"Let's go for a walk!": identification and prioritisation of accessibility and safety measures involving elderly people in a residential area.
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ABSTRACT:
SUBMITTER: Stahl A
PROVIDER: S-EPMC5546335 | biostudies-other | 2008 Sep
REPOSITORIES: biostudies-other
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Project description:BackgroundIn the event of a sudden illness or injury, elderly individuals are often dependent on self-help and mutual assistance from partners. With poor access to medical services during natural and other disasters, the importance of first aid knowledge of elderly individuals increases even more. We assessed the opinions of different generations of Slovenian population regarding the importance of knowing the basic first aid measures. In addition, we aimed to examine the knowledge of first aid in the most common emergencies that threaten elderly people's health and lives, focusing on the knowledge of elderly.MethodsA structured questionnaire was conducted with a representative Slovenian adult population (n = 1079). Statistically significant differences in average ratings of the importance of first aid knowledge were compared among different age groups with one-way ANOVA followed by a post hoc test. Significant differences in percentages of correct answers in particular cases of health conditions between different age groups were determined using the χ 2 test followed by post hoc tests.ResultsSlovenes are well aware of the importance of first aid knowledge and feel personally responsible for acquiring this knowledge. The general opinion is that older retirees need less first aid knowledge than individuals in younger populations. We found a high level of knowledge about symptoms and first aid measures for some of the most common health conditions that occur in old age. The level of knowledge in the group of the oldest respondents was comparable with that of younger age groups. However, their recognition of health conditions was also somewhat worse, especially when recognising the symptoms and signs of hypoglycaemia and heart attack. Most of the tested knowledge did not depend on a person's age but on the time since that person was last educated in first aid.ConclusionsThe knowledge of people older than 80 years is somewhat poorer than that in the younger population, mainly because too much time has passed since they were last educated in first aid. Public awareness of first aid needs to be increased and appropriate guidelines should be given with a focus on the elderly population.
| S-EPMC9281334 | biostudies-literature
Project description:OBJECTIVES:It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities. METHODS:We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights. RESULTS:Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation. DISCUSSION:One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.
| S-EPMC6748711 | biostudies-literature
Project description:BACKGROUND:When healthcare professionals' workloads are greater than available resources, care activities can be missed, omitted or delayed, potentially leading to adverse patient outcomes. Prioritisation, a precursor to missed care, involves decision-making about the order of care task completion based on perceived importance or urgency. Research on prioritisation and missed care has predominantly focused on acute care settings, which differ from residential aged care facilities in terms of funding, structure, staffing levels, skill mix, and approaches to care. The objective of this study was to investigate how care staff prioritise the care provided to residents living in residential aged care. METHODS:Thirty-one staff members from five Australian residential aged care facilities engaged in a Q sorting activity by ranking 34 cards representing different care activities on a pre-defined grid from 'Least important' (-?4) to 'Most important' (+?4). Concurrently, they participated in a think-aloud task, verbalising their decision-making processes. Following sorting, participants completed post-sorting interviews, a demographics questionnaire and semi-structured interviews. Q sort data were analysed using centroid factor analysis and varimax rotation in PQMethod. Factor arrays and data from the think-aloud task, field notes and interviews facilitated interpretation of the resulting factors. RESULTS:A four-factor solution, representing 22 participants and 62% of study variance, satisfied the selection criteria. The four distinct viewpoints represented by the solution were: 1. Prioritisation of clinical care, 2. Prioritisation of activities of daily living, 3. Humanistic approach to the prioritisation of care, and 4. Holistic approach to the prioritisation of care. Participants' prioritisation decisions were largely influenced by their occupations and perceived role responsibilities. Across the four viewpoints, residents having choices about their care ranked as a lower priority. CONCLUSIONS:This study has implications for missed care, as it demonstrates how care tasks deemed outside the scope of staff members' defined roles are often considered a lower priority. Our research also shows that, despite policy regulations mandating person-centred care and the respect of residents' preferences, staff members in residential aged care facilities tend to prioritise more task-oriented aspects of care over person-centredness.
