151
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Collin S, Robichaud S. Réforme du système public de santé du Nouveau-Brunswick : les mœurs au lieu des structures. Healthc Manage Forum 2020; 33:233-238. [PMID: 32336160 DOI: 10.1177/0840470420915728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
La plus récente réforme du système public de santé du Nouveau-Brunswick (NB) a été lancée en 2008. Les deux principaux objectifs explicites de cette réforme étaient de rendre le système de soins de santé plus efficace et efficient. Plus de dix ans après l’implantation de ce changement d’envergure, peu d’amélioration est notée au niveau de la performance du système public de santé. Les résultats produits dans le cadre d’une recherche qualitative nous permettent de mettre en lumière des raisons pour lesquelles le système de santé ne s’est pas véritablement transformé. De notre analyse découlent certaines recommandations que nous désirons partager aux décideurs publics qui participeront à l’élaboration d’une prochaine réforme. Elles ont surtout trait à la gouvernance, aux cibles à atteindre et à l’engagement des citoyens.
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Affiliation(s)
| | - Stéphane Robichaud
- Conseil de la santé du Nouveau-Brunswick, Moncton, New Brunswick, Canada
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152
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Park S, Smith J, Dunkle RE, Ingersoll-Dayton B, Antonucci TC. Health and Social-Physical Environment Profiles Among Older Adults Living Alone: Associations With Depressive Symptoms. J Gerontol B Psychol Sci Soc Sci 2020. [PMID: 28637214 DOI: 10.1093/geronb/gbx003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We examined differences in depressive symptoms among people 65 and older who live alone, exploring whether these differences are associated with both health and environmental contexts. METHOD Data are from the 2006 wave of Health Retirement Study (N = 2,956, age range: 65-104). We used a two-step cluster analytical approach to identify subgroups of health-limitation profiles and environmental profiles. Logistic regression models determined associations between subgroups and depressive symptoms. RESULTS Cluster analysis identified four health-profile subgroups (sensory-cognitively impaired, physically impaired, multiply impaired, and healthy) and three different physical-social environmental-profile subgroups (physically average/socially unsupported, physically unsupported/socially supported, and physically supported/socially above average). Compared to members of healthier groups, members of the multiply impaired group were the oldest and were more likely both to live in senior housing and to have depressive symptoms if they lived in a physically average/socially unsupported environment. Members of the sensory-cognitively impaired group were more likely to have depressive symptoms when they lived in a physically unsupported/socially supported environment. DISCUSSION Findings regarding the range of both health and social-physical environmental profiles as well as the associations between person-environment profiles combinations (fit) and depressive symptomatology have important policy and intervention implications.
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Affiliation(s)
- Sojung Park
- Brown School of Social Work, Washington University in Saint Louis, Missouri
| | - Jacqui Smith
- Department of Psychology and Institute for Social Research, Ann Arbor
| | - Ruth E Dunkle
- School of Social Work, University of Michigan, Ann Arbor
| | | | - Toni C Antonucci
- Department of Psychology and Institute for Social Research, Ann Arbor
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153
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Ferguson SL, Pitt C, Pitt L. Using artificial intelligence to examine online patient reviews. J Health Psychol 2020; 26:2424-2434. [PMID: 32301353 DOI: 10.1177/1359105320913954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Healthcare consumers are increasingly turning to online sources such as educational websites, forums and social media platforms to share their experiences with medical services and to demystify the uncertainties associated with undergoing various procedures. This study demonstrates a non-invasive way of understanding the feelings and emotions that consumers share via electronic word of mouth. By using IBM Watson, a content analysis tool that harnesses artificial intelligence, we show how a large amount of unstructured qualitative data can be transformed into quantitative data that can be subsequently analysed to generate novel insights into what patients are sharing about their healthcare experiences online.
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154
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Bai Z, Wang Z, Shao T, Qin X, Hu Z. Relationship between Individual Social Capital and Functional Ability among Older People in Anhui Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082775. [PMID: 32316472 PMCID: PMC7216206 DOI: 10.3390/ijerph17082775] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/06/2020] [Accepted: 04/16/2020] [Indexed: 02/07/2023]
Abstract
This study aimed to explore the relationship between individual social capital and functional ability, with a focus on whether there is an interactive relationship that exists among social capital related to functional ability among older people in Anhui province, China. We conducted a cross-sectional study with a multi-stage stratified cluster random sampling method from July to September 2017. Data were collected through questionnaire including demographic characteristics, individual social capital status, and functional capability status. Binary logistic regression analysis model and classification and regression tree model (CART) were utilized. Overall, this study included 1810 elderly people, 43% of whom had functional disability. After the adjustment, subjects with lower social participation (AOR = 1.60; 95% CI: 1.26–2.03) and lower social connection (AOR = 1.74; 95% CI: 1.34–2.25) had an increased risk of functional disability. However, social support (AOR = 0.73; 95% CI: 0.57–0.94) was inversely related to functional ability. We also observed interactive relationship of social capital associated with functional ability, which indicated that special attention and efforts should be paid to older adults with less educational attainment, with multimorbidity, with advanced age, and with lower level of social participation, cohesion for the purpose of maintaining sound functional ability. Our findings may be of salient relevance for devising more targeted and effective interventions to prevent the onset of functional limitations among community-dwelling older adults.
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Affiliation(s)
- Zhongliang Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - Zijing Wang
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - Tiantai Shao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - Xia Qin
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei 230032, China
| | - Zhi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei 230032, China
- Correspondence: ; Tel.: +86-0551-6516-1005
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155
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Jacinto AF, Gordon AL, Samra R, Steiner AB, Mayoral VFDS, Citero VDA. Comparing knowledge and attitudes to dementia care in Brazilian and UK GPs to guide future decisions about educational interventions. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:250-257. [PMID: 30554557 DOI: 10.1080/02701960.2018.1551216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Dementia training for Brazilian general practitioners (GPs) is underdeveloped. We investigated knowledge and attitudes to dementia management among Brazilian GPs and compared these with previous UK findings to inform future decisions about how training is structured.Methods: A total of 115 Brazilian GPs were asked to complete a Portuguese translation of a questionnaire previously used in the UK. This comprised a 14-item multiple-choice knowledge quiz, and a 5-point Likert-scale questionnaire assessing attitudes across 10 dementia management domains. Exploratory factorial analysis was conducted for attitudes.Results: Attitudes toward dementia demonstrated the same underlying factor structure, "heartsink" and "heartfelt" factors, in Brazil as in previous UK studies, explaining 61.6% of variance in responses. Knowledge scores were negatively correlated with heartfelt and heartsink factors.Conclusions: Greater knowledge about dementia was associated with some pessimism about dementia care. The similarity in the structure of attitudes toward dementia management between Brazilian and UK GPs provides a starting point for shared educational approaches targeting attitudes.
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Affiliation(s)
- Alessandro Ferrari Jacinto
- Department of Internal Medicine, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Botucatu, SP, Brazil
| | - Adam Lee Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, UK
- Derby Teaching Hospitals NHS Foundation Trust, UK
- East Midlands Collaboration for Leadership in Applied Health Research and Care, UK
- Nottingham Biomedical Research Centre (BRC): Musculoskeletal Disease (MSK) Theme, Nottingham, UK
| | - Rajvinder Samra
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education & Language Studies, Open University, UK
| | - Ana Beatriz Steiner
- Psychiatry Department, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Vania Ferreira de Sá Mayoral
- Department of Internal Medicine, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Botucatu, SP, Brazil
| | - Vanessa de Albuquerque Citero
- Psychiatry Department, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
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156
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Lacker TJ, Walther A, Fiacco S, Ehlert U. The Relation Between Steroid Secretion Patterns and the Androgen Receptor Gene Polymorphism on Physical Health and Psychological Well-Being-Longitudinal Findings From the Men's Health 40+ Study. Front Hum Neurosci 2020; 14:43. [PMID: 32116617 PMCID: PMC7033643 DOI: 10.3389/fnhum.2020.00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022] Open
Abstract
Research is increasingly focusing on promoting healthy aging and the related extension of the health span by targeting crucial biological processes responsible for age-related conditions. While age-related gradual changes in steroid hormones such as testosterone, estradiol, or cortisol are well described in men, their interactions among each other or with genetic markers have not been sufficiently investigated with regard to physical health or psychological well-being. More specifically, the examination of age-related alterations in hormone interactions and the androgen receptor polymorphism, which modulates androgen action on target cells, in relation to physical health and psychological well-being represents a promising avenue for research on healthy aging in men. A total of 97 healthy aging men provided complete data on psychometric health measures as well as hormonal and genetic parameters at baseline and a 4-year follow-up assessment. Fasting saliva samples were taken at 8:00 am under standardized laboratory conditions, while the androgen receptor gene polymorphism was analyzed from dried blood spots. Longitudinal analyses revealed that psychological well-being and physical health remained stable over time. Analyses indicated that E2 moderated the course of psychological well-being, while the androgen receptor gene polymorphism moderated the course of physical health. Further, T was a strong predictor of physical health. These results suggest that the hypothalamic-pituitary-gonadal (HPG) axis might be important for the maintenance of psychological well-being in men, while physical health depends more on interindividual differences in the androgen receptor gene and T.
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Affiliation(s)
- Tim Jonas Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Biopsychology, TU Dresden, Dresden, Germany
| | - Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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157
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Pettersson C, Malmqvist I, Gromark S, Wijk H. Enablers and Barriers in the Physical Environment of Care for Older People in Ordinary Housing: A Scoping Review. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/02763893.2019.1683671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Cecilia Pettersson
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Inga Malmqvist
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Sten Gromark
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health & Care Sciences, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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158
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Bäccman C, Bergkvist L, Kristensson P. Elderly and care personnel’s user experiences of a robotic shower. JOURNAL OF ENABLING TECHNOLOGIES 2020. [DOI: 10.1108/jet-07-2019-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to explore the expectations and experiences regarding a robotic shower, from a dual user perspective.
Design/methodology/approach
This was an explorative qualitative study in which elderly and personnel were interviewed before the robotic shower was installed and again after four or five months of usage.
