Zhang, Xin; Fung, Helene H; Stanley, Jennifer T; Isaacowitz, Derek M; Ho, Man Yee
How perspective-taking ability changes with age (i.e., whether older adults are better at understanding others' behaviors and intentions and show greater empathy to others or not) is not clear, with prior empirical findings on this phenomenon yielding mixed results. In a series of experiments, we investigated the phenomenon from a motivational perspective. Perceived closeness between participants and the experimenter (Study 1) or the target in an emotion recognition task (Study 2) was manipulated to examine whether the closeness could influence participants' performance in faux pas recognition (Study 1) and emotion recognition (Study 2). It was found that the well-documented negative age effect (i.e., older adults performed worse than younger adults in faux pas and emotion recognition tasks) was only replicated in the control condition for both tasks. When closeness was experimentally increased, older adults enhanced their performance, and they now performed at a comparable level as younger adults. Findings from the 2 experiments suggest that the reported poorer performance of older adults in perspective-taking tasks might be attributable to a lack of motivation instead of ability to perform in laboratory settings. With the presence of strong motivation, older adults have the ability to perform equally well as younger adults.
Conejero, Ismael; Olié, Emilie; Courtet, Philippe; Calati, Raffaella
Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. PMID:29719381
Full Text Available Ismael Conejero,1,2 Emilie Olié,1–3 Philippe Courtet,1–3 Raffaella Calati1–3 1Institut National de la Santé Et de la Recherche Médicale (INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; 2Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU Montpellier, Montpellier, France; 3FondaMental Foundation, Créteil, France Abstract: Suicidal behavior in older adults (65 years old and over is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. Keywords: suicide, attempted suicide, older adults, risk
Khabra, K K; Compton, S M; Keenan, L P
The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
As an older woman therapist, I find that my life experience grounds me in my work with people of all ages and backgrounds as they deal with life crises, aging issues, and loss. People with whom I work in therapy appreciate the fact that I am older and have had varied life experiences. Gender issues are still central to my work with clients whether I am working with a man or a woman. I am an integrative therapist, with a background in cognitive-behavioral therapy and gestalt therapy. Therapists need to help clients to identify less with their aging bodies and our culture's view of attractiveness, shifting instead to a paradigm that values life experience and the cultivation of wisdom. We need to find ways of embracing what we have learned about life instead of extolling youthful values. As I get older, I more fully appreciate a constructivism framework and life-cycle perspective, focusing on making sense of clients' life narratives. Storytelling and memoirs have both provided a framework for working with clients on coping with the many changes and challenges of life that bring them to therapy and added another layer to my integrative therapeutic work. © 2015 Wiley Periodicals, Inc.
Poortman, A.; van Tilburg, T.
In this study we apply a lifecourse perspective to an examination of older adults' attitudes about gender roles and moral issues. The study goes beyond previous research in that it examines the relationships between older adults' attitudes and: (a) experiences in the parental home, (b) people's own
Chen, Tao; Liu, Lu-Lu; Cui, Ji-Fang; Chen, Xing-Jie; Wang, Ya
Time perspective is a fundamental dimension of the psychological time construct, with a pervasive and powerful influence on human behavior. However, the developmental trajectory of time perspective across a human lifespan remains unclear. The current study aimed to portray the developmental trajectory of all dimensions of time perspectives from children to older adults in a large sample. A total of 1,901 individuals (aged 9-84 years) completed measures of time perspective. They were then divided into five age groups: children, teenagers, young adults, middle-aged adults, and older adults. Results suggested that each time perspective showed a unique developmental pattern across the lifespan. Moreover, perceived economic situation and education were related to some dimensions of time perspective. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.
Drewes, Yvonne M; Koenen, Julia M; de Ruijter, Wouter; van Dijk-van Dijk, D J Annemarie; van der Weele, Gerda M; Middelkoop, Barend J C; Reis, Ria; Assendelft, Willem J J; Gussekloo, Jacobijn
Preventive care traditionally aims to prevent diseases or injuries. For older people, different aims of prevention, such as maintenance of independence and wellbeing, are increasingly important. To explore GPs' perspectives on preventive care for older people. Qualitative study comprising six focus groups with GPs in the Netherlands. The focus-group discussions with 37 GPs were analysed using the framework analysis method. Whether or not to implement preventive care for older people depends on the patient's individual level of vitality, as perceived by the GP. For older people with a high level of vitality, GPs confine their role to standardised disease-oriented prevention on a patient's request; when the vitality levels in older people fall, the scope of preventive care shifts from prevention of disease to prevention of functional decline. For older, vulnerable people, GPs expect most benefit from a proactive, individualised approach, enabling them to live as independently as possible. Based on these perspectives, a conceptual model for preventive care was developed, which describes GPs' different perspectives toward older people who are vulnerable and those with high levels of vitality. It focuses on five main dimensions: aim of care (prevention of disease versus prevention of functional decline), concept of care (disease model versus functional model), initiator (older persons themselves versus GP), target groups (people with requests versus specified risk groups), and content of preventive care (mainly cardiovascular risk management versus functional decline). GPs' perspectives on preventive care are determined by their perception of the level of vitality of their older patients. Preventive care for older people with high levels of vitality may consist of a standardised disease-oriented approach; those who are vulnerable will need an individualised approach to prevent functional decline.
Full Text Available This paper explores some important theoretical questions on the relationship between sports and older people, beyond the health perspective. Sport has been attributed numerous social functions and meanings. Also policymakers have experimented with the use of sport for social purposes. However, both research and poli cy initiatives are in general cons idered from a functional and instrumental point of view. Especially considering older people sport is mainly approached from a health perspective. A combination of insights from gerontology and sport sciences should help us gain a better view on how sport can contribute to the social integration of older people. This paper offers an extensive literature review focusing on formulating opportunities for further research about sport participation among older people.
Kasif, Talia; Band-Winterstein, Tova
Sexuality is a significant component in human experience and has an important impact on the individual's general well-being. Life course events and the social construction of sexuality lead older widows to reflect upon their sexuality. To explore and describe the ways in which older widows construct and perceive their sexuality along the life course. A phenomenological-qualitative approach was conducted. Data collection was performed through in-depth, semi-structured interviews with 17 widows, between the ages of 62-91, followed by content analysis. Three major themes emerged: (a) Approaching sexuality: Conservative vs. progressive attitudes; (b) Multiple ways of perceiving sexuality: Constructing a sexual identity along the life course; and (c) Sexual self-perception: Integrating late life and widowhood. Sexuality among widows in later life includes continuity and change processes. In the context of social construction, sexuality is a subject that should be examined in greater depth. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Kylie Johnston1, Karen Grimmer-Somers1, Michele Sutherland21International Centre for Allied Health Evidence, University of South Australia, Adelaide; 2Falls Prevention Unit, Department of Health, Government of South Australia, Adelaide, AustraliaBackground: Personal alarms are proposed as a reliable mechanism for older people to obtain assistance after falling. However, little is known about how older people feel about owning and using personal alarms.Aim: This paper reports on experiences of independently living older people, who have recently fallen, regarding alarm use and their independence.Method: Volunteers older than 65 years who had sustained a fall in the previous six months were sought via community invitations. Semistructured telephone interviews were conducted to gain information about their fall and their perspectives on personal alarm use. Interviews were content-analyzed to identify key concepts and themes.Results: Thirty-one interviews were conducted. Twenty callers owned personal alarms. Four subgroups of older fallers were identified; the first group used personal alarms effectively and were advocates for their benefits, the second group owned an alarm but did not use it effectively, the third group did not own alarms mostly because of cost, although were receptive to an alarm should one be provided, and the fourth group did not have an alarm and would not use it even if it was provided.Discussion: Personal alarms produce positive experiences when used effectively by the right people. The cost of personal alarms prohibits some older fallers from being effective alarm users. However, other elderly fallers remain unwilling to consider alarm use even if one was provided. In view of their cost, personal alarms should be targeted to people who will benefit most. Alternative strategies should be considered when alarms are unlikely to be used appropriately.Keywords: personal alarm devices, falls, older people, patient perspective
Verweij, L.M.; Wehrens, R.; Oldenhof, L.; Bal, R.; Francke, A.L.