| S-EPMC7222492 | biostudies-literature
Project description:We investigated the conservation concern of Azorean forest fragments and the entire Terceira Island surface using arthropod species vulnerability as defined by the Kattan index, which is based on species rarity. Species rarity was evaluated according to geographical distribution (endemic vs. non endemic species), habitat specialization (distribution across biotopes) and population size (individuals collected in standardized samples). Geographical rarity was considered at 'global' scale (species endemic to the Azorean islands) and 'regional' scale (single island endemics). Measures of species vulnerability were combined into two indices of conservation concern for each forest fragment: (1) the Biodiversity Conservation Concern index, BCC, which reflects the average rarity score of the species present in a site, and (2) one proposed here and termed Biodiversity Conservation Weight, BCW, which reflects the sum of rarity scores of the same species assemblage. BCW was preferable to prioritise the areas with highest number of vulnerable species, whereas BCC helped the identification of areas with few, but highly threatened species due to a combination of different types of rarity.A novel approach is introduced in which BCC and BCW indices were also adapted to deal with probabilities of occurrence instead of presence/absence data. The new probabilistic indices, termed pBCC and pBCW, were applied to Terceira Island for which we modelled species distributions to reconstruct species occurrence with different degree of probability also in areas from which data were not available. The application of the probabilistic indices revealed that some island sectors occupied by secondary vegetation, and hence not included in the current set of protected areas, may in fact host some rare species. This result suggests that protecting marginal non-natural areas which are however reservoirs of vulnerable species may also be important, especially when areas with well preserved primary habitats are scarce.
| S-EPMC3316514 | biostudies-literature
Project description:BackgroundA residential area supportive for walking may facilitate elderly to live longer independently. However, current evidence on area characteristics potentially important for walking among older persons is mixed. This study hypothesized that the importance of area characteristics for transportational walking depends on the size of the area characteristics measured, and older person's frailty level.MethodsThe study population consisted of 408 Dutch community-dwelling persons aged 65 years and older participating in the Elderly And their Neighborhood (ELANE) study in 2011-2012. Characteristics (aesthetics, functional features, safety, and destinations) of areas surrounding participants' residences ranging from a buffer of 400 meters up to 1600 meters (based on walking path networks) were linked with self-reported transportational walking using linear regression analyses. In addition, interaction effects between frailty level and area characteristics were tested.ResultsAn increase in functional features (e.g. presence of sidewalks and benches) within a 400 meter buffer, in aesthetics (e.g. absence of litter and graffiti) within 800 and 1200 meter buffers, and an increase of one destination per buffer of 400 and 800 meters were associated with more transportational walking, up to 2.89 minutes per two weeks (CI 1.07-7.32; p < 0.05). No differences were found between frail and non-frail elderly.ConclusionsBetter functional and aesthetic features, and more destinations in the residential area of community-dwelling older persons were associated with more transportational walking. The importance of area characteristics for transportational walking differs by area size, but not by frailty level. Neighbourhood improvements may increase transportational walking among older persons, thereby contributing to living longer independently.
| S-EPMC4015736 | biostudies-literature
Project description:Interaction between different chromatin regions plays critical roles in genome organization and regulation of transcription. Existing technologies of analyzing genome-wide chromatin interactions rely on in vitro proximity-based ligation of interacting chromatin fragments and thus are prone to potential artifacts. We now report a novel technique, Transposase-mediated Analysis of Chromatin loops (TrAC-loop), for detection of genome-wide chromatin interactions between regulatory regions. With this technique, a bivalent oligonucleotide linker is inserted between two interacting chromatin regions such that the distant interacting chromatin regions can be directly amplified by PCR and thus avoids the prior chromatin fragmentation and subsequent error-prone re-ligation steps. TrAC-loop selectively targets accessible regions, which effectively reduces the sequencing cost for detecting promoter-enhancer interactions at high resolution. Application of TrAC-loop to human CD4+ T cells reveals a substantial reorganization of enhancer-promoter interaction associated with changes in gene expression upon TCR stimulation.