Findings
The elderly participants found the robotic shower empowering. The personnel’s experiences encompassed their own work conditions, as well as the user value for the elderly. A shared experience for both user groups was a more independent shower situation for the elderly.
Research limitations/implications
Low user frequency among the elderly may have affected the results; more frequent use may lead to different user experiences. Understanding whether and to what extent long-term use affects user experience is important for future adoption and implementation.
Practical implications
Implementation of digital assistive technology (DAT) should focus on the user value of the DAT for all possible user groups, as the different users may experience different values over time. In addition, approaching adoption and acceptance issues of DAT from a learned helplessness perspective may help users find value in the DAT and the independence these aim to provide, helping users maintain or increase quality of life.
Originality/value
This study presents a dual user experience of a DAT in an intimate care situation and shows the importance of including both elderly and personnel to fully understand the value of DATs.
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159
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The Impact of Sprint Interval Training Frequency on Blood Glucose Control and Physical Function of Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020454. [PMID: 31936725 PMCID: PMC7013863 DOI: 10.3390/ijerph17020454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 01/14/2023]
Abstract
Exercise is a powerful tool for improving health in older adults, but the minimum frequency required is not known. This study sought to determine the effect of training frequency of sprint interval training (SIT) on health and physical function in older adults. Thirty-four (13 males and 21 females) older adults (age 65 ± 4 years) were recruited. Participants were allocated to a control group (CON n = 12) or a once- (n = 11) or twice- (n = 11) weekly sprint interval training (SIT) groups. The control group maintained daily activities; the SIT groups performed 8 weeks of once- or twice-weekly training sessions consisting of 6 s sprints. Metabolic health (oral glucose tolerance test), aerobic capacity (walk test) and physical function (get up and go test, sit to stand test) were determined before and after training. Following training, there were significant improvements in blood glucose control, physical function and aerobic capacity in both training groups compared to control, with changes larger than the smallest worthwhile change. There was a small to moderate effect for blood glucose (d = 0.43–0.80) and physical function (d = 0.43–0.69) and a trivial effect for aerobic capacity (d = 0.01) between the two training frequencies. Once a week training SIT is sufficient to produce health benefits. Therefore, the minimum time and frequency of exercise required is much lower than currently recommended.
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160
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Vasconcelos ACDSE, Marques APDO, Leite VMM, Carvalho JC, Costa MLGD. Prevalência de fragilidade e fatores associados em idosos pós-acidente vascular cerebral. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo avaliar a prevalência da fragilidade e fatores associados em idosos acometidos por acidente vascular cerebral (AVC). Método estudo transversal, com pacientes de idade igual ou maior que 60 anos, assistidos em ambulatório de neurologia. A coleta de dados foi realizada por questionário contendo dados sociodemográficos, clínicos, hábitos de vida e assistência na área de reabilitação e pelos instrumentos Mini Exame do Estado Mental e Escala de Fragilidade de Edmonton. Resultados a população do estudo foi composta por 69 pessoas idosas, com média de idade de 72 (±7,4) anos. Entre os frágeis estavam os indivíduos mais longevos (90,9%), do sexo feminino (92,3%), com estado civil que representasse ter tido companheiro em algum momento da vida (separado, divorciado ou viúvo) (94,4%), que não moravam sozinhos (80,3%), sem nenhuma escolaridade (80,6%) e renda (100%), que se declararam da cor negra (100%) e de religião espírita (100%). A maioria não apresentou comorbidades ou hábitos de vida deletérios, a exceção da hipertensão arterial sistêmica. Houve ainda, baixa assistência na área de reabilitação. A avaliação pelo MEEM indicou estado mental alterado para 83,7% dos idosos frágeis. Foram encontradas associações significativas entre a fragilidade e o estado civil (p=0,042), com a presença da diabetes mellitus (p=0,002), e ausência de infarto agudo do miocárdio (p=0,030). Conclusão Sugere-se a realização de estudos que possam acompanhar esse tipo de população acometida pelo AVC, desde a hospitalização até a alta da reabilitação, com vistas a esclarecer o processo de declínio funcional e cognitivo e sua relação com a fragilidade.
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161
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Fiório CE, Cesar CLG, Alves MCGP, Goldbaum M. Prevalência de hipertensão arterial em adultos no município de São Paulo e fatores associados. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200052. [DOI: 10.1590/1980-549720200052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Analisar o comportamento da prevalência de hipertensão arterial no município de São Paulo e seus fatores associados. Métodos: O presente trabalho utilizou os dados do Inquérito de Saúde no Município de São Paulo (ISA Capital), estudo transversal de base populacional executado no município de São Paulo. Foram utilizados dados de 1.667 e de 3.184 indivíduos em 2003 e 2015, respectivamente, com idade de 20 anos e mais. Fizeram-se análises descritivas das prevalências de hipertensão arterial com respectivos intervalos de 95% de confiança. Análises simples e múltiplas foram realizadas para analisar possíveis associações com as variáveis socioeconômicas, demográficas e de estilo de vida por meio de regressão de Poisson. Resultados: A prevalência de hipertensão arterial passou de 17,2% em 2003 para 23,2% em 2015. Os fatores associados à hipertensão foram: sexo feminino; idade (60 anos e mais); situação conjugal (casados, separados e viúvos); ter religião; baixa escolaridade; ter nascido no estado de São Paulo (exceto capital); estado nutricional (baixo peso, sobrepeso e obesidade); e ex-fumantes. Conclusão: A prevalência de hipertensão autorreferida aumentou significativamente no período estudado em São Paulo. Considerando o impacto dessa doença na sociedade, conhecendo sua atual prevalência e identificando seus principais fatores associados, evidencia-se a necessidade de intensificar atividades que contribuam para a prevenção desse agravo, atenuando os danos aos indivíduos e gastos públicos.
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162
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Mariano PP, Carreira L, Lucena ACRM, Salci MA. Desenvolvimento de atividades de estímulo cognitivo e motor: perspectiva de idosos institucionalizados. ESCOLA ANNA NERY 2020. [DOI: 10.1590/2177-9465-ean-2019-0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar o desenvolvimento de atividades de estímulo cognitivo e motor na perspectiva de idosos institucionalizados. Método Pesquisa qualitativa com 13 idosos institucionalizados de um munícipio do Paraná, Brasil. Realizaram-se atividades de estímulo cognitivo e motor e, posteriormente, entrevistas semiestruturadas. Os dados foram submetidos à Análise de Similitude por meio do software IraMuTeQ®. Resultados A representação gráfica formada pela zona central “atividade” ligada às zonas periféricas “cabeça”, “bom”, “difícil” e “fácil”, evidenciou a percepção dos idosos sobre os benefícios das atividades. Os idosos consideraram que as atividades, especialmente as de estimulação motora, geram benefícios para a saúde, pois promovem o exercício corporal. O estímulo cognitivo foi relacionado à melhoria do desempenho de habilidades como memória, raciocínio, concentração e atenção. Identificou-se que na categoria de estímulo motor, existem diferentes graus de dificuldade entre os idosos, relacionado ao declínio funcional que estes apresentam. Ainda, as atividades proporcionaram momentos de lazer para os idosos. Considerações finais e implicações para a prática O idoso institucionalizado vivencia uma rotina generalizada limitada às necessidades biológicas em detrimento do estímulo das funções cognitiva e motora. Essa estimulação é necessária, a fim de alcançar a integralidade da assistência à pessoa idosa.
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163
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Capurso C, Bellanti F, Lo Buglio A, Vendemiale G. The Mediterranean Diet Slows Down the Progression of Aging and Helps to Prevent the Onset of Frailty: A Narrative Review. Nutrients 2019; 12:nu12010035. [PMID: 31877702 PMCID: PMC7019245 DOI: 10.3390/nu12010035] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023] Open
Abstract
The aging population is rapidly increasing all over the world. This results in significant implications for the planning and provision of health and social care. Aging is physiologically characterized by a decrease in lean mass, bone mineral density and, to a lesser extent, fat mass. The onset of sarcopenia leads to weakness and a further decrease in physical activity. An insufficient protein intake, which we often observe in patients of advanced age, certainly accelerates the progression of sarcopenia. In addition, many other factors (e.g., insulin resistance, impaired protein digestion and absorption of amino acids) reduce the stimulation of muscle protein synthesis in the elderly, even if the protein intake is adequate. Inadequate intake of foods can also cause micronutrient deficiencies that contribute to the development of frailty. We know that a healthy eating style in middle age predisposes to so-called "healthy and successful" aging, which is the condition of the absence of serious chronic diseases or of an important decline in cognitive or physical functions, or mental health. The Mediterranean diet is recognized to be a "healthy food" dietary pattern; high adherence to this dietary pattern is associated with a lower incidence of chronic diseases and lower physical impairment in old age. The aim of our review was to analyze observational studies (cohort and case-control studies) that investigated the effects of following a healthy diet, and especially the effect of adherence to a Mediterranean diet (MD), on the progression of aging and on onset of frailty.
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164
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Visagie S, Mji G, Scheffler E, Ohajunwa C, Seymour N. Exploring the inclusion of teaching and learning on assistive products in undergraduate curricula of health sciences faculties at three South African Universities. Disabil Rehabil Assist Technol 2019; 16:722-729. [PMID: 31835925 DOI: 10.1080/17483107.2019.1701104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Providers must be knowledgeable on policy, systems and products to provide a person centred service and prescribe the most appropriate assistive product for each user. AIM This study aimed to determine to what extent teaching and learning on assistive products are included in undergraduate curricula of the Health science faculties at three universities in the Western Cape Province of South Africa. METHODS Data were gathered through a cross sectional survey. Fifteen programmes were approached of whom eight participated. Information on teaching on assistive products was sourced from purposively identified key informants, through e-mail questionnaires. Descriptive analysis was done. RESULTS A total of 104 assistive products were included in the eight programmes. Manual wheelchairs were the only product for which teaching was underscored by policy guidelines. Handheld mobility devices and wheelchairs were covered by five programmes. Teaching on assistive products for self-care, participation in domestic life, indoor and outdoor activities, employment and leisure was limited. Thirty seven products listed on the GATE List of 50 were taught by at least one of the programmes. Teaching and examination were theoretical in nature and occurred in professional silos. Clinical exposure was often incidental. For many products none of the four service delivery steps were covered. CONCLUSION Assistive products were included in all the participating undergraduate programmes. The range of included products and the level of training were insufficient to prepare graduates to effectively address user's needs. Newly appointed graduates will require early in-service training to ensure appropriate assistive product service delivery.Implications for rehabilitationUndergraduate teaching on assistive products is provided in professional silos.Not all products on the GATE APL of 50 are included in under graduate teaching.Teaching does not always ensure a proficiency level that will support graduates to provide an independent AT service.