Background: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program
Verweij, L.M. (Lisanne Marlieke); R.L.E. Wehrens (Rik); L.E. Oldenhof (Lieke); R.A. Bal (Roland); Francke, A.L. (Anneke)
textabstractBackground: The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide
Full Text Available Dejana Braithwaite,1 Joshua Demb,1 Louise M Henderson2 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 2Department of Radiology, University of North Carolina, Chapel Hill, NC, USA Abstract: Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. Keywords: aging, breast cancer, precision cancer screening
Kim, Suk-Sun; Hayward, R David; Reed, Pamela G
This study used structural equation modeling to test the mediated model of late-life depression to understand the mechanisms that account for the direct and indirect effects of spiritual variables and purpose in life on depression within the context of Korean family caregiving relationships. A secondary analysis study design used data from a study that tested a theory of family interdependence of 157 Korean elder-family caregiver dyads in Seoul, Korea. Both caregivers' and elders' self-transcendence was positively related to their own sense of purpose in life. However, only elders' spiritual perspective was related to purpose in life. Also, elders' purpose in life was positively associated with caregivers' purpose in life. Furthermore, there was a strong negative relationship between elders' purpose in life and their depressive symptoms, but there was not a significant negative relationship between caregivers' purpose in life and elders' depressive symptoms. Last, elders' purpose in life mediated the negative effects of elders' self-transcendence and spiritual perspective and of caregivers' self-transcendence and purpose in life on elders' depression. The findings suggest that purpose in life for both the caregiver and elder played an important role in elders' depression. Self-transcendence also was related to decreased depression in elders. It is suggested that more attention be given to caregiver and elder purpose in life in developing interventions to reduce or avoid elder depression in Korean elders.
Exploring access to care among older people in the last phase of life using the behavioural model of health services use: a qualitative study from the perspective of the next of kin of older persons who had died in a nursing home.
Condelius, Anna; Andersson, Magdalena
There is little investigation into what care older people access during the last phase of their life and what factors enable access to care in this group. Illuminating this from the perspective of the next of kin may provide valuable insights into how the health and social care system operates with reference to providing care for this vulnerable group. The behavioural model of health services use has a wide field of application but has not been tested conceptually regarding access to care from the perspective of the next of kin. The aim of this study was to explore the care accessed by older people during the last phase of their life from the perspective of the next of kin and to conceptually test the behavioural model of health services use. The data collection took place in 2011 by means of qualitative interviews with 14 next of kin of older people who had died in a nursing home. The interviews were analysed using directed content analysis. The behavioural model of health services use was used in deriving the initial coding scheme, including the categories: utilization of health services, consumer satisfaction and characteristics of the population at risk. Utilization of health services in the last phase of life was described in five subcategories named after the type of care accessed i.e. admission to a nursing home, primary healthcare, hospital care, dental care and informal care. The needs were illuminated in the subcategories: general deterioration, medical conditions and acute illness and deterioration when death approaches. Factors that enabled access to care were described in three subcategories: the organisation of care, next of kin and the older person. These factors could also constitute barriers to accessing care. Next of kin's satisfaction with care was illuminated in the subcategories: satisfaction, dissatisfaction and factors influencing satisfaction. One new category was constructed inductively: the situation of the next of kin. A bed in a nursing
Full Text Available Background: Approaches for investigating health-promoting lifestyle generally focus on physical activity and regular diet. To explore the perspectives of Iranian elders regarding health, healthy eating and physical activity (PA this study was conducted in 2012. Methods: Participants in this qualitative study were selected through purposeful sampling. Ten focus groups were conducted with 60 older adults in 3 elderly centers in Tehran. A moderator’s guideline that consisted of general and specific questions was used. Focus groups were audio recorded, transcribed verbatim and analysis was performed using conventional content analysis. Results: Participants explained their perspectives regarding health, healthy eating and PA in the following 5 categories: meaning of health was represented based on issues such as absence of pain and disorder, complete body wellbeing, staying away from hazards, complete individual satisfaction, experiencing positive events, effective communication, faithfulness and trust in God. The healthy eating category was featured by adequate eating, age balanced diet, refraining from under or over nutrition and sensible consumption of fruits and vegetables. The PA was described - according to the level of performing outdoor activities or household tasks. Expressions about the perceived benefits and barriers of healthy eating and PA were aligned the two remaining categories. Conclusions: Participants have referred to the association between both PA and dietary practices and health. Understanding how older people define physical activity and nutritional behavior and recognition of the most important perceived benefits and barriers that might contribute to have a healthy eating or adequate PA profile could procure insight into the type of interventions that are required to promote healthy lifestyle among Iranian older adults.
Frins, W.; Ruysseveldt, J. van; Dam, K. van; Bossche, S.N.J. van den
Purpose. Using the job demands-resources (JD-R) model as a theoretical framework, the purpose of this paper is to investigate how job demands and job resources affect older employees’ desired retirement age, through an energy-depletion and a motivational process. Furthermore, the importance of gain
Pinter, Jule; Hanson, Camilla S; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C; Schell, Jane O; Tong, Allison
Older kidney transplant recipients are susceptible to cognitive impairment, frailty, comorbidities, immunosuppression-related complications, and chronic graft failure, however, there has been limited focus on their concerns and expectations related to transplantation. This study aims to describe the perspectives of older kidney transplant recipients about their experience of kidney transplantation, self-management, and treatment goals to inform strategies and interventions that address their specific needs. Face-to-face semistructured interviews were conducted with 30 kidney transplant recipients aged 65-80 years from five renal units in Australia. Transcripts were analyzed thematically. Six themes were identified: restoring vitality of youth (with subthemes of revived mindset for resilience, embracing enjoyment in life, drive for self-actualization); persisting through prolonged recovery (yielding to aging, accepting functional limitations, pushing the limit, enduring treatment responsibilities); imposing sicknesses (combatting devastating comorbidities, painful restrictions, emerging disillusionment, anxieties about accumulating side effects, consuming treatment burden); prioritizing graft survival (privileged with a miracle, negotiating risks for longevity, enacting a moral duty, preserving the last opportunity); confronting health deterioration (vulnerability and helplessness, narrowing focus to immediate concerns, uncertainty of survival); and value of existence (purpose through autonomy, refusing the burden of futile treatment, staying alive by all means). Older kidney transplant recipients felt able to enjoy life and strived to live at their newly re-established potential and capability, which motivated them to protect their graft. However, some felt constrained by slow recuperation and overwhelmed by unexpected comorbidities, medication-related side effects, and health decline. Our findings suggest the need to prepare and support older recipients for self
Full Text Available Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge. Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood.
Strough, JoNell; de Bruin, Wändi Bruine; Peters, Ellen
Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood. PMID:26157398
Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L
The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals
Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L S; Seidell, Jacob C; Slaets, Joris P J; Smits, Carolien H M
Objective: This study explores older adults' perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative
West, Robin L.; Hastings, Erin C.
Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-effi...
