Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls.

The authors conducted a systematic review of studies examining correlations between assessments of function obtained using self-report and those obtained using performance-based measures for community-dwelling older adults.METHODSArticles for this review were identified using electronic searching in MEDLINE, CINHAL, and AGELINE and hand-searching techniques. Two reviewers selected the studies that met the inclusion criteria, extracted the data, and assessed the methodological quality of the data.RESULTSSeventeen studies met the inclusion criteria for review. Correlations between self-report and performance ranged from −0.72 to 0.60. Sixty per cent of the studies compared self-report instruments measuring disability with performance measures addressing functional limitations. In studies that assessed the same functional tasks and functional limitations using the two methods, the correlation varied between 0.60 and 0.86.CONCLUSIONWhen the construct measured by the two methods was the same, the correlations were moderate to large and, therefore, measurement of functional limitations by self-report or performance probably reflected a similar assessment of function.

Aim:The primary objective of this study was to determine whether adults with a chronic illness within a primary care setting who received a rehabilitation intervention in this setting showed greater improvement in health status and had fewer hospital admissions and emergency room visits compared with adults who do not receive the intervention. Background: More than half of Canadians (16 million people) live with chronic illness. Persons with chronic illness in primary care, especially older persons who are most at risk for functional decline, are currently not receiving effective management. Methods: A randomized controlled trial was used. A rehabilitation multi-component intervention was delivered by a physiotherapist (PT) and occupational therapist in a primary care setting and included collaborative goal setting for rehabilitation needs, a six-week chronic disease self-management (SM) workshop, referral to community programs and a web-based education programme. Findings: Three hundred and three patients participated, n 5 152 intervention group and n 5 151 in the control group. There was a significant difference between the groups for planned hospital days (F 5 6.3, P 5 0.00) with an adjusted difference 0.60 day per person, and increased satisfaction with rehabilitation services however no difference on health status or emergency room visits. This rehabilitation intervention which had a strong SM component prevented planned hospitalizations that resulted in a conservative estimated cost saving from reduced hospitalizations of $65 000. Future research needs to examine which patient groups with chronic illness show positive responses to rehabilitation and self-management.

Although problem-based learning (PBL) has been linked to several theories of teaching and learning, how these theories are applied remains unclear. The objective of this paper is to explore how theories of teaching and learning relate to and can inform problem-based learning within health professional education programs. We conducted a scoping review on current theories of teaching and learning and considered their relevancy to the problem-based learning approach. The findings suggest that no single theory of teaching and learning can fully represent the complexity of learning in PBL. Recognizing the complexity of the PBL environment and the fluidity between theories of teaching and learning, we proposed eight principles from across 11 theories of teaching and learning that can inform how PBL is operationalised in university-based health professional education: 1) Adult learners are independent and self-directed; 2) Adult learners are goal oriented and internally motivated; 3) Learning is most effective when it is applicable to practice; 4) Cognitive processes support learning; 5) Learning is active and requires active engagement; 6) Interaction between learners supports learning; 7) Activation of prior knowledge and experience supports learning; and 8) Elaboration and reflection supports learning. These eight principles provide the foundation for curriculum design recommendations relevant to PBL within university-based education programs. Specifically, our findings suggest that active engagement and interactions should be encouraged, that students should be prompted to activate their prior knowledge and experiences, and that elaboration and reflection on learning is critical. The small group format of PBL can facilitate this engagement if students question each other, consider alternative perspectives, and are actively involved in setting learning objectives. Further research is needed to develop the empirical basis for these principles and examine if PBL is an effective approach for implementing these principles.

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