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Affiliation(s)
- Surona Visagie
- Center for Disability and Rehabilitation, Stellenbosch University, Cape Town, South Africa
| | - Gubela Mji
- Center for Disability and Rehabilitation, Stellenbosch University, Cape Town, South Africa
| | - Elsje Scheffler
- Center for Disability and Rehabilitation, Stellenbosch University, Cape Town, South Africa
| | - Chioma Ohajunwa
- Center for Disability and Rehabilitation, Stellenbosch University, Cape Town, South Africa
| | - Nicky Seymour
- Motivation Charitable Trust, Cape Town, South Africa
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165
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Derhun FM, Scolari GADS, Puig-Llobet M, Salci MA, Baldissera VDA, Carreira L. Participation in university activities for the elderly: Motivations of Brazilian and Spanish Seniors. Rev Bras Enferm 2019; 72:104-110. [PMID: 31826198 DOI: 10.1590/0034-7167-2018-0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 11/11/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To understand the reasons that lead Brazilian and Spanish seniors to enroll in a university for the elderly. METHOD A qualitative study that used Symbolic Interactionism as a theoretical reference and the Grounded Theory as a methodological reference. We interviewed 44 seniors enrolled in universities for the elderly from two countries (Brazil and Spain) between October 2014 and May 2016. RESULTS The motivations were related to the necessity of occupying the free time, even for improving health; to the opportunity of access to university learning bypassing formal education criteria; to the expansion of social relations, sought through the creation of new friendships, the desire to know other people's life experiences, and the exchange of knowledge. FINAL CONSIDERATIONS Older people have sought in universities for the elderly a pleasurable way of learning and occupying the free time.
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Affiliation(s)
| | | | | | | | | | - Lígia Carreira
- Universidade Estadual de Maringá. Maringá, Paraná, Brazil
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166
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Shiraishi A, Yoshimura Y, Wakabayashi H, Tsuji Y, Shimazu S, Jeong S. Impaired oral health status on admission is associated with poor clinical outcomes in post-acute inpatients: A prospective cohort study. Clin Nutr 2019; 38:2677-2683. [DOI: 10.1016/j.clnu.2018.11.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 09/04/2018] [Accepted: 11/26/2018] [Indexed: 01/07/2023]
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167
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Tao D, Yuan J, Qu X. Presenting self-monitoring test results for consumers: the effects of graphical formats and age. J Am Med Inform Assoc 2019; 25:1036-1046. [PMID: 29762686 DOI: 10.1093/jamia/ocy046] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 04/11/2018] [Indexed: 02/05/2023] Open
Abstract
Objective To examine the effects of graphical formats and age on consumers' comprehension and perceptions of the use of self-monitoring test results. Methods Participants (36 older and 36 young adults) were required to perform verbatim comprehension and value interpretation tasks with hypothetical self-monitoring test results. The test results were randomly presented by four reference range number lines: basic, color enhanced, color/text enhanced, and personalized information enhanced formats. We measured participants' task performance and eye movement data during task completion, and their perceptions and preference of the graphical formats. Results The 4 graphical formats yielded comparable task performance, while text/color and personalized information enhanced formats were believed to be easier and more useful in information comprehension, and led to increased confidence in correct comprehension of test results, compared with other formats (all p's < .05). Perceived health risk increased as the formats applied more information cues (p = .008). There were age differences in task performance and visual attention (all p's < .01), while young and older adults had similar perceptions for the 4 formats. Personalized information enhanced format was preferred by both groups. Conclusions Text/color and personalized information cues appear to be useful for comprehending test results. Future work can be directed to improve the design of graphical formats especially for older adults, and to assess the formats in clinical settings.
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Affiliation(s)
- Da Tao
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Juan Yuan
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Xingda Qu
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
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168
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Verspoor E, Voortman T, van Rooij FJA, Rivadeneira F, Franco OH, Kiefte-de Jong JC, Schoufour JD. Macronutrient intake and frailty: the Rotterdam Study. Eur J Nutr 2019; 59:2919-2928. [PMID: 31728680 PMCID: PMC7501120 DOI: 10.1007/s00394-019-02131-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/29/2019] [Indexed: 02/04/2023]
Abstract
Purpose To investigate the longitudinal association between the macronutrient composition of the diet and frailty. Methods Data were obtained from 5205 Dutch middle-aged and older adults participating in the Rotterdam Study. Frailty was measured using a frailty index based on the accumulation of 38 health-related deficits, score between 0 and 100, and a higher score indicating more frailty. Frailty was assessed at baseline and 11 years later (range of 23 years). Macronutrient intake was assessed using food-frequency questionnaires. The association between macronutrients and frailty over time was evaluated using multivariable linear regression, adjusted for the frailty index at baseline, energy intake, and other relevant confounders. All analyses were performed in strata of BMI. Results Median frailty index score was 13.8 points (IQR 9.6; 19.1) at baseline and increased by a median of 2.3 points (IQR − 2.0; 7.6) after 11 years. Overall, we found no significant associations between intake of carbohydrates or fat and frailty over time. We did observe a significant positive association between an iso-energetic intake of 10 g protein and frailty over time (β 0.31 (95% CI 0.06; 0.55)) which was mainly driven by animal protein (β 0.31 (95% CI 0.07; 0.56)). It did not depend on whether it was substituted fat or carbohydrates. Conclusions Our findings suggest that a reduction in the intake of animal protein may improve the overall health status over time in a relatively healthy population. More research is needed on the optimal macronutrient composition of the diet and frailty in more vulnerable populations. Electronic supplementary material The online version of this article (10.1007/s00394-019-02131-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eline Verspoor
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center/LUMC Campus, The Hague, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Faculty of Sports and Nutrition, ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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169
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Quantification of the resilience of primary care networks by stress testing the health care system. Proc Natl Acad Sci U S A 2019; 116:23930-23935. [PMID: 31712415 PMCID: PMC6883827 DOI: 10.1073/pnas.1904826116] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We shock a full-scale simulation model of a national health care system by locally removing health care providers. We measure resilience of the system in terms of how fast and to what extent it can recover its ability to deliver adequate health services to the population. The model is based on actual regional primary care networks in Austria, where all patients and physicians are represented as anonymized avatars that are calibrated with nationwide data. After removal of a critical fraction of physicians, networks generically undergo a transition from resilient to nonresilient behavior, where it is impossible to maintain coverage for all patients. These “stress tests” allow us to quantify regional health care resilience and identify systemically risky health care providers. There are practically no quantitative tools for understanding how much stress a health care system can absorb before it loses its ability to provide care. We propose to measure the resilience of health care systems with respect to changes in the density of primary care providers. We develop a computational model on a 1-to-1 scale for a countrywide primary care sector based on patient-sharing networks. Nodes represent all primary care providers in a country; links indicate patient flows between them. The removal of providers could cause a cascade of patient displacements, as patients have to find alternative providers. The model is calibrated with nationwide data from Austria that includes almost all primary care contacts over 2 y. We assign 2 properties to every provider: the “CareRank” measures the average number of displacements caused by a provider’s removal (systemic risk) as well as the fraction of patients a provider can absorb when others default (systemic benefit). Below a critical number of providers, large-scale cascades of patient displacements occur, and no more providers can be found in a given region. We quantify regional resilience as the maximum fraction of providers that can be removed before cascading events prevent coverage for all patients within a district. We find considerable regional heterogeneity in the critical transition point from resilient to nonresilient behavior. We demonstrate that health care resilience cannot be quantified by physician density alone but must take into account how networked systems respond and restructure in response to shocks. The approach can identify systemically relevant providers.
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170
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Calculating State-Level Estimates of Upcoming Older Adult Health Needs. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 24:E9-E16. [PMID: 29112038 DOI: 10.1097/phh.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Census demographers have provided projections of the increased numbers of older adults in upcoming decades, but it is less clear whether they will also be any more or less healthy than current seniors. This is critical information for state planners, as the majority of older adults will need assistance with activities of daily living to remain in their homes. Previous longitudinal and cohort studies have yielded national estimates, but those more costly sources are generally beyond the resources of state public health agencies. We provide a more practicable model for assessing state-level changes in health-related quality of life (HRQOL) among middle-aged versus older adults as a guide to probable upcoming home- and community-based service needs. METHODS We used 2 sets of state Behavioral Risk Factor Surveillance System data 15 years apart to calculate and compare adjusted odds ratios of 8 poor HRQOL measures for middle-aged and older adults. RESULTS Compared with their peers only 15 years earlier, recent middle-aged adults had higher odds of poor outcomes across all HRQOL measures, whereas adults 65-74 years had higher odds of poor outcomes for far fewer of the measures. Among adults 75 years and older, odds were higher compared with 15 years ago for only 1 measure (multiple days of poor mental health). CONCLUSIONS Compared with older adults, the health profile of middle-aged adults in this state appears to have worsened much more rapidly in the past 15 years, indicating that these adults will have many more health-related needs when they become seniors. While this model is less sophisticated than others using longitudinal data, it provides the state-level data that are often more compelling to state policy makers.