Huh, Jina; Le, Thai; Reeder, Blaine; Thompson, Hilaire J; Demiris, George
Our purpose was to understand different stakeholder perceptions about the use of self-monitoring tools, specifically in the area of older adults' personal wellness. In conjunction with the advent of personal health records, tracking personal health using self-monitoring technologies shows promising patient support opportunities. While clinicians' tools for monitoring of older adults have been explored, we know little about how older adults may self-monitor their wellness and health and how their health care providers would perceive such use. We conducted three focus groups with health care providers (n=10) and four focus groups with community-dwelling older adults (n=31). Older adult participants' found the concept of self-monitoring unfamiliar and this influenced a narrowed interest in the use of wellness self-monitoring tools. On the other hand, health care provider participants showed open attitudes toward wellness monitoring tools for older adults and brainstormed about various stakeholders' use cases. The two participant groups showed diverging perceptions in terms of: perceived uses, stakeholder interests, information ownership and control, and sharing of wellness monitoring tools. Our paper provides implications and solutions for how older adults' wellness self-monitoring tools can enhance patient-health care provider interaction, patient education, and improvement in overall wellness. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Huh, Jina; Le, Thai; Reeder, Blaine; Thompson, Hilaire J.; Demiris, George
Purpose Our purpose was to understand different stakeholder perceptions about the use of self-monitoring tools, specifically in the area of older adults’ personal wellness. In conjunction with the advent of personal health records, tracking personal health using self-monitoring technologies shows promising patient support opportunities. While clinicians’ tools for monitoring of older adults have been explored, we know little about how older adults may self-monitor their wellness and health and how their health care providers would perceive such use. Methods We conducted three focus groups with health care providers (n=10) and four focus groups with community-dwelling older adults (n=31). Results Older adult participants’ found the concept of self-monitoring unfamiliar and this influenced a narrowed interest in the use of wellness self-monitoring tools. On the other hand, health care provider participants showed open attitudes towards wellness monitoring tools for older adults and brainstormed about various stakeholders’ use cases. The two participant groups showed diverging perceptions in terms of: perceived uses, stakeholder interests, information ownership and control, and sharing of wellness monitoring tools. Conclusions Our paper provides implications and solutions for how older adults’ wellness self-monitoring tools can enhance patient-health care provider interaction, patient education, and improvement in overall wellness. PMID:24041452
Demeyer, Ineke; De Raedt, Rudi
Research suggests that older adults display a positivity bias at the level of information processing. However, because studies investigating attentional bias for emotional information in older adults have produced mixed findings, research identifying inter-individual differences that may explain these inconsistent results is necessary. Therefore, we investigated whether mood, symptoms of depression, symptoms of anxiety and future time perspective are related to attentional bias in older adults. Thirty-seven healthy older adults and 25 healthy middle-aged adults completed questionnaires to assess mood, symptoms of depression, symptoms of anxiety and future time perspective. Attentional bias towards happy, sad and neutral information was measured using a modified exogenous cueing paradigm with long cue presentations, to measure maintained attention versus avoidance of emotional stimuli. Older adults showed attentional avoidance for all emotional faces, whereas no attentional biases were found in the middle-aged group. Moreover, in the older adult group, avoidance for negative information was related to anxiety. Future time perspective was unrelated to attentional bias. These findings suggest that anxiety may lead to inter-individual differences in attentional bias in older adults, and that avoidance from negative information may be an emotion regulation strategy.
Buchacz, Kate; Gebo, Kelly A.; Mermin, Jonathan
HIV disease is often perceived as a condition affecting young adults. However, approximately 11% of new infections occur in adults aged 50 years or older. Among persons living with HIV disease, it is estimated that more than half will be aged 50 years or older in the near future. In this review, we highlight issues related to HIV prevention and treatment for HIV-uninfected and HIV-infected older Americans, and outline unique considerations and emerging challenges for public health and patient management in these 2 populations. PMID:22698038
Ferrari, Lea; Nota, Laura; Soresi, Salvatore
Career choices involve an orientation towards the future and the propensity to planning. The "mental picture" of the past, present and future was defined by Savickas as time perspective. The present paper reports the findings of two studies examining time perspective in Italian adolescents. The first study surveyed 498 students aged…
This report, “Data Sources Available for Modeling Environmental Exposures in Older Adults,” focuses on information sources and data available for modeling environmental exposures in the older U.S. population, defined here to be people 60 years and older, with an emphasis on those...
Fox, Mary T; Butler, Jeffrey I
To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities. Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care. Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed. Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency. Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context. The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency. © 2016 John Wiley & Sons Ltd.
Spinney, Jamie E L
Numerous health benefits are associated with a physically active population. This study sought to discover the aerobic activity preferences among older Canadians. Four cycles of nationally representative time use data were fused with energy expenditure information to determine both participation rates and time spent in the 10 most frequently reported aerobic activities. Aerobic activity preferences are dominated by domestic chores (15% to 30% participation for about two hours per day), recreational walking (15% to 30% participation for about one hour per day), and active transportation (generally less than 5% participation for less than 30 minutes per day). Although there have been several changes in older Canadians’ revealed preferences for aerobic activities over the past three decades, the prevalence of domestic chores points towards the importance of policies that support older Canadians remaining in their homes, whereas the popularity of walking suggests that “walkability” needs to be considered in neighbourhood design.
Banerjee, S. [Univ. of California, Santa Barbara, CA (United States)
Multifield models for prediction of nuclear reactor thermalhydraulics are reviewed from the viewpoint of their structure and requirements for closure relationships. Their strengths and weaknesses are illustrated with examples, indicating that they are effective in predicting separated and distributed flow regimes, but have problems for flows with large oscillations. Needs for multifield models are also discussed in the context of reactor operations and accident simulations. The highest priorities for future developments appear to relate to closure relationships for three-dimensional multifield models with emphasis on those needed for calculations of phase separation and entrainment/de-entrainment in complex geometries.
Multifield models for prediction of nuclear reactor thermalhydraulics are reviewed from the viewpoint of their structure and requirements for closure relationships. Their strengths and weaknesses are illustrated with examples, indicating that they are effective in predicting separated and distributed flow regimes, but have problems for flows with large oscillations. Needs for multifield models are also discussed in the context of reactor operations and accident simulations. The highest priorities for future developments appear to relate to closure relationships for three-dimensional multifield models with emphasis on those needed for calculations of phase separation and entrainment/de-entrainment in complex geometries
Marston, Hannah R.
There were two objectives to this study: (a) to establish flow and (2) to establish whether computer game interaction or content was important to the older adult, using the Nintendo Wii and the Sony PlayStation 2 consoles. An earlier study had identified the sports genre as a preference, and three games (golf, tennis, and boxing) were selected…
Hank, Karsten; Jurges, Hendrik
Using microdata from the 2004 Survey of Health, Ageing and Retirement in Europe (SHARE), this study takes a cross-national perspective to investigate the division of household labor among older couples (aged 50 years or more). Across nine continental European countries, the authors find considerable variation in the overall distribution of…
Ferrer, Ilyan; Grenier, Amanda; Brotman, Shari; Koehn, Sharon
This article proposes the development of an intersectional life course perspective that is capable of exploring the links between structural inequalities and the lived experience of aging among racialized older people. Merging key concepts from intersectionality and life course perspectives, the authors suggest an analytic approach to better account for the connections between individual narratives and systems of domination that impinge upon the everyday lives of racialized older people. Our proposed intersectional life course perspective includes four dimensions: 1) identifying key events and their timing, 2) examining locally and globally linked lives, 3) exploring categories of difference and how they shape identities, 4) and assessing how processes of differentiation, and systems of domination shape the lives, agency and resistance among older people. Although applicable to various forms of marginalization, we examine the interplay of racialization, immigration, labour and care in later life to highlight relationships between systems, events, trajectories, and linked lives. The illustrative case example used in this paper emerged from a larger critical ethnographic study of aging in the Filipino community in Montreal, Canada. We suggest that an intersectional life course perspective has the potential to facilitate a deeper understanding of the nexus of structural, personal and relational processes that are experienced by diverse groups of older people across the life course and into late life. Copyright © 2017 Elsevier Inc. All rights reserved.
Bindels, J.; Cox, K.; Abma, T.A.; van Schayck, O.C.P.; Widdershoven, G.
Objective: To examine the issues that influenced the implementation of programmes designed to identify and support frail older people in the community in the Netherlands. Methods: Qualitative research methods were used to investigate the perspectives of project leaders, project members and members
Full Text Available There are various theories, strategies and techniques regarding teaching different language skills. At the same time, as practice shows listening remains the most challenging skill for the educators to teach effectively and for the learners to master. Moreover, both the learners and their teachers have their own, not infrequently rather disparate, subjective theories, as well as learning and teaching preferences. Older adult learners are a peculiar case as they are a very diverse group, aware of their needs and cognitive abilities. At the same time, their teachers are unfortunately often unaware of these needs and do not adapt the materials to suit their students. The aim of this paper is, thus, to present the opinions of the teachers of older adult students and to provide basis for future research.
