpose of the present study was to examine the role of achievement in explaining the poor social and behavioral functioning associated with LD status, and to evaluate potential gender differences in patterns of interpersonal functioning among youth with learning disabilities (LD) and nondisabled (NLD) youth. Thirty-two students with learning disabilities (21 boys, 11 girls) were matched with same-sex, same-race classmates whose reading achievement was low (LA) or average (AA), and these groups were compared on peer ratings of liking and disliking, perceptions of self-worth and social acceptance, and teacher ratings of conduct problems, anxiety-withdrawal, and attention problems. Students with learning disabilities were less accepted and less well-liked than children in the LA or AA groups and also perceived their self-worth and social acceptance to be lower than LA or AA students. Group by Sex interactions were apparent for several of the peer rating and behavioral variables, indicating that different patterns of social and behavioral functioning distinguished LD boys and LD girls from their NLD peers. The findings highlight the potential role of low achievement in peers' dislike of LD girls and suggest the importance of investigating well-defined subgroups of youth with LD in future research.

Achievement↗