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171
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Lushchak O, Strilbytska O, Koliada A, Zayachkivska A, Burdyliuk N, Yurkevych I, Storey KB, Vaiserman A. Nanodelivery of phytobioactive compounds for treating aging-associated disorders. GeroScience 2019; 42:117-139. [PMID: 31686375 DOI: 10.1007/s11357-019-00116-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/04/2019] [Indexed: 12/15/2022] Open
Abstract
Aging population presents a major challenge for many countries in the world and has made the development of efficient means for healthspan extension a priority task for researchers and clinicians worldwide. Anti-aging properties including antioxidant, anti-inflammatory, anti-tumor, and cardioprotective activities have been reported for various phytobioactive compounds (PBCs) including resveratrol, quercetin, curcumin, catechin, etc. However, the therapeutic potential of orally administered PBCs is limited by their poor stability, bioavailability, and solubility in the gastrointestinal tract. Recently, innovative nanotechnology-based approaches have been developed to improve the bioactivity of PBCs and enhance their potential in preventing and/or treating age-associated disorders, primarily those caused by aging-related chronic inflammation. PBC-loaded nanoparticles designed for oral administration provide many benefits over conventional formulations, including enhanced stability and solubility, prolonged half-life, improved epithelium permeability and bioavailability, enhanced tissue targeting, and minimized side effects. The present review summarizes recent advances in this rapidly developing research area.
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Affiliation(s)
- Oleh Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenka str., Ivano-Frankivsk, 76018, Ukraine.
| | - Olha Strilbytska
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenka str., Ivano-Frankivsk, 76018, Ukraine
| | - Alexander Koliada
- Laboratory of Epigenetics, D.F. Chebotarev Institute of Gerontology, NAMS, 67 Vyshgorodska str., Kyiv, 04114, Ukraine
| | - Alina Zayachkivska
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenka str., Ivano-Frankivsk, 76018, Ukraine
| | - Nadia Burdyliuk
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenka str., Ivano-Frankivsk, 76018, Ukraine
| | - Ihor Yurkevych
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenka str., Ivano-Frankivsk, 76018, Ukraine
| | - Kenneth B Storey
- Department of Biology, Carleton University, 1125 Colonel by Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Alexander Vaiserman
- Laboratory of Epigenetics, D.F. Chebotarev Institute of Gerontology, NAMS, 67 Vyshgorodska str., Kyiv, 04114, Ukraine.
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172
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Chen HL, Xiao Y, Liu YJ, Zhang TM, Luo W, Zeng Y, Hu SH, Yang HJ, Yang X, Liu B, Xu MJ, Chan CLW, Conwell Y, Ran MS. Treatment Status of Elderly Patients With Severe Mental Disorders in Rural China. J Geriatr Psychiatry Neurol 2019; 32:291-297. [PMID: 31480980 DOI: 10.1177/0891988719862622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was performed to compare the treatment status between older (≥65 years) and younger adults (18-64 years) with severe mental illness (SMI) and explore factors associated with treatment status in rural China. Persons with SMI were identified in one mental health survey in 2015 in 6 townships of Xinjin County, Chengdu, China. Logistic regressions were conducted to explore factors associated with treatment status. Older adults with SMI, especially major depressive disorder, reported significantly lower rates of treatment than younger group. Older age, longer duration of illness, and poor mental status were risk factors for never-treated status in these patients. Never-treated status (46.3%) and poor treatment status in these older patients are serious issues. Different treatment statuses in these patients had various influencing factors. It is crucial to develop culture-specific, community-based mental health services to improve early identification, diagnosis, treatment, and recovery of older adults with SMI in rural China.
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Affiliation(s)
- Hong-Lin Chen
- 1 Department of Social Work, Fudan University, Shanghai, China
| | - Yunyu Xiao
- 2 Silver School of Social Work, New York University, New York, NY, USA
| | - Yu-Jun Liu
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Tian-Ming Zhang
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Wei Luo
- 4 Xinjin Second People's Hospital, Xinjin, Chengdu, China
| | - Ya Zeng
- 4 Xinjin Second People's Hospital, Xinjin, Chengdu, China
| | - Shi-Hui Hu
- 5 Chengdu Mental Health Center, Chengdu, China
| | | | - Xin Yang
- 6 Guangyuan Mental Health Center, Guangyuan, China
| | - Bo Liu
- 7 Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Mei-Jun Xu
- 7 Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Cecilia Lai-Wan Chan
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yeates Conwell
- 8 Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Mao-Sheng Ran
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
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173
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de Cock TP, Rosato M, Ferry F, Curran E, Leavey G. Patterns of long-term conditions in older age and subsequent mortality: a national study of inequalities in health. Eur J Public Health 2019; 30:588-594. [DOI: 10.1093/eurpub/ckz194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AbstractBackgroundMultiple long-term health conditions in older people are associated with increased mortality. The study aims to identify patterns of long-term health in a national ageing population using a census-based self-reported indicator of long-term health conditions. We assessed associations with subsequent mortality and socio-economic and demographic risk factors.MethodsUsing linked administrative data from the Northern Ireland Mortality Study, we assessed the presence of latent classes of morbidity in self-reported data on 11 long-term health conditions in a population aged 65 or more (N = 244 349). These classes were associated with demographic and socio-economic predictors using multi-nomial logistic regression. In a 3.75-year follow-up, all-cause and cause-specific mortality were regressed on morbidity patterns.ResultsFour latent classes of long-term ill-health conditions were derived, and labelled: ‘low impairment’; ‘pain/mobility’; ‘cognitive/mental’; ‘sensory impairment’. Groupings reflecting higher levels of long-term ill-health were associated with class-specific increases in all-cause and cause-specific mortality. Strongest effects were found for the ‘cognitive/mental’ group, which predicted all-cause mortality [hazard ratio (HR) = 2.96: 95% confidence interval (CI) = 2.83, 3.10) as well as some cause-specific mortality (i.e. dementia-related death: HR = 10.78: 95% CI = 9.39, 12.15). Class membership was predicted by a range of socio-demographic factors. Lower socio-economic status was associated with poorer health.ConclusionResults indicate that long-term ill-health clusters in specific patterns, which are both predicted by socio-demographic factors and are themselves predictive of mortality in the elderly. The syndromic nature of long-term ill-health and functioning in ageing populations has implications for healthcare planning and public health policy in older populations.
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Affiliation(s)
- T Paul de Cock
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Emma Curran
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
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174
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Abstract
This article analyses the influence of workforce ageing on labour productivity in Europe. This question is relevant because of the impact it may have on economic activity, social security systems sustainability and the wellbeing of the population. The method applied is a quantitative contrast using the panel data technique for 24 countries in the period 1983–2014. This research is framed in the open conversation in the literature on the possible impact of ageing on productivity and takes as reference the seminal work of James Feyrer and the contrast model developed by Shekhar Aiyar, Christian Ebeke, and Xiaobo Shao. The results obtained show how a 1% increase in the workforce between the ages of 55 and 64 is related to a decrease of the annual increase in productivity between −0.106% and −0.479%. The main contribution of the article is to provide, as far as the authors are aware, the first evidence of this negative relationship for the period 1983–2014, in addition to suggesting that the influence of ageing on productivity may be reduced by the evolution of the economies in question toward capital and/or knowledge-intensive sectors.
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175
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Mohan T, Čas A, Bračič M, Plohl O, Vesel A, Rupnik M, Zemljič LF, Rebol J. Highly Protein Repellent and Antiadhesive Polysaccharide Biomaterial Coating for Urinary Catheter Applications. ACS Biomater Sci Eng 2019; 5:5825-5832. [DOI: 10.1021/acsbiomaterials.9b01288] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Tamilselvan Mohan
- Laboratory for Characterization and Processing of Polymers (LCPP), Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, Maribor 2000, Slovenia
| | - Alja Čas
- Laboratory for Characterization and Processing of Polymers (LCPP), Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, Maribor 2000, Slovenia
| | - Matej Bračič
- Laboratory for Characterization and Processing of Polymers (LCPP), Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, Maribor 2000, Slovenia
| | - Olivija Plohl
- Laboratory for Characterization and Processing of Polymers (LCPP), Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, Maribor 2000, Slovenia
| | - Alenka Vesel
- Department of Surface Engineering and Optoelectronics, Jožef Stefan Institute, Teslova 30, Ljubljana SI-1000, Slovenia
| | - Maja Rupnik
- Faculty of Medicine, University of Maribor, Taborska ulica 8, Maribor 2000, Slovenia
- National Laboratory for Health, Environment and Food, Prvomajska ulica 1, Maribor 2000, Slovenia
| | - Lidija Fras Zemljič
- Laboratory for Characterization and Processing of Polymers (LCPP), Faculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, Maribor 2000, Slovenia
| | - Janez Rebol
- Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Medical Centre Maribor, Ljubljanska ulica 5, Maribor 2000, Slovenia
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176
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Cesari M, Vanacore N, Agostoni C. The two extremes meet: pediatricians, geriatricians and the life-course approach. Pediatr Res 2019; 86:432-435. [PMID: 31238332 DOI: 10.1038/s41390-019-0479-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 03/19/2019] [Accepted: 06/14/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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177
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Vusirikala A, Ben-Shlomo Y, Kuh D, Stafford M, Cooper R, Morgan GS. Mid-life social participation and physical performance at age 60-64: evidence from the 1946 British Birth Cohort Study. Eur J Public Health 2019; 29:986-992. [PMID: 30726911 DOI: 10.1093/eurpub/ckz005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies linking social activity and disability have been limited by focussing on self-reported physical performance in older adults (>65). We examined whether social participation in mid-life is associated with objective and subjective measures of physical performance in older age. METHODS Participants of the Medical Research Council National Survey of Health and Development reported their involvement in social activities at ages 43 and 60-64 years; frequency of such involvement was classified into thirds. Physical performance was measured at age 60-64 using: grip strength; standing balance; chair rises; timed get-up-and-go; self-reported physical function from the Short Form-36. Multivariable regression was used to examine longitudinal associations between social participation and each physical performance measure. We also investigated whether change in social participation between 43 and 60-64 was associated with each outcome. RESULTS In fully adjusted models, higher frequency of social participation at 43 was associated with faster chair rise (1.42 repetitions/min, 95% CI 0.45-2.39) and timed get-up-and-go speed (2.47 cm/s, 95% CI 0.27-4.67) and lower likelihood of self-report limitations (OR of low physical function 0.67, 95% CI 0.50-0.91) at 60-64 compared with low frequency. Better performance in objectively measured outcomes was observed only if higher social participation persisted over time whereas lower odds of self-reported limitations were found in all groups when compared to those with persistently low participation (ORs 0.43-0.56, all P≤0.02). CONCLUSION Our findings suggest that associations between higher levels of social participation in mid-life and better physical performance exist only if this social participation persists through to older age.