2018-07-12 | GSE87254 | GEO
Project description:BackgroundSophisticated approaches are needed to improve the quality of care for elderly people living in residential care facilities. We determined the effects of multidisciplinary integrated care on the quality of care and quality of life for elderly people in residential care facilities.MethodsWe performed a cluster randomized controlled trial involving 10 residential care facilities in the Netherlands that included 340 participating residents with physical or cognitive disabilities. Five of the facilities applied multidisciplinary integrated care, and five provided usual care. The intervention, inspired by the disease management model, consisted of a geriatric assessment of functional health every three months. The assessment included use of the Long-term Care Facility version of the Resident Assessment Instrument by trained nurse-assistants to guide the design of an individualized care plan; discussion of outcomes and care priorities with the family physician, the resident and his or her family; and monthly multidisciplinary meetings with the nurse-assistant, family physician, psychologist and geriatrician to discuss residents with complex needs. The primary outcome was the sum score of 32 risk-adjusted quality-of-care indicators.ResultsCompared with the facilities that provided usual care, the intervention facilities had a significantly higher sum score of the 32 quality-of-care indicators (mean difference - 6.7, p = 0.009; a medium effect size of 0.72). They also had significantly higher scores for 11 of the 32 indicators of good care in the areas of communication, delirium, behaviour, continence, pain and use of antipsychotic agents.InterpretationMultidisciplinary integrated care resulted in improved quality of care for elderly people in residential care facilities compared with usual care.Trial registrationwww.controlled-trials.com trial register no. ISRCTN11076857.
| S-EPMC3153543 | biostudies-literature
Project description:Today, falls constitute a substantial health problem, especially in the elderly, and the diagnostic tests used by clinicians present often a low sensitivity and specificity. This is the case for the Timed Up and Go test which lacks contextualization with regard to everyday life limiting the relevance of its diagnosis. Virtual reality enables the creation of immersive, reproducible and secure environments, close to situations encountered in daily life, and as such could improve falling risk assessment. This study aims to evaluate the effect of immersive virtual reality by wearing a virtual reality headset with a non-disturbing virtual environment compared to real world on the Timed Up and Go test completion. Thirty-one elders (73.7 ± 9 years old) volunteered to participate in the study and the mean times and number of steps to complete a Timed Up and Go were compared in two conditions: actual-world clinical and virtual reality conditions. The results showed that the mean completion times and most of the mean number of steps of the Timed Up and Go in virtual reality condition were significantly different to those in clinical condition. These results suggest that there is a virtual reality effect and this effect is significantly correlated to the time taken to complete the Timed Up and Go. This information will be of interest to quantify the potential part of virtual reality effect on the motor control, measured in a virtual task using virtual controlled disturbances.
| S-EPMC7069621 | biostudies-literature
Project description:Long-range chromatin interactions play critical roles in genome organization and regulation of transcription. We now report transposase-mediated analysis of chromatin looping (Trac-looping) for simultaneous detection of multiscale genome-wide chromatin interactions among regulatory elements and chromatin accessibility. With this technique, a bivalent oligonucleotide linker is inserted between two interacting regions such that the chromatin interactions are captured without prior chromatin fragmentation and proximity-based ligation. Application of Trac-looping to human CD4+ T cells revealed substantial reorganization of enhancer-promoter interactions associated with changes in gene expression after T cell receptor stimulation.
| S-EPMC7212307 | biostudies-literature
Project description:This analysis estimates the whole-of-system direct costs for people living with dementia in residential care by using a broad health and social care provision perspective and compares it to people without dementia living in residential care.Data were collected from 541 individuals living permanently in 17 care facilities across Australia. The annual cost of health and residential care was determined by using individual resource use data and reported by the dementia status of the individuals.The average annual whole-of-system cost for people living with dementia in residential care was approximately AU$88 000 (US$ 67 100) per person in 2016. The cost of residential care constituted 93% of the total costs. The direct health care costs were comprised mainly of hospital admissions (48%), pharmaceuticals (31%) and out-of-hospital attendances (15%). While total costs were not significantly different between those with and without dementia, the cost of residential care was significantly higher and the cost of health care was significantly lower for people living with dementia.This study provides the first estimate of the whole-of-system costs of providing health and residential care for people living with dementia in residential aged care in Australia using individual level health and social care data. This predominantly bottom-up cost estimate indicates the high cost associated with caring for people with dementia living permanently in residential care, which is underestimated when limited cost perspectives or top-down, population costing approaches are taken.
| S-EPMC6032872 | biostudies-other