Olivia Lee Pethtel
Full Text Available The purpose of the present study was to examine the present fatalistic time perspective as a mechanism that may partially account for age differences in purpose in life and personal growth. An additional purpose of this study was to explore the relations among age, time perspective, and psychological well-being. Seventy-five older adults (M=73.43, SD=7.91 and 77 younger adults (M=19.58, SD=1.19 completed surveys measuring time perspective (past positive, past negative, present fatalistic, present hedonistic, future and psychological well-being (autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Hierarchical regression analyses revealed that the present fatalistic time perspective predicted purpose in life and personal growth above and beyond age and income. Several significant correlations were found among the time perspective and psychological well-being variables. Results showed that age was positively correlated with the past negative and present fatalistic time perspectives, but negatively correlated with the future time perspective. Results showed that age negatively correlated with purpose in life and personal growth, but positively correlated with autonomy. Results are discussed in light of socioemotional selectivity theory, theory of time perspective, and implications for incorporating time perspective into mental health counseling.
Walsh, Bronagh; Lattimer, Valerie; Wintrup, Julie; Brailsford, Sally
There is debate worldwide about the best way to manage increased healthcare demand within ageing populations, particularly rising rates of unplanned and avoidable hospital admissions. To understand health and social care professionals' perspectives on barriers to admission avoidance throughout the admissions journey, in particular: the causes of avoidable admissions in older people; drivers of admission and barriers to use of admission avoidance strategies; and improvements to reduce unnecessary admissions. A qualitative framework analysis of interview data from a System dynamics (SD) modelling study. Semi-structured interviews were conducted with twenty health and social care professionals with experience of older people's admissions. The interviews were used to build understanding of factors facilitating or hindering admission avoidance across the admissions system. Data were analysed using framework analysis. Three overarching themes emerged: understanding the needs of the patient group; understanding the whole system; and systemwide access to expertise in care of older people. There were diverse views on the underlying reasons for avoidable admissions and recognition of the need for whole-system approaches to service redesign. Participants recommended system redesign that recognises the specific needs of older people, but there was no consensus on underlying patient needs or specific service developments. Access to expertise in management of older and frailer patients was seen as a barrier to admission avoidance throughout the system. Providing access to expertise and leadership in care of frail older people across the admissions system presents a challenge for service managers and nurse educators but is seen as a prerequisite for effective admission avoidance. System redesign to meet the needs of frail older people requires agreement on causes of avoidable admission and underlying patient needs. © 2014 John Wiley & Sons Ltd.
Segerstrom, Suzanne C; Geiger, Paul J; Combs, Hannah L; Boggero, Ian A
Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, 1 with younger adults (N = 101) and 1 with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Charlton, Kimberly; Murray, Carolyn M; Kumar, Saravana
Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67-89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn't fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups. Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling. Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.
Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long
Lette, Manon; Stoop, Annerieke; Lemmens, Lidwien C; Buist, Yvette; Baan, Caroline A; de Bruin, Simone R
A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people's needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people's perspectives on health and living environment in relation to living independently at home; 2) older people's needs and preferences in relation to initiating and receiving care and support; and 3) professionals' views on what would be necessary to enable the alignment of early detection initiatives with older people's own needs and preferences. In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method. From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues. Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed
Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that
de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana
The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.
Karki, Sushmita; Bhatta, Dharma Nand; Aryal, Umesh Raj
Background Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people’s perspectives on an “elderly-friendly” hospital. Methods Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people’s health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that focus on older people’s health benefits and friendly services. PMID:26028980
Ke, Li-Shan; Huang, Xiaoyan; Hu, Wen-Yu; O'Connor, Margaret; Lee, Susan
Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. To understand the experiences and perspectives of older people regarding advance care planning. A systematic review of qualitative studies and meta-synthesis was conducted. CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people's willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Older people's perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people's attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.
Abu Al Hamayel, Nebras; Isenberg, Sarina R; Hannum, Susan M; Sixon, Joshua; Smith, Katherine Clegg; Dy, Sydney M
Despite increased focus on measuring and improving quality of serious illness care, there has been little emphasis on the primary care context or incorporation of the patient perspective. To explore older patients' perspectives on the quality of serious illness care in primary care. Qualitative interview study. Twenty patients aged 60 or older who were at risk for or living with serious illness and who had participated in the clinic's quality improvement initiative. We used a semistructured, open-ended guide focusing on how older patients perceived quality of serious illness care, particularly in primary care. We transcribed interviews verbatim and inductively identified codes. We identified emergent themes using a thematic and constant comparative method. We identified 5 key themes: (1) the importance of patient-centered communication, (2) coordination of care, (3) the shared decision-making process, (4) clinician competence, and (5) access to care. Communication was an overarching theme that facilitated coordination of care between patients and their clinicians, empowered patients for shared decision-making, related to clinicians' perceived competence, and enabled access to primary and specialty care. Although access to care is not traditionally considered an aspect of quality, patients considered this integral to the quality of care they received. Patients perceived serious illness care as a key aspect of quality in primary care. Efforts to improve quality measurement and implementation of quality improvement initiatives in serious illness care should consider these aspects of care that patients deem important, particularly communication as an overarching priority.
van Gennip, Isis E; Pasman, H Roeline W; Kaspers, Pam J; Oosterveld-Vlug, Mariska G; Willems, Dick L; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D
Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1) To assess the prevalence of death with dignity in older adults from the perspective of family caregivers, (2) to determine factors that diminish dignity during the dying phase according to family caregivers, and (3) to identify physical, psychosocial, and care factors associated with death with dignity. A survey study with a self-administered questionnaire. Family caregivers of 163 deceased older (>55 years of age) adults ("patients") who had participated in the Longitudinal Aging Study Amsterdam. Of the family caregivers, 69% reported that their relative had died with dignity. Factors associated with a dignified death in a multivariate regression model were patients feeling peaceful and ready to die, absence of anxiety and depressive mood, presence of fatigue, and a clear explanation by the physician of treatment options during the final months of life. The physical and psychosocial condition of the patient in combination with care factors contributed to death with dignity from the perspective of the family caregiver. The patient's state of mind during the last phase of life and clear communication on the part of the physician both seem to be of particular importance.
Ayalon, Liat; Roziner, Ilan
Given the increasing reliance on both formal (paid) and informal (unpaid) assistance for the care of older adults and the close relationships which are often formed with home care workers, the present study evaluated satisfaction with the relationship from the perspectives of the three members that make up the home caregiving triad: older adults, their family members and their home care workers. We relied on a representative sample of 223 complete caregiving triads composed of an older adult, a family member and a home care worker. Each of the members rated his or her level of satisfaction with all other members in the unit, using a seven-item self-report satisfaction with the relationship scale (e.g., satisfaction with communication, intimacy). The Social Relations Model (SRM) was used to partial out the specific variance associated with each of the members as either an actor (i.e., the average satisfaction as a rater, unrelated to whom the person rates) or a partner (i.e., the unique satisfaction level elicited by a person, which is consistent across all ratings of this person). The structural equations model yielded acceptable results: χ²(3) = 6.94, p = .07. Our analysis revealed that the variability associated with the worker as partner was significantly greater than the variability associated with the older adult as partner (∆χ²  = 9.21, p = .002) or with the family member as partner (∆χ²  = 8.46, p = .004). The study highlights the importance of studying satisfaction with the relationship in the home care setting and calls for further examination of the entire caregiving triad. The home care worker plays a key role in ensuring the overall satisfaction in the caregiving triad.
Wrosch, Carsten; Jobin, Joelle; Scheier, Michael F
This study examined whether the emotional benefits of dispositional optimism for managing stressful encounters decrease across older adulthood. Such an effect might emerge because age-related declines in opportunities for overcoming stressors could reduce the effectiveness of optimism. This hypothesis was tested in a 6-year longitudinal study of 171 community-dwelling older adults (age range = 64-90 years). Hierarchical linear models showed that dispositional optimism protected relatively young participants from exhibiting elevations in depressive symptoms over time, but that these benefits became increasingly reduced among their older counterparts. Moreover, the findings showed that an age-related association between optimism and depressive symptoms was observed particularly during periods of enhanced, as compared to reduced, stress. These results suggest that dispositional optimism protects emotional well-being during the early phases of older adulthood, but that its effects are reduced in advanced old age. © 2016 Wiley Periodicals, Inc.