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Affiliation(s)
- A Vusirikala
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Y Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - D Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - M Stafford
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - R Cooper
- Medical Research Council Unit for Lifelong Health and Ageing at University College London (UCL), UK
| | - G S Morgan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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178
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Liu YB, Xue LL, Xue HP, Hou P. Health Literacy, Physical and Mental Health, and Activities of Daily Living Among Older Chinese Adults in Nursing Homes. Asia Pac J Public Health 2019; 30:592-599. [PMID: 30324821 DOI: 10.1177/1010539518800368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is very important to estimate the prevalence of inadequate health literacy and determine whether or not health literacy level differences predict the physical and mental health status of older adults. A cluster sampling method was selected. A total of 1396 older adults were interviewed. Three instruments were included: the Chinese Citizen Health Literacy Questionnaire, Short Form 36, and Activity of Daily Living (ADL) Scale. The health literacy scores were very low (71.74 ± 28.35). The physical and mental health scores were all moderate. The ADLs was ⩾22, which suggests that the ADLs of older adults were poor. The major influencing factors of physical health include health literacy, ADL, alcohol consumption, household income, marital status, and former occupation. The major factors influencing mental health included ADL, former occupation, age, and smoking. Health literacy was associated with physical health, but was not associated with mental health. Improving health literacy could increase health management and health status of older adults.
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Affiliation(s)
| | | | | | - Ping Hou
- 1 Yangzhou University, Yangzhou, Jiangsu, China
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179
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Determinants of access to eHealth services in regional Australia. Int J Med Inform 2019; 131:103960. [PMID: 31518858 DOI: 10.1016/j.ijmedinf.2019.103960] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Australia has a universal public healthcare system, but access to eHealth services (i.e. use of the Internet and related technologies for healthcare services) remains a remarkable challenge, particularly in regional, rural and remote communities. Similar to many other countries, Australia faces the challenges of an ageing population and chronic disease management as well as balancing the supply of and the demand for quality healthcare and advanced medical procedures. The prima facie case for inequality in accessing eHealth services across geographical settings is widely acknowledged. However, regional residents' perceptions on access to eHealth services lack empirical evidence. Therefore, this study empirically investigates the current state and predictors of eHealth service access in regional Australia. METHODS A cross-sectional questionnaire-based household survey was conducted within a total of 390 randomly selected adults from the Western Downs Region in Southeast Queensland, Australia. Bivariate analysis was conducted to examine the relationship between eHealth access and respondents' characteristics. A multivariate logistic regression model was also performed to identify the significant predictors of eHealth service access in regional Australia. RESULTS Approximately 78% of the households have access to eHealth services. However, access to eHealth services in socioeconomically disadvantaged households was lower (19%) than that of their advantaged counterparts (25%). Factors that significantly increased the likelihood of accessing eHealth services included middle age (odds ratio [OR] = 2.75, 95% confidence interval [CI]: 1.84, 8.66), household size (three to four members) (OR = 2.29, 95% CI: 1.19, 4.73), broadband Internet access (OR = 1.67, 95% CI: 1.15, 2.90) and digital literacy (OR = 2.39, 95% CI: 1.23, 4.59). Factors that negatively influenced access to eHealth services were low educational levels (OR = 0.28, 95% CI: 0.09, 0.61), low socioeconomic status (OR = 0.65, 95% CI: 0.28, 0.83) and remote locations (OR = 0.66, 95% CI: 0.23, 0.80). CONCLUSION Emerging universal eHealth access provides immense societal benefits in regional settings. The findings of this study could assist policy makers and healthcare practitioners in identifying factors that influence eHealth access and thereby formulate effective health policies to optimise healthcare utilisation in regional Australia.
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Geography of Lumbar Paravertebral Muscle Fatty Infiltration: The Influence of Demographics, Low Back Pain, and Disability. Spine (Phila Pa 1976) 2019; 44:1294-1302. [PMID: 30946297 DOI: 10.1097/brs.0000000000003060] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. SUMMARY OF BACKGROUND DATA Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimize interventions. METHODS This cross-sectional study employed lumbar axial T1-weighted magnetic resonance imaging in 107 Southern-Chinese adults (54 females, 53 males). Single-slices at the vertebral inferior end-plate per lumbar level were measured for quartiled-FI, and analyzed against demographics, LBP, and disability (Oswestry Disability Index). RESULTS Mean FI% was higher in females, on the right, increased per level caudally, and from medial to lateral in men (P < 0.05). FI linearly increased with age for both sexes (P < 0.01) and was notably higher at L 4&5 than L1, 2&3 for cases aged 40 to 65 years. BMI and FI were unrelated in females and inversely in males (P < 0.001). Females with LBPweek and males with LBPyear had 1.7% (each) less average FI (P < 0.05) than those without pain at that time-point. Men locating their LBP in the back had less FI than those without pain (P < 0.001). Disability was unrelated to FI for both sexes (P > 0.05). CONCLUSION Lumbar paravertebral muscle FI predominates in the lower lumbar spine, notably for those aged 40 to 65, and depends more on sagittal than transverse distribution. Higher FI in females and differences of mean FI between sexes for BMI, LBP, and disabling Oswestry Disability Index suggest sex-differential accumulation patterns. Our study contradicts pain models rationalizing lumbar muscle FI and may reflect a normative sex-dependent feature of the natural history of lumbar paravertebral muscles. LEVEL OF EVIDENCE 2.
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Wang R, Bishwajit G, Zhou Y, Wu X, Feng D, Tang S, Chen Z, Shaw I, Wu T, Song H, Fu Q, Feng Z. Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015. PLoS One 2019; 14:e0221430. [PMID: 31425559 PMCID: PMC6699736 DOI: 10.1371/journal.pone.0221430] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background The general benefit of physical activity (PA) to one’s mental health has been widely acknowledged. Nevertheless, the specific type and amount of PA that associates with lower risk of depression in China awaits further investigation. The present study was conducted on middle- and older-aged Chinese population with two objectives: 1) to understand the patterns of PA; 2) to measure the associations between depression and PA at different levels from various aspects. Methods Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2015), we selected 9118 community residents aged 45 years and older. Depressive symptoms were measured by 10-item Center for Epidemiologic Studies (CES-D 10). Multivariate logistic regression model was performed to examine the association between risk of depression and PA from four aspects including intensity, frequency, duration, and volume. Results Spending 1–2 days/week (OR = 0.58, 95% CI: 0.36, 0.91), less than 30 minutes each time (OR = 0.66, 95% CI: 0.42, 1.03) or 150–299 min/week (OR = 0.49, 95% CI: 0.28, 0.87) on Moderate Physical Activity (MPA) was associated with lower odds of depression in women. Spending 3–5 days/week (OR = 1.98, 95% CI: 1.29, 3.05) or 6–7 days/week (OR = 1.50, 95% CI: 1.07, 2.11), 4 hours and longer each time (OR = 1.65, 95% CI: 1.18, 2.32), 300 min/week or longer (OR = 1.65, 95% CI: 1.22, 2.24) on Vigorous Physical Activity (VPA) in total, or 2250 Metabolic Equivalent of Task (OR = 1.73, 95% CI: 1.26, 2.38) on Moderate-to-Vigorous PA was associated with higher risk of depression in men. Conclusions The association between depression and PA depended largely on intensity and gender. Lower frequency, shorter duration, and moderate amount of MPA was associated with lower risk of depression in women. Risk of depression was higher in men who spent higher frequency, longer duration, and overlong time on VPA.
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Affiliation(s)
- Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
| | - Yongjie Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
- Affiliated Mental Health Center of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Ian Shaw
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | - Tailai Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qian Fu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail:
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Epidemiology of Comorbid Conditions Among Adults 50 Years and Older With Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:15-24. [PMID: 28060201 DOI: 10.1097/htr.0000000000000273] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. SETTING Level I Trauma centers. PARTICIPANTS Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). DESIGN A TBI-MS prospective cohort study. MAIN MEASURES International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. RESULTS The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. CONCLUSION This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.
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183
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Nicholas SO, Giang AT, Yap PLK. The Effectiveness of Horticultural Therapy on Older Adults: A Systematic Review. J Am Med Dir Assoc 2019; 20:1351.e1-1351.e11. [PMID: 31402135 DOI: 10.1016/j.jamda.2019.06.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Although the therapeutic effects of horticulture on older adults have been widely investigated, a recent and comprehensive synthesis of available evidence on outcomes is lacking. We systematically reviewed evidence for the therapeutic effects of horticulture on older adults. DESIGN A systematic search of PubMed, MEDLINE, Sage Journals, ProQuest, Science Direct, and CINAHL was conducted. Articles were selected if they were quantitative studies published in English from 2008 to 2018. SETTING AND PARTICIPANTS Articles were selected if they included participants aged 60 years and older and used horticulture as the main intervention. MEASURES Experimental studies were appraised using the Physiotherapy Evidence Database Scale. RESULTS The systematic search yielded 20 articles. Significant pre-post improvement was reported in quality of life, anxiety, depression, social relations, physical effects, and cognitive effects. However, between-group results were lacking or nonsignificant. CONCLUSIONS AND IMPLICATIONS There is evidence for benefits of horticulture among older adults, particularly in long-term care facilities. Nonetheless, as the robustness of evidence is lacking, more rigorous randomized controlled trials and between-group effects need to be investigated.
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Affiliation(s)
| | - Anh T Giang
- Rehabilitation Services, Khoo Teck Puat Hospital, Singapore
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184
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Liyanage H, Liaw ST, Jonnagaddala J, Schreiber R, Kuziemsky C, Terry AL, de Lusignan S. Artificial Intelligence in Primary Health Care: Perceptions, Issues, and Challenges. Yearb Med Inform 2019; 28:41-46. [PMID: 31022751 PMCID: PMC6697547 DOI: 10.1055/s-0039-1677901] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is heralded as an approach that might augment or substitute for the limited processing power of the human brain of primary health care (PHC) professionals. However, there are concerns that AI-mediated decisions may be hard to validate and challenge, or may result in rogue decisions. OBJECTIVE To form consensus about perceptions, issues, and challenges of AI in primary care. METHOD A three-round Delphi study was conducted. Round 1 explored experts' viewpoints on AI in PHC (n=20). Round 2 rated the appropriateness of statements arising from round one (n=12). The third round was an online panel discussion of findings (n=8) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. RESULTS PHC and informatics experts reported AI has potential to improve managerial and clinical decisions and processes, and this would be facilitated by common data standards. The respondents did not agree that AI applications should learn and adapt to clinician preferences or behaviour and they did not agree on the extent of AI potential for harm to patients. It was more difficult to assess the impact of AI-based applications on continuity and coordination of care. CONCLUSION While the use of AI in medicine should enhance healthcare delivery, we need to ensure meticulous design and evaluation of AI applications. The primary care informatics community needs to be proactive and to guide the ethical and rigorous development of AI applications so that they will be safe and effective.
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Affiliation(s)
- Harshana Liyanage
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
| | - Siaw-Teng Liaw
- School of Public Health & Community Medicine, UNSW Medicine Australia, Ingham Institute of Applied Medical Research, NSW, Australia
| | - Jitendra Jonnagaddala
- School of Public Health & Community Medicine, UNSW Medicine Australia, Ingham Institute of Applied Medical Research, NSW, Australia
| | | | - Craig Kuziemsky
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda L Terry
- Centre for Studies in Family Medicine, Department of Family Medicine, Interfaculty Program in Public Health, Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Simon de Lusignan
- Department of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
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Daskalopoulou C, Koukounari A, Wu YT, Terrera GM, Caballero FF, de la Fuente J, Tyrovolas S, Panagiotakos DB, Prince M, Prina M. Healthy ageing trajectories and lifestyle behaviour: the Mexican Health and Aging Study. Sci Rep 2019; 9:11041. [PMID: 31363117 PMCID: PMC6667468 DOI: 10.1038/s41598-019-47238-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 07/12/2019] [Indexed: 01/04/2023] Open
Abstract
Projections show that the number of people above 60 years old will triple by 2050 in Mexico. Nevertheless, ageing is characterised by great variability in the health status. In this study, we aimed to identify trajectories of health and their associations with lifestyle factors in a national representative cohort study of older Mexicans. We used secondary data of 14,143 adults from the Mexican Health and Aging Study (MHAS). A metric of health, based on the conceptual framework of functional ability, was mapped onto four waves (2001, 2003, 2012, 2015) and created by applying Bayesian multilevel Item Response Theory (IRT). Conditional Growth Mixture Modelling (GMM) was used to identify latent classes of individuals with similar trajectories and examine the impact of physical activity, smoking and alcohol on those. Conditional on sociodemographic and lifestyle behaviour four latent classes were suggested: high-stable, moderate-stable, low-stable and decliners. Participants who did not engage in physical activity, were current or previous smokers and did not consume alcohol at baseline were more likely to be in the trajectory with the highest deterioration (i.e. decliners). This study confirms ageing heterogeneity and the positive influence of a healthy lifestyle. These results provide the ground for new policies.
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Affiliation(s)
- Christina Daskalopoulou
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Artemis Koukounari
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
| | - Yu-Tzu Wu
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Graciela Muniz Terrera
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain.,Ciber of Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Javier de la Fuente
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona. Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Martin Prince
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Matthew Prina
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Sherwood R, Bismark M. The ageing surgeon: a qualitative study of expert opinions on assuring performance and supporting safe career transitions among older surgeons. BMJ Qual Saf 2019; 29:113-121. [PMID: 31363015 PMCID: PMC7045790 DOI: 10.1136/bmjqs-2019-009596] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 12/01/2022]
Abstract
Background Unlike some other safety critical professions, there is no mandatory age of retirement for doctors, including surgeons. Medical regulators in Australia are implementing additional checks on doctors from the age of 70. We describe expert opinions on assuring performance and supporting career transitions among older surgeons. Methods In this qualitative study, experts in four countries were purposively selected for their expertise in surgical governance. Experts responded to interviews (Australia, New Zealand and UK) or a survey (Canada). A tiered framework of interventions was developed by integrating findings with previous literature and responsive regulation theory. Results 52 experts participated. Participants valued the contribution of senior surgeons, while acknowledging that age-related changes can affect performance. Participants perceived that identity, relationships and finances influence retirement decisions. Experts were divided on the need for age-specific testing, with some favouring whole-of-career approaches to assuring safe care. A lack of validated tools for assessing performance of older surgeons was highlighted. Participants identified three options for addressing performance concerns—remediate, restrict or retire—and emphasised the need for co-ordinated and timely responses. Conclusion Experts perceive the need for a staged approach to assessing the performance of older surgeons and tailoring interventions. Most older surgeons are seen to make decisions around career transitions with self-awareness and concern for patient safety. Some older surgeons may benefit from additional guidance and support from employers and professional colleges. A few poorly performing older surgeons, who are recalcitrant or lack insight, require regulatory action to protect patient safety. Developing robust processes to assess performance, remediate deficits and adjust scopes of practice could help to support safe career transitions at any age.
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Affiliation(s)
- Rupert Sherwood
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia .,Division of Women's and Children's, Western Health, St Albans, Victoria, Australia
| | - Marie Bismark
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Hu Y, Leinonen T, van Hedel K, Myrskylä M, Martikainen P. The relationship between living arrangements and higher use of hospital care at middle and older ages: to what extent do observed and unobserved individual characteristics explain this association? BMC Public Health 2019; 19:1011. [PMID: 31357984 PMCID: PMC6664712 DOI: 10.1186/s12889-019-7296-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 07/10/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous research has shown that certain living arrangements, such as living alone, are associated with worse health at older ages. We assessed the association between living arrangements and hospital care use among middle-aged and older adults, and investigated to what extent observed and unobserved individual characteristics explain this association. METHODS Longitudinal Finnish registry data for men and women aged 50-89 years were used for the period 1987-2007. The relationship between living arrangements (based on whether an individual lived with a partner, other adults or alone, and whether they lived with minor/adult children) and heavy hospital care use (i.e., having been in hospital for 8 or more days in a year) was studied. First, we applied logistic regression models and linear probability models controlling for observed time-invariant factors (socioeconomic status measured by education, labour force status, and household income; and marital status), and then individual linear probability models with fixed-effects to further account for unobserved time-invariant individual characteristics in the measurement period. Analyses were done separately for 10 year age-groups. RESULTS In the logistic regression models, men and women who lived alone had higher crude odds of heavy hospital care use than those living only with their partner. These odds ratios were highest for men and women in the youngest age category (50-59 years, 1.72 and 1.36 respectively) and decreased with age. Adjusting for observed time-invariant socioeconomic status attenuated these odds by 14-40%, but adjusting for marital status did not affect the results. Lower odds were observed among adults aged 50-59 years who lived with their partner and (minor or adult) children. But odds were higher for individuals aged 60-79 years who co-resided with their adult children, regardless of whether they lived with a partner. Adjusting for observed time-invariant factors generally did not change these results. After further adjusting for unobserved time-invariant individual characteristics in the individual fixed-effects models, most of these associations largely attenuated or disappeared, particularly for ages 80-89 years. CONCLUSIONS The association between living arrangements and higher use of hospital care at middle and older ages is largely explained by socioeconomic disadvantage and unobserved time-invariant individual characteristics.
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Affiliation(s)
- Yaoyue Hu
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany
| | - Taina Leinonen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Karen van Hedel
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany
| | - Mikko Myrskylä
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Department of Social Policy, London School of Economics and Political Science, London, UK
| | - Pekka Martikainen
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
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[DIABDEM project: A pilot study of prevalence of cognitive impairment in diabetes mellitus in 2 Hispanic countries]. Rev Esp Geriatr Gerontol 2019; 54:339-345. [PMID: 31326101 DOI: 10.1016/j.regg.2019.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The prevalence of chronic noncommunicable diseases such as type 2 diabetes mellitus (T2DM) and dementia increase with ageing. In this context, an association between T2DM and cognitive impairment has been described in the literature. However, there are few studies in the Hispanic population. This research project presents a pilot study that will evaluate the feasibility of the DIABDEM project that will determine the prevalence of cognitive impairment in old people with diagnosis of T2DM in Spain and Chile. MATERIALS AND METHODS It is a observation-based pilot study, non-experimental, descriptive-comparative and cross-sectional. The sample will involve 72 participants (39 Spaniards and 33 Chileans), 65 year-old or older, men and women, community dwelling, and who have not been previously diagnosed with dementia, with or without a T2DM diagnosis. Participants will fill in a research protocol form collecting socio-demographic and clinical data, lifestyle details, and neuropsychological variables. EXPECTED RESULTS This study will evaluate the feasibility of the DIABDEM project that will determine the prevalence rate of cognitive impairment in old people with T2DM. On one hand, the aim of this study will establish risk and protectors factors potentially associated with the development of cognitive impairment in T2DM. On the other hand, it is expected to identify a specific neuropsychological profile in people with T2DM, proposing later a brief and useful neuropsychological battery in order to discriminate early cognitive impairment in people with T2DM. CONCLUSION Findings in this pilot study will obtain greater knowledge about the feasibility of the DIABDEM project, which will provide evidence about cognitive complications in T2DM.