Butler, Jeffrey I; Fox, Mary T
Older people present with complex health issues on admission to hospital and are at high risk for functional decline and related complications. Thus, they require the services of diverse health-care professionals working in concert to support their functioning. Despite nurses' central role in caring for this patient population, and evidence indicating that interprofessional communication is a persistent challenge for nurses in acute-care settings, little is known about nurses' views on interprofessional communication in care preserving functioning in acutely admitted older people. To fill this knowledge gap, we gathered acute-care staff nurses' perspectives on interprofessional communication in a function-focused, interprofessional approach to hospital care for older adults. Thirteen focus groups were conducted with a purposeful, criterion-based sample of 57 nurses working in acute-care hospitals. Thematic analysis revealed two overarching themes capturing nurses' perspectives on key factors shaping interprofessional communication in a function-focused interprofessional approach to care (1) context of direct communication and (2) context of indirect communication. The first theme demonstrates that nurses preferred synchronous modes of communication, but some ascribed greater importance to unstructured forms of direct information-sharing, while others stressed structured direct communication, particularly interprofessional rounds. The second theme also documents divergence in nurses' views on asynchronous communication, with some emphasizing information technology and others analog tools. Perceptions of some modes of interprofessional communication were found to vary by practice setting. Theoretical and pragmatic conclusions are drawn that can be used to optimize interprofessional communication processes supporting hospitalized older people's functioning.
Maher, Ann Butler
The second part of this paper provides those who care for orthopaedic patients with evidence-supported international perspectives about acute nursing care of the older adult with fragility hip fracture. Developed by an international group of nurse experts and guided by a range of information from research and clinical practice, it focuses on nurse sensitive quality indicators during the acute hospitalisation for fragility hip fracture. Optimal care for the patient who has experienced such a fracture is the focus. This includes (in the first, earlier, part):\\r\
Background Numerous social factors, generally studied in isolation, have been associated with older adults’ health. Even so, older people’s social circumstances are complex and an approach which embraces this complexity is desirable. Here we investigate many social factors in relation to one another and to survival among older adults using a social ecology perspective to measure social vulnerability among older adults. Methods 2740 adults aged 65 and older were followed for ten years in the Canadian National Population Health Survey (NPHS). Twenty-three individual-level social variables were drawn from the 1994 NPHS and five Enumeration Area (EA)-level variables were abstracted from the 1996 Canadian Census using postal code linkage. Principal Component Analysis (PCA) was used to identify dimensions of social vulnerability. All social variables were summed to create a social vulnerability index which was studied in relation to ten-year mortality. Results The PCA was limited by low variance (47%) explained by emergent factors. Seven dimensions of social vulnerability emerged in the most robust, yet limited, model: social support, engagement, living situation, self-esteem, sense of control, relations with others and contextual socio-economic status. These dimensions showed complex inter-relationships and were situated within a social ecology framework, considering spheres of influence from the individual through to group, neighbourhood and broader societal levels. Adjusting for age, sex, and frailty, increasing social vulnerability measured using the cumulative social vulnerability index was associated with increased risk of mortality over ten years in a Cox regression model (HR 1.04, 95% CI:1.01-1.07, p = 0.01). Conclusions Social vulnerability has important independent influence on older adults’ health though relationships between contributing variables are complex and do not lend themselves well to fragmentation into a small number of discrete factors. A
Mahieu, Lieslot; Gastmans, Chris
emotional discomfort brought on by witnessing this behavior. Relatively little work has been published on older residents' perspectives regarding aged sexuality in institutionalized elderly care. If, however, we wish to devote ourselves to individualized or person-centered nursing care, we will have to gain more insight into the patient's perspective and take notice of the needs, expectations, attitudes, experiences and behaviors of residents with regard to (aged) sexuality. Hence more research is needed that depicts the issue of aged sexuality in institutionalized elderly care from a patient's and thus resident oriented perspective. Copyright © 2015 Elsevier Ltd. All rights reserved.
Yeom, Hye A; Fleury, Julie; Keller, Colleen
Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.
Relations between minors under the age of consent and older persons are legally prohibited in many countries. However, the nature of these relationships, their impact on the lives of minors involved, and how they should be dealt by law enforcement and welfare systems are highly controversial. The differences between the way these relations are perceived by the minors involved and the public are also unclear. This literature review examines them as perceived by youths or young adults who had experienced sexual relations with a person at least 2 years older during their adolescence as well as by students and other adult members of the public. A systematic search of 977 studies initially identified as relevant yielded 16 studies that fit the inclusion criteria. Most (13) research samples were located in the United States, and the remainder were in the United Kingdom (2) and Australia (1). All were published in English. Four main themes emerged from the analysis of these studies: adolescent motives for sexual relations with older persons (two studies); characteristics of sexual relations between adolescents and older persons (6); contextual factors affecting the way such relations are perceived, including the partners' ages and genders (11); and perspectives on the legal framing of such relations (6). The studies' findings are discussed and implications for future research, policy, and practice are suggested, highlighting the complexity and ambiguity of the phenomenon and calling on intervention programs to focus on strengthening the family unit and social network of these youth and for policies to address teen sexuality as defined both normatively and legally.
Putney, Jennifer M; Leafmeeker, Rebecca R; Hebert, Nicholas
Older lesbian-identified women are a health disparate yet resilient population about whom knowledge is limited and emerging. Among the areas in need of research are older lesbians' experiences of later life and stress-related growth. This article presents the findings from a qualitative study that investigated older lesbians' experiences of adversity and adaptation as they age. In-depth, exploratory interviews were conducted with 12 lesbian-identified women who were between the ages of 65-80. This study applied grounded theory methodology to identify respondents sources of stress and fear, their strengths and coping strategies and how those relate to each other and to their growth in later life. We advance a model of adaptive change that shows how spirituality, social support, and resistance to cultural norms help older lesbian adults cope with loss, illness, and discrimination and develop wisdom in later life. Knowledgeable practitioners can help older lesbian women identify and maintain sources of social support, explore spirituality, and facilitate continuous growth through the end of life. Social workers can advocate for services that are welcoming and affirmative so as to reduce fears of isolation and dependence associated with health decline.
Baltes, B.B.; Wynne, K.; Sirabian, M.; Krenn, D.; Lange, A.H. de
This study examines the behavioral processes through which future time perspective (FTP) and regulatory focus may influence coping behaviors in older workers. A three-wave longitudinal study was conducted to test a novel model, positing that FTP affects regulatory focus, which then influences the
Jarling, Aleksandra; Rydström, Ingela; Ernsth-Bravell, Marie; Nyström, Maria; Dalheim-Englund, Ann-Charlotte
To describe the meaning of the phenomenon home care from the perspective of older persons who live alone with multimorbidity. In line with worldwide changing demographics, conditions for older people in need of home care are changing. In Sweden there is a stay-in-place policy and older people are expected to live and be cared for in their own home as long as possible. Home care, instituted by different laws, is a challenge affecting the older person when the private home becomes a workplace. This study uses a qualitative design with a lifeworld approach. The study having been conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data were analysed using qualitative content analysis. The findings illustrate four sub-themes: adapting to a caring culture, feeling exposed, unable to influence care and forced relations. The overall theme reveals that older people experience a life-changing situation when receiving home care and they become a guest in their own home. Becoming older with increased needs means to disrupt one's life when one's private home becomes a public arena. The gap between an older person's rights by law and the older person's experiences of receiving home care needs to be highlighted to meet the oncoming challenges in providing a home care that includes participation of the older themselves. Only then can care be offered that enables older people to have a sense of control and experience their home as their own. The findings emphasise the need to view older people as being self-determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers. © 2018 John Wiley & Sons Ltd.
Kim, Jong In; Kim, Gukbin
Population is aging rapidly in Europe. Older age life expectancy (OLE) can be influenced by country-level depth of credit information (DCI) as an indicator of financial crisis, gross national income (GNI) per capita, and gender inequality index (GII). These factors are key indicators of socio-ecological inequality. They can be used to develop strategies to reduce country-level health disparity. The objective of this study was to confirm the relationship between socio-ecological factors and OLE in Europe. Data were obtained from World Bank, WHO, and UN database for 34 Europe countries. Associations between socio-ecological factors and OLE were assessed with Pearson correlation coefficients and three regression models. These models assumed that appropriate changes in country-level strategies of healthy aging would produce changes in GNI per capital as personal perspective, GII in social environment perspective, and DCI in public policy perspective to implement socio-ecological changes. Hierarchal linear regression was used for final analysis. Although OLE (women and men) had significant negative correlation with GII (gender inequality index, r = - 0.798, p = 0.001), it had positive correlations with GNI (gross national income per capita, r = 0.834, p = 0.001) and DCI (depth of credit information index, r = 0.704, p = 0.001) levels caused by financial crisis. Higher levels GNI and DCI but lower GII were found to be predictors of OLE (women and men) (R 2 = 0.804, p effect on OLE levels. Thus, country-level strategies of successful aging in Europe should target socio-ecological factors such as GII, GNI, and DCI value.
Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer; Dow, Briony
Older Chinese immigrants are one of the largest and fastest growing groups in Western societies. This article used the solidarity-conflict model to synthesize current research examining parent-child relationships in this group. A comprehensive literature search was conducted in the CINAHL, Medline, and PubMed databases to identify relevant articles. A narrative approach was used to review the literature. Thirty-six articles were identified. Compared with Caucasians, older Chinese immigrants are more likely to live with children and have higher filial expectations. However, considerable numbers live independently. Of these, most live in public housing and rely on the community rather than their children for instrumental help. Many older Chinese immigrants have adjusted their filial expectations and valued being independent. They also provide extensive household help to their children. There are indications of intergenerational conflict, probably due to generational differences in attitudes toward life and limited intergenerational contact. This review suggests that although filial piety continues to influence older parent-child relationship in Chinese immigrant families, many changes have occurred. These findings have important implications for service planning and delivery for this cultural group. This review also provides evidence for the utility of the solidarity-conflict model. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Stefanov, Dimitar H; Bien, Zeungnam; Bang, Won-Chul
Smart houses are considered a good alternative for the independent life of older persons and persons with disabilities. Numerous intelligent devices, embedded into the home environment, can provide the resident with both movement assistance and 24-h health monitoring. Modern home-installed systems tend to be not only physically versatile in functionality but also emotionally human-friendly, i.e., they may be able to perform their functions without disturbing the user and without causing him/her any pain, inconvenience, or movement restriction, instead possibly providing him/her with comfort and pleasure. Through an extensive survey, this paper analyzes the building blocks of smart houses, with particular attention paid to the health monitoring subsystem as an important component, by addressing the basic requirements of various sensors implemented from both research and clinical perspectives. The paper will then discuss some important issues of the future development of an intelligent residential space with a human-friendly health monitoring functional system.
Pialoux, Vincent; Corbett, Dale; Drogos, Lauren; Erickson, Kirk I.; Eskes, Gail A.
Abstract The rise in incidence of age‐related cognitive impairment is a global health concern. Ageing is associated with a number of changes in the brain that, collectively, contribute to the declines in cognitive function observed in older adults. Structurally, the ageing brain atrophies as white and grey matter volumes decrease. Oxidative stress and inflammation promote endothelial dysfunction thereby hampering cerebral perfusion and thus delivery of energy substrates and nutrients. Further, the development of amyloid plaques and neurofibrillary tangles contributes to neuronal loss. Of interest, there are substantial inter‐individual differences in the degree to which these physical and functional changes impact upon cognitive function as we grow older. This review describes how engaging in physical activity and cognitive activities and adhering to a Mediterranean style diet promote ‘brain health’. From a physiological perspective, we discuss the effects of these modifiable lifestyle behaviours on the brain, and how some recent human trials are beginning to show some promise as to the effectiveness of lifestyle behaviours in combating cognitive impairment. Moreover, we propose that these lifestyle behaviours, through numerous mechanisms, serve to increase brain, cerebrovascular and cognitive reserve, thereby preserving and enhancing cognitive function for longer. PMID:27524792
Classen, Sherrilene; Lopez, Ellen DS; Winter, Sandra; Awadzi, Kezia D; Ferree, Nita; Garvan, Cynthia W
The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research), and views (qualitative research) of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long-term outcomes. After completing the detailed plan we will test the effectiveness of this intervention on multiple levels. PMID:18225470
Backonja, Uba; Hall, Amanda K.; Thielke, Stephen
Technologies have become a major force in people’s lives. They change how people interact with the environment, even as the environment changes. We propose that technology use in the setting of changing environments is motivated by essential needs and tensions experienced by the individual. We apply three developmental and behavioral theories (Erikson’s stages of psychosocial development, Maslow’s hierarchy of needs, and Bronfenbrenner’s ecological model) to explain technology-related behaviors among older adults. We consider how technology use has addressed and can address major ecological changes, in three areas: health promotion, natural disasters, and disparities. We propose that considering these theories can help researchers and developers ensure that technologies will help promote a healthier world for older adults. PMID:26215298
West, Robin L; Hastings, Erin C
Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills.
Marrink, Siewert J.; Tieleman, D. Peter
The Martini model, a coarse-grained force field for biomolecular simulations, has found a broad range of applications since its release a decade ago. Based on a building block principle, the model combines speed and versatility while maintaining chemical specificity. Here we review the current state
Mastel-Smith, Beth; Binder, Brenda; Hersch, Gayle; Davidson, Harriett A; Walsh, Teresa
The purpose of this exploratory, qualitative study was to investigate storytelling by home care clients to their home care workers (HCWs). Specific research questions were: (a) When does storytelling by a care recipient occur during usual care?; (b) How do HCWs engage older clients in storytelling?; (c) How do HCWs respond to the stories told by clients?; and (d) What is the perceived effect of storytelling by older clients on the relationship between the client and the HCW? Two focus groups consisting of 10 HCWs each were conducted. Verbatim transcripts of both focus groups were analyzed using the constant comparative analysis method. Categories and concepts were identified. Characteristics of the HCW and client set the stage for storytelling. The process of storytelling included context, triggers, and temporal aspects. HCWs also shared the content of stories, the impact on their relationship with the client, and the perceived effect on each individual. A visual model depicting the nature of storytelling in association with the care of older clients is presented. Copyright 2011, SLACK Incorporated.
Full Text Available Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM to which the patient has been invited. The aim of this study is to highlight nurses’ experiences of older patients’ participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients’ vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: “the need for a guide,” “patient participation challenged by structures,” and “creating space for the whole human being.” In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.
McWilliams, A E
This article outlines the basic tenets of attachment theory and its relevance to adult couple psychotherapy. The paper also explores the nihilism around psychic change in older people and people with cancer and explores some possible reasons for this nihilism. A case study of older people, a couple, one of whom has a terminal cancer diagnosis, is presented to demonstrate the usefulness of therapeutic intervention in such cases from an attachment theory perspective. A discussion of the usefulness and difficulties of this approach follows. Other therapeutic models could also be applied usefully to this type of clinical presentation. However, the focus of this paper is the specific elucidation of attachment theory to demonstrate that change can occur regardless of a person's age and physical circumstances. The particular therapeutic approach presented here also represents the specialist interest and training of the writer in regard to couple work.
Ellis, R.K.; Hill, C.T.; Lykken, J.D.
Particle physics is an experimentally based science, with a need for the best theorists to make contact with data and to enlarge and enhance their theoretical descriptions as the subject evolves. The authors felt it imperative that the TASI (Theoretical Advanced Study Institute) program reflect this need. The goal of this conference, was to provide the students with a comprehensive look at the current understanding of the standard model, as well as the techniques which promise to advance that understanding in the future. Topics covered include: symmetry breaking in the standard model; physics beyond the standard model; chiral effective Lagrangians; semi-classical string theory; renormalization of electroweak gauge interactions; electroweak experiments at LEP; the CKM matrix and CP violation; axion searches; lattice QCD; perturbative QCD; heavy quark effective field theory; heavy flavor physics on the lattice; and neutrinos. Separate abstracts were prepared for 13 papers in this conference
Potter, G.L.; Mobely, R.L.; Drach, R.S.; Corsetti, T.G.; Williams, D.N.; Slingo, J.M.