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Gvozd R, Rossaneis MA, Pissinati PDSC, Guirardello EDB, Haddad MDCFL. Cultural adaptation of the Retirement Resources Inventory for Brazilian culture. Rev Saude Publica 2019; 53:60. [PMID: 31340352 PMCID: PMC6629292 DOI: 10.11606/s1518-8787.2019053000863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 11/04/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To translate and adapt the Retirement Resources Inventory for Brazilian culture. METHODS Methodological research including the stages of translation, synthesis, evaluation by committee of judges, back-translation and pre-test. The internal consistency of the instrument with Cronbach’s alpha coefficient was evaluated. RESULTS We considered the stages of translation and cultural adaptation adequate. The evaluation of the synthesis version by the judges resulted in the need to change 95.0% of the items to ensure the semantic, idiomatic, cultural and conceptual equivalence between the original and translated versions. In general consensus of the instrument, the agreement rate among the judges for the equivalences was 84.4%. As for the pre-test stage, 25 pre-retirees participated. The participants suggested adjustments in the instrument. The instrument’s internal consistency was 0.85. The mean time to fill in the instrument was 18.7 minutes CONCLUSIONS The methodological process of cultural adaptation of the Retirement Resources Inventory resulted in adequate content validity and ease of understanding by the participants. We emphasize that this study precedes the evaluation process of the psychometric properties of the instrument, which will be carried out in new studies.
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Affiliation(s)
- Raquel Gvozd
- Universidade Estadual de Londrina. Departamento de Enfermagem. Londrina, PR, Brasil
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Shang B, Yin H, Jia Y, Zhao J, Meng X, Chen L, Liu P. Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review. Geriatr Nurs 2019; 40:405-416. [DOI: 10.1016/j.gerinurse.2019.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/11/2019] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
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191
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Crombie KM, Leitzelar BN, Almassi NE, Mahoney JE, Koltyn KF. Translating a "Stand Up and Move More" intervention by state aging units to older adults in underserved communities: Protocol for a randomized controlled trial. Medicine (Baltimore) 2019; 98:e16272. [PMID: 31277151 PMCID: PMC6635154 DOI: 10.1097/md.0000000000016272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION As aging is associated with functional decline, preventing functional limitations and maintaining independence throughout later life has emerged as an important public health goal. Research indicates that sedentary behavior (prolonged sitting) is associated with functional loss and diminished ability to carry out activities of daily living. Despite many efforts to increase physical activity, which can be effective in countering functional loss, only an estimated 8% of older adults meet national physical activity guidelines. Thus, shifting the focus to reducing sitting time is emerging as a potential new intervention strategy but little research has been conducted in this area. With community support and funding, we developed and pilot tested a 4-week "Stand Up and Move More" intervention and found decreases in sedentary behavior, increases in physical activity, and improvements in mobility and vitality in a small sample of older adults. The purpose of this project is to expand upon these pilot results and examine the effectiveness and feasibility of translating a "Stand Up and Move More" intervention by State Aging Units to older adults in underserved communities. Eighty older adults from 4 counties across Wisconsin predominantly made up of rural older adults and older African American adults are randomly assigned to intervention (n = 40) or wait-list control (n = 40) groups. The intervention consists of 4 weekly sessions plus a refresher session at 8 weeks, and is delivered by community partners in each county. The sessions are designed to elicit ideas from older adults regarding how they can reduce their sitting time, help them set practical goals, develop action plans to reach their goals, and refine their plans across sessions to promote behavior change. Sedentary behavior, physical activity levels, functional performance, and health-related quality of life are assessed before and after the intervention to examine the effectiveness of the program. Feasibility of implementing the program by our community partners is assessed via semi-structured interviews. Strengths of this project include strong community collaborations and a high need given that the older adult population is projected to increase substantially in the next 15 years. CONCLUSION This project will provide an important step in developing effective strategies for maintaining independence in older adults through determining the feasibility and impact of a community-based intervention to break up sitting time.
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Affiliation(s)
| | | | | | - Jane E. Mahoney
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Tran T, Hammarberg K, Ryan J, Lowthian J, Freak-Poli R, Owen A, Kirkman M, Curtis A, Rowe H, Brown H, Ward S, Britt C, Fisher J. Mental health trajectories among women in Australia as they age. Aging Ment Health 2019; 23:887-896. [PMID: 29790785 DOI: 10.1080/13607863.2018.1474445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To ascertain the trajectories of mental health among women in Australia assessed in repeat waves from their early 70 s to the end of their lives or their mid 80 s. METHOD Secondary analysis of data contributed by the 1921-26 cohort of the Australian Longitudinal Study of Women's Health Waves 1-6. Primary outcome was the 4-item SF-36 Vitality Subscale, which assesses mental health as life satisfaction, social participation, energy and enthusiasm. Structural, individual and intermediary factors were assessed using study-specific and standardised measures. Trajectories were identified using Growth Mixture Modelling and associations with baseline characteristics with Structural Equation Modelling. RESULTS 12,432 women completed Survey One. Three mental health trajectories: stable high (77%); stable low (18.2%) and declining from high to low (4.8%) were identified. Compared to the stable high group, women in the stable low group were significantly less physically active, had more nutritional risks, more recent adverse life events, fewer social interactions and less social support, reported more stress and were more likely to have a serious illness or disability at Survey One. The declining group had similar characteristics to the stable high group, but were significantly more likely to report at baseline that they had experienced recent financial, physical and emotional elder abuse. These interact, but not directly with socioeconomic position and marital status. CONCLUSION Mental health among older women is related to social relationships, general health, access to physical activity and healthy nutrition, coincidental adverse life events and experiences of interpersonal violence, in particular elder abuse.
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Affiliation(s)
- Thach Tran
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Karin Hammarberg
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Joanne Ryan
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.,b INSERM, Université Montpellier , Neuropsychiatry: Epidemiological and Clinical Research , Montpellier , France
| | - Judy Lowthian
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.,c Bolton Clarke Research Institute , Melbourne , Australia
| | - Rosanne Freak-Poli
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.,d Department of Epidemiology , Erasmus Medical Centre , Rotterdam , The Netherlands
| | - Alice Owen
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Maggie Kirkman
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Andrea Curtis
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Heather Rowe
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Helen Brown
- e Department of Translation, Education and Communication, The Jean Hailes Foundation , Melbourne , Australia
| | - Stephanie Ward
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Carlene Britt
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Jane Fisher
- a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
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193
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Neighborhood Influence: A Qualitative Study in Cáceres, an Aspiring Age-Friendly City. SOCIAL SCIENCES-BASEL 2019. [DOI: 10.3390/socsci8060195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study is to understand the perspective of elderly residents on their neighborhood and how the composition of the neighborhood influences their daily life. The study took place in the city of Cáceres (Spain) that aspires to become an age-friendly city. This study focused on the intangible elements of the neighborhood related to feelings of safety, well-being, loneliness, belonging to the community and development of trusting relationships. The research was based on the sociology of aging, specifically referencing the theory of the activity of aging, and also urban sociology, which assumes the environment as a conditioning agent of daily life. Using a qualitative approach, 32 in-depth interviews were conducted with individuals over 65. The interviews were analyzed according to grounded theory. The results show how social aspects are key factors for the elderly in their perception of the neighborhood. Therefore, psychological, social and emotional dimensions of the neighborhood influence elderly residents and could have a positive or negative effect on successful aging. These findings also suggest that a crucial aspect of the positive perceptions of the environment lies in the quality of social interactions that take place inside the neighborhood.
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194
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Association of diet quality and physical activity with healthy ageing in the French NutriNet-Santé cohort. Br J Nutr 2019; 122:93-102. [PMID: 31162001 DOI: 10.1017/s0007114519000898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A growing number of studies have explored overall health during ageing in a holistic manner by investigating multidimensional models of healthy ageing (HA). However, little attention has been given to the role of adherence to national nutrition guidelines in that context. This study aimed to investigate the prospective association between adherence to the French nutrition guidelines and HA. The authors analysed data from 21 407 participants of the NutriNet-Santé study with a median baseline age of 55·6 years (2009-2014) and initially free of major chronic diseases. HA was defined as not developing major chronic disease, no depressive symptoms, no function-limiting pain, independence in instrumental activities of daily living, good physical, cognitive and social functioning, as well as good self-perceived health. Adherence to guidelines of the French Nutrition and Health Programme (Programme National Nutrition Santé or PNNS) was measured via the PNNS Guideline Score (PNNS-GS), using baseline data from repeated 24-h dietary records and physical activity questionnaires. After a median follow-up of 5·7 years, 46·3 % of participants met our HA criteria. Robust-error-variance Poisson regression revealed that higher PNNS-GS scores, reflecting higher adherence to nutrition recommendations (including both diet and physical activity guidelines), were associated with a higher probability to age healthily (relative riskquartile 4 v. quartile 1 = 1·17 (95 % CI 1·12, 1·22)). Supplementary analyses revealed that this association may, to a small part, be mediated by weight status. The results suggest that high adherence to the French national nutrition recommendations may be linked to better overall health throughout ageing.
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195
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Yang Y, Langellier BA, Stankov I, Purtle J, Nelson KL, Diez Roux AV. Examining the possible impact of daily transport on depression among older adults using an agent-based model. Aging Ment Health 2019. [PMID: 29543502 DOI: 10.1080/13607863.2018.1450832] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Daily transport may impact depression risk among older adults through several pathways including facilitating the ability to meet basic needs, enabling and promoting contact with other people and nature, and promoting physical activity (e.g. through active transportation such as walking or walking to public transit). Both daily transport and depression are influenced by the neighborhood environment. To provide insights into how transport interventions may affect depression in older adults, we developed a pilot agent-based model to explore the contribution of daily transport and neighborhood environment to older adults' depression in urban areas. METHOD The model includes about 18,500 older adults (i.e. agents) between the ages of 65 and 85 years old, living in a hypothetical city. The city has a grid space with a number of neighborhoods and locations. Key dynamic processes in the model include aging, daily transport use and feedbacks, and the development of depression. Key parameters were derived from US data sources. The model was validated using empirical studies. RESULTS An intervention that combines a decrease in bus fares, shorter bus waiting times, and more bus lines and stations is most effective at reducing depression. Lower income groups are likely to be more sensitive to the public transit-oriented intervention. CONCLUSION Preliminary results suggest that promoting public transit use may be a promising strategy to increase daily transport and decrease depression. Our results may have implications for transportation policies and interventions to prevent depression in older adults.