Radiation fields from a perpetual July integration of a T106 version of the ECMWF operational model are used as surrogate observations of the radiation budget at the top of the atmosphere to illustrate various difficulties that modellers might face when trying to reconcile cloud radiation forcings derived from satellite observations with model-generated ones. Differences between the so-called Methods 1 and 2 of Cess and Potter (1987) and a variant Method 3 are addressed. Method 1 is shown to be the least robust of all methods, due to potential uncertainties related to persistent cloudiness, length of the period over which clear-sky conditions are looked for, biases in retrieved clear-sky quantities due to an insufficient sampling of the diurnal cycle. We advocate the use of Method 2 as the only unambiguous one to produce consistent radiative diagnostics for intercomparing model results. Impact of the three methods on the derived sensitivities and cloud feedbacks following an imposed change in sea surface temperature (used as a surrogate climate change) is discussed. 17 refs., 12 figs., 1 tab
Mathematical modeling is the art and craft of building a system of equations that is both sufficiently complex to do justice to physical reality and sufficiently simple to give real insight into the situation. Mathematical Modeling: A Chemical Engineer's Perspective provides an elementary introduction to the craft by one of the century's most distinguished practitioners.Though the book is written from a chemical engineering viewpoint, the principles and pitfalls are common to all mathematical modeling of physical systems. Seventeen of the author's frequently cited papers are reprinted to illus
Beelen, J.; Vasse, Emmelyne; Ziylan, C.; Janssen, N.; Roos, de N.M.; Groot, de C.P.G.M.
Background: Many older adults are at risk of undernutrition. Dietitians play a key role in the management and treatment of undernutrition, but older adults have difficulties to comply with dietetic recommendations. This qualitative study investigated which barriers older adults experience in
Wang, Renfeng; De Donder, Liesbeth; De Backer, Free; Shihua, Li; Honghui, Pan; Thomas, Valerie; Vanslambrouck, Silke; Lombaerts, Koen
Background and aim: Even though the beneficial effects of elderly learning are widely acknowledged, many older Chinese people are still not involved. This paper aims to examine the barriers that affect the level of educational participation of older adults in China. Methodology: Using a focus group methodology, 43 older participants (aged 55 years…
Overgaard, Jesper; Rosbjerg, Dan; Butts, M.B.
The purpose of this paper is to provide a review of the different types of energy-based land-surface models (LSMs) and discuss some of the new possibilities that will arise when energy-based LSMs are combined with distributed hydrological modelling. We choose to focus on energy-based approaches......, and the difficulties inherent in various evaluation procedures are presented. Finally, the dynamic coupling of hydrological and atmospheric models is explored, and the perspectives of such efforts are discussed......., because in comparison to the traditional potential evapotranspiration models, these approaches allow for a stronger link to remote sensing and atmospheric modelling. New opportunities for evaluation of distributed land-surface models through application of remote sensing are discussed in detail...
Vijande, J.; Valcarce, A.; Caramés, T.F.; Garcilazo, H.
We present recent results of hadron spectroscopy and hadron–hadron interaction from the perspective of constituent quark models. We pay special attention to the role played by higher order Fock space components in the hadron spectra and the connection of this extension with the hadron–hadron interaction. The main goal of our description is to obtain a coherent understanding of the low-energy hadron phenomenology without enforcing any particular model, to constrain its characteristics and learn about low-energy realization of the theory
Arbaje, Alicia I; Newcomer, Alison R; Maynor, Kenric A; Duhaney, Robert L; Eubank, Kathryn J; Carrese, Joseph A
Article-at-a-Glance Background: Care transitions across health care settings are common and can result in adverse outcomes for older adults. Few studies have examined health care professionals' perspectives on important process measures or pay-for-performance (P4P) strategies related to transitional care. A study was conducted to characterize health care professionals' perspectives on (1) successful transitional care of older adults (age 65 years and older), (2) suggestions for improvement, and (3) P4P strategies related to transitional care. In a qualitative study, one-hour semistructured in-depth interviews were conducted in an acute care hospital, a skilled nursing facility, two community-based primary care practices, and one home health care agency with 20 health care professionals (18 physicians and 2 home health care administrators) with direct experience in care transitions of older adults and who were likely to be affected by P4P strategies. Findings were organized into three thematic domains: (1) components and markers of effective transitional care, (2) difficulties in design and implementation of P4P strategies, and (3) health care professionals' concerns and unmet needs related to delivering optimal care during transitions. A conceptual framework was developed on the basis of the findings to guide design and implementation of P4P strategies for improving transitional care. In characterizing health care professionals' perspectives, specific care processes to target, challenges to address in the design of P4P strategies, and unmet needs to consider regarding education and feedback for health care professionals were described. Future investigations could evaluate whether performance targets, educational interventions, and implementation strategies based on this conceptual framework improve quality of transitional care.
El-Saifi, Najwan; Moyle, Wendy; Jones, Cindy; Alston-Knox, Clair
ABSTRACTBackground:Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers' perspective, and to identify influencing factors. Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale. Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61-0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77-0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient-provider relationship and less medical problems. Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.
Laura U. A. Gärtner
Full Text Available Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers’ preferences for joining a new team might vary in different ways. Based on Carstensen’s socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers’ OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design. Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46 were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline, under an expanded OFTP (amendment of retirement age, and under a restricted OFTP (insolvency of the current company. Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers’ OFTP on the relation between workers’ age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers’ age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams.
Gärtner, Laura U. A.; Hertel, Guido
Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers’ preferences for joining a new team might vary in different ways. Based on Carstensen’s socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP) is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers’ OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design). Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46) were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline), under an expanded OFTP (amendment of retirement age), and under a restricted OFTP (insolvency of the current company). Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers’ OFTP on the relation between workers’ age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers’ age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams. PMID:29018376
Gärtner, Laura U A; Hertel, Guido
Working in teams is quite popular across different industries and cultures. While some of these teams exist for longer time periods, other teams collaborate only for short periods and members switch into new teams after goals are accomplished. However, workers' preferences for joining a new team might vary in different ways. Based on Carstensen's socioemotional selectivity theory, we predict that emotionally meaningful teams are prioritized when occupational future time perspective (OFTP) is perceived as limited. Building and expanding on studies outside of the work context, we expected that older as compared to younger workers prefer more familiar teams, and that this effect is mediated by workers' OFTP. Moreover, we assumed that experimentally manipulated OFTP can change such team preferences. The hypotheses were tested in an online scenario study using three experimental conditions (within-person design). Four hundred and fifty-four workers (57% female, age M = 45.98, SD = 11.46) were asked to choose between a familiar and a new team in three consecutive trials: under an unspecified OFTP (baseline), under an expanded OFTP (amendment of retirement age), and under a restricted OFTP (insolvency of the current company). Whereas the baseline condition was always first, the order of the second and third conditions was randomized among participants. In the baseline condition, results showed the expected mediation effect of workers' OFTP on the relation between workers' age and preference for a familiar over a new team. Higher age was associated with more limited OFTP, which in turn was associated with higher preference for a familiar over a new team. Moreover, experimentally restricting OFTP increased preference for a familiar team over a new team regardless of workers' age, providing further evidence for the assumed causal processes and showing interesting avenues for practical interventions in occupational teams.
Boggs, Jennifer M; Dickman Portz, Jennifer; King, Diane K; Wright, Leslie A; Helander, Kenneth; Retrum, Jessica H; Gozansky, Wendolyn S
This qualitative study conducted by a community-research partnership used multiple types of data collection to examine variables relevant for LGBTQ older adults who wished to age in place in their urban Denver neighborhood. Focus groups, interviews, and a town hall meeting were used to identify barriers and supports to aging in place. Participants (N = 73) identified primarily as lesbian or gay, aged 50-69, and lived with a partner. Ageism, heterosexism, and cisgenderism emerged as cross-cutting themes that negatively impact access to health care, housing, social support, home assistance, and legal services. Resilience from weathering a lifetime of discrimination was identified as a strength to handle aging challenges. Recommendations for establishing an aging in place model included establishing welcoming communities and resource centers and increasing cultural competence of service providers. This study provides a unique contribution to understanding the psychosocial, medical, and legal barriers for successfully aging in place.