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Affiliation(s)
- Yong Yang
- a School of Public Health , University of Memphis , Memphis , Tennessee , USA
| | - Brent A Langellier
- b Department of Health Management and Policy, Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | - Ivana Stankov
- c Urban Health Collaborative, Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | - Jonathan Purtle
- b Department of Health Management and Policy, Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | - Katherine L Nelson
- b Department of Health Management and Policy, Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | - Ana V Diez Roux
- c Urban Health Collaborative, Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
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196
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Brooke J, Cronin C, Stiell M, Ojo O, Belcina MT, Smajlović SK, Slark J. Nursing students' cultural beliefs and understanding of dementia: A phenomenological study across three continents. NURSE EDUCATION TODAY 2019; 77:6-11. [PMID: 30878702 DOI: 10.1016/j.nedt.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/23/2018] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Migrant nurses have reported difficulties adapting to their new culture and providing culturally sensitive care for people with dementia. However, to date no studies have explored the impact of student nurse's cultural heritage on their beliefs and understanding of dementia. OBJECTIVES To explore the cultural beliefs of dementia of student nurses studying in England, Slovenia, Philippines and New Zealand. DESIGN An explorative hermeneutic phenomenology design. SETTINGS Higher Education Institutes delivering undergraduate nursing education in England (University of Greenwich and University of Essex), Slovenia (Angela Boškin Faculty of Health Care), New Zealand (University of Auckland), and the Philippines (University of Silliman). PARTICIPANTS Student nurses studying nursing in England (n = 81), Slovenia (n = 41), Philippines (n = 53) and New Zealand (n = 6). Participants from England and New Zealand were from diverse cultural backgrounds. Student nurses at the beginning of their studies (n = 100) and towards the end of their studies (n = 81) participated. METHODS Completion of focus groups (n = 23), in England (n = 10), Slovenia (n = 6), Philippines (n = 6), and New Zealand (n = 1). All focus groups were audio recorded and transcribed verbatim. Data was analysed by applying an inductive theoretical approach of the Framework Method, which supports the generation of themes through open unhindered coding, pinpointing, examining, and recording patterns within the data. RESULTS Two major themes were identified in the data: familial piety and dementia discourse. Familial piety emerged from the importance of family and caring for family members with dementia, subthemes included: 'my granddad': familial experience, and 'better to be with her': familial home. Dementia discourse emerged from the terminology student nurses applied, such as: 'preconceptions and misconceptions' of aggression, and 'considered crazy' stigma of dementia due to a lack of awareness. CONCLUSIONS The cultural heritage of student nurses impacted on their beliefs of dementia; however their understanding of the needs, care and support of a person with dementia changed and developed through clinical experience and education.
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Affiliation(s)
- Joanne Brooke
- Centre for Social Care, Health and Related Research, Birmingham City University, Ravensbury House, City South Campus, Westbourne Road, Birmingham, B15 3TN, United Kingdom of Great Britain and Northern Ireland.
| | - Camille Cronin
- School of Health and Human Sciences, University of Essex, Elmer Approach, Southend-on-Sea SS1 1LW, United Kingdom of Great Britain and Northern Ireland.
| | - Marlon Stiell
- Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London. SE9 2UG, United Kingdom of Great Britain and Northern Ireland.
| | - Omorogieva Ojo
- Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London. SE9 2UG, United Kingdom of Great Britain and Northern Ireland.
| | - Maria Theresa Belcina
- Silliman University, College of Nursing, 1 Hibbard Avenue, Dumaguete City 6200, Negros Oriental, Philippines
| | | | - Julia Slark
- University of Auckland, Level 2, Building 505, Grafton, Auckland 1142, New Zealand.
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Movahedi S, Eliyas S, Fisher N. Early years postgraduate learning and training in prosthodontic dentistry: 2019 and beyond. Br Dent J 2019; 226:801-806. [DOI: 10.1038/s41415-019-0317-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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198
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Longobucco Y, Benedetti C, Tagliaferri S, Angileri VV, Adorni E, Pessina M, Zerbinati L, Cicala L, Pelà G, Giacomini V, Barbolini M, Lauretani F, Maggio MG. Proactive interception and care of Frailty and Multimorbidity in older persons: the experience of the European Innovation Partnership on Active and Healthy Ageing and the response of Parma Local Health Trust and Lab through European Projects. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:364-374. [PMID: 31125023 PMCID: PMC6776195 DOI: 10.23750/abm.v90i2.8419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 01/03/2023]
Abstract
According to the 2018 European Union Ageing Report, the demographic profile of the European population is projected to be older. Aging cannot be considered a homogeneous process, and only in certain cases is “successful”, with maintained functional ability, which is determined by intrinsic capacity, the environment, and their interaction. When intrinsic capacity is lost, elders with chronic diseases develop frailty, a condition with high-risk of disability. Old-age dependency-ratio is projected to increase from 29.6% to 51.2% in the EU in 2070: thus, the need of new approaches targeting the prevention of disability. Numerous studies are conducted in the European Innovation Partnership on Active and Healthy Ageing and addressing identification, treatment, coordination and integration of care in frail older subjects. SUNFRAIL is aimed at developing a model, good practices and tools to improve the identification, prevention and care of frailty and management of multimorbidity. SPRINTT is testing the effectiveness of a multi-component treatment able to treat frailty and sarcopenia. VIGOUR, a project aimed at strengthening integrated-care in different contexts of European Countries, verifies enablers and obstacles encountered in the real world by these good practices. Through the creation of Parma-Lab and Frailty-Team in the Academic-Hospital of Parma combined with the contribution of Parma Health-Trust in the “Community Health-Centers”, the Projects were translated into Health Services Arena. This response bridging European Studies and clinical practice, aims to early detecting and caring 75-year older citizens with frailty and multimorbidity, living in the community, not institutionalized and at risk of hospitalization and mobility ADL-disability. (www.actabiomedica.it)
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Lee KE, Lee Y, Kim J, Ki SK, Chon D, Jung EJ. Five-year survival rate among older adults participating in the national geriatric screening program: A South Korean population-based cohort study. Arch Gerontol Geriatr 2019; 83:179-184. [PMID: 31071534 DOI: 10.1016/j.archger.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to assess the health benefits of a geriatric screening program comprising of physical function tests, screening questionnaires for depression and cognitive impairment, and bone mineral density measurements for women as a part of the National Screening Program for Transitional Ages (NSPTA). We compared the all-cause mortality between subjects who did and did not participate in the screening program. METHODS This was a nationwide longitudinal study with a 5-year follow-up based on a 10% sample of the National Health Insurance beneficiaries aged 60 years and older. Mortality records were obtained from the qualification dataset in the elderly cohort database of 2005-2013 provided by the National Health Insurance Service. A Cox proportional hazards model was used to analyze the mortality risk. We sampled 11,986 subjects each in the screened (intervention) and non-screened (control) groups after exact matching using propensity score. RESULTS After adjusting for demographic and socioeconomic characteristics (age, sex, household income, smoking, alcohol drinking, physical activity, body mass index, and the Charlson Comorbidity Index), all-cause mortality rates were found to be significantly lower (a) in the intervention group compared to the control group (hazard ratio = 0.73; 95% confidence interval: 0.65, 0.82) and (b) among women compared to men (hazard ratio = 0.50; 95% confidence interval: 0.44, 0.56). Lower hazard ratios were also observed among those with a higher body mass index, fewer comorbidities, and higher income. CONCLUSION A nationwide geriatric screening program might be helpful in reducing the incidence of premature deaths among older people.
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Affiliation(s)
- Kyung-Eun Lee
- Jungbu Area Epidemiologic Investigation Team, Occupational Safety, and Health Research Institute, Incheon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Yunhwan Lee
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Jinhee Kim
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung Kook Ki
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Doukyoung Chon
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Eun-Joo Jung
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Hansung Institute of Industrial Medicine, Gunpo, Republic of Korea
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Edvardsson D, Baxter R, Corneliusson L, Anderson RA, Beeber A, Boas PV, Corazzini K, Gordon AL, Hanratty B, Jacinto A, Lepore M, Leung AYM, McGilton KS, Meyer J, Schols JMGA, Schwartz L, Shepherd V, Skoldunger A, Thompson R, Toles M, Wachholz P, Wang J, Wu B, Zúñiga F. Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life. Gerontol Geriatr Med 2019; 5:2333721419842672. [PMID: 31106240 PMCID: PMC6506925 DOI: 10.1177/2333721419842672] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/07/2019] [Indexed: 12/20/2022] Open
Abstract
To support the development of internationally comparable common data elements
(CDEs) that can be used to measure essential aspects of long-term care (LTC)
across low-, middle-, and high-income countries, a group of researchers in
medicine, nursing, behavioral, and social sciences from 21 different countries
have joined forces and launched the Worldwide Elements to Harmonize Research in
LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop
a common data infrastructure for international use across the domains of
organizational context, workforce and staffing, person-centered care, and care
outcomes, as these are critical to LTC quality, experiences, and outcomes. This
article reports measurement recommendations for the care outcomes domain,
focusing on previously prioritized care outcomes concepts of well-being, quality
of life (QoL), and personhood for residents in LTC. Through literature review
and expert ranking, we recommend nine measures of well-being, QoL, and
personhood, as a basis for developing CDEs for long-term care outcomes across
countries. Data in LTC have often included deficit-oriented measures; while
important, reductions do not necessarily mean that residents are concurrently
experiencing well-being. Enhancing measurement efforts with the inclusion of
these positive LTC outcomes across countries would facilitate international LTC
research and align with global shifts toward healthy aging and person-centered
LTC models.
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Affiliation(s)
- David Edvardsson
- Umeå University, Umeå, Sweden.,La Trobe University, Victoria, Australia
| | | | | | | | - Anna Beeber
- The University of North Carolina at Chapel Hill, NC, USA
| | | | | | | | | | | | | | | | | | | | | | - Lindsay Schwartz
- American Health Care Association/National Center for Assisted Living, Washington, DC, USA
| | | | | | | | - Mark Toles
- The University of North Carolina at Chapel Hill, NC, USA
| | | | | | - Bei Wu
- New York University, New York City, USA
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