For many years, Germany has been regarded in international comparisons as an example of a generous early retirement culture, resulting in a low labor market participation of older employees. Recently, however, employment rates of older employees have increased remarkably. Reasons are the demographic structure of older persons in Germany, a long-term trend of increasing female labor market participation, and reforms in labor-market policies and pension policies during the last 10 years. Despite an increasing labor market participation of older employees, traditional labor market risks for older persons partly remained, but some new risks evolved as well. Therefore, social differentiation among older employees increased.Although detailed macro descriptions exist, the causes of labor market developments cannot be fully understood with cross-sectional data alone. An important stimulus is to be expected from individual longitudinal data which reflect employment histories and labor market transitions such as employment exit and retirement.
Hinton, Ladson; Apesoa-Varano, Ester Carolina; Unützer, Jürgen; Dwight-Johnson, Megan; Park, Mijung; Barker, Judith C
The aim of this study is to describe the roles of family members in older men's depression treatment from the perspectives of older men and primary care physicians (PCPs). Cross-sectional, descriptive qualitative study conducted from 2008-2011 in primary care clinics in an academic medical center and a safety-net county teaching hospital in California's Central Valley. Participants in this study were the following: (1) 77 age ≥ 60, noninstitutionalized men with a 1-year history of clinical depression and/or depression treatment who were identified through screening in primary care clinics and (2) a convenience sample of 15 PCPs from the same recruitment sites. Semi-structured and in-depth qualitative interviews were conducted and audiotaped then transcribed and analyzed thematically. Treatment-promoting roles of family included providing an emotionally supportive home environment, promoting depression self-management and facilitating communication about depression during primary care visits. Treatment-impeding roles of family included triggering or worsening men's depression, hindering depression care during primary care visits, discouraging depression treatment and being unavailable to assist men with their depression care. Overall, more than 90% of the men and the PCPs described one or more treatment-promoting roles of family and over 75% of men and PCPs described one or more treatment-impeding roles of family. Families play important roles in older men's depression treatment with the potential to promote as well as impede care. Interventions and services need to carefully assess the ongoing roles and attitudes of family members and to tailor treatment approaches to build on the positive aspects and mitigate the negative aspects of family support. Copyright © 2014 John Wiley & Sons, Ltd.
Ageing-in-place policies have been implemented by many Western governments in order to delay and decrease older adults’ reliance on expensive institutionalised care. Such policies stimulate older adults to remain in their own homes and neighbourhoods for as long as possible and stress that this is
Wright, Tim; Hyner, Gerald C.
Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…
Stephan, Yannick; Boiche, Julie; Le Scanff, Christine
Drawing upon Self-Determination Theory, the purpose of our study was to examine the motivational determinants of older women's dropout and participation in physical activity (PA). Older women who dropped out (n = 242) or remained (n = 332) in an organized PA program completed the Sport Motivation Scale as well as health and PA measures. We found…
To test any hypothesis about any dynamic system, it is necessary to build a model that places that hypothesis into the context of everything else that we know about the system: initial and boundary conditions and interactions between various governing processes (Hempel and Oppenheim, 1948, Cartwright, 1983). No hypothesis can be tested in isolation, and no hypothesis can be tested without a model (for a geoscience-related discussion see Clark et al., 2011). Science is (currently) fundamentally reductionist in the sense that we seek some small set of governing principles that can explain all phenomena in the universe, and such laws are ontological in the sense that they describe the object under investigation (Davies, 1990 gives several competing perspectives on this claim). However, since we cannot build perfect models of complex systems, any model that does not also contain an epistemological component (i.e., a statement, like a probability distribution, that refers directly to the quality of of the information from the model) is falsified immediately (in the sense of Popper, 2002) given only a small number of observations. Models necessarily contain both ontological and epistemological components, and what this means is that the purpose of any robust scientific method is to measure the amount and quality of information provided by models. I believe that any viable philosophy of science must be reducible to this statement. The first step toward a unified theory of scientific models (and therefore a complete philosophy of science) is a quantitative language that applies to both ontological and epistemological questions. Information theory is one such language: Cox' (1946) theorem (see Van Horn, 2003) tells us that probability theory is the (only) calculus that is consistent with Classical Logic (Jaynes, 2003; chapter 1), and information theory is simply the integration of convex transforms of probability ratios (integration reduces density functions to scalar
Courtney, Karen L; Demiris, George; Rantz, Marilyn; Skubic, Marjorie
At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs), which range from independent apartments to assisted living and skilled-nursing facilities. With predictions of a large increase in the segment of the population aged 65 and older, a subsequent increase in demand on CCRCs can be anticipated. With these expectations, researchers have begun exploring the use of smart home information-based technologies in these care facilities to enhance resident quality of life and safety, but little evaluation research exists on older adults' acceptance and use of these technologies. This study investigated the factors that influence the willingness of older adults living in independent and assisted living CCRCs to adopt smart home technology. Participants (n = 14) were recruited from community-dwelling older adults, aged 65 or older, living in one of two mid-western US CCRC facilities (independent living and assisted living type facilities). This study used a qualitative, descriptive approach, guided by principles of grounded theory research. Data saturation (or when no new themes or issues emerged from group sessions) occurred after four focus groups (n = 11 unique respondents) and was confirmed through additional individual interviews (n = 3). The findings from this study indicate that although privacy can be a barrier for older adults' adoption of smart home technology their own perception of their need for the technology can override their privacy concerns. Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.
Knudstrup, Mary-Ann; Møller, Kurt
The relationship between housing and the well-being of older people is a topic of growing interest. The focus is often on a specific aspect of housing, for example accessibility, location or interior design, and the perspective taken is typically that of a specific discipline. The influence...
Knudstrup, Mary-Ann; Møller, Kurt
The relationship between housing and the well-being of older people is a topic of growing interest. The focus is often on a specific aspect of housing, for example accessibility, location or interior design, and the perspective taken is typically that of a specific discipline. The influence...
Romo, Rafael D; Dawson-Rose, Carol S; Mayo, Ann M; Wallhagen, Margaret I
Understanding changes in decision making among older adults across time is important for health care providers. We examined how older adults with a limited prognosis used their perception of prognosis and health in their decision-making processes and related these findings to prospect theory. The theme of decision making in the context of ambiguity emerged, reflecting how participants used both prognosis and health to value choices, a behavior not fully captured by prospect theory. We propose an extension of the theory that can be used to better visualize decision making at this unique time of life among older adults.
Bal, P. Matthijs; Jansen, Paul G. W.; van der Velde, Mandy E. G.; de Lange, Annet H.; Rousseau, Denise M.
Using a sample of post-retirement workers (N = 176), this study investigated the role of future time perspective (FTP) in psychological contracts. The study aimed to test: (i) whether future time perspective is related to employer psychological contract fulfillment and (ii) whether it moderates relations between psychological contract fulfillment…
Bal, P. Matthijs; Jansen, Paul G. W.; van der Velde, Mandy E. G.; de Lange, Annet H.; Rousseau, Denise M.
Using a sample of post-retirement workers (N = 176), this study investigated the role of future time perspective (FTP) in psychological contracts. The study aimed to test: (i) whether future time perspective is related to employer psychological contract fulfillment and (ii) whether it moderates
Bal, P.M.; Jansen, P.G.W.; van der Velde, M.E.G.|info:eu-repo/dai/nl/183262107; de Lange, A.H.; Rousseau, D.M.
Using a sample of post-retirement workers (N = 176), this study investigated the role of future time perspective (FTP) in psychological contracts. The study aimed to test: (i) whether future time perspective is related to employer psychological contract fulfillment and (ii) whether it moderates
Bal, P.M.; Jansen, P.G.W.; van der Velde, E.G.; de Lange, A.H.; Rousseau, D.M.
Using a sample of post-retirement workers (N=176), this study investigated the role of future time perspective (FTP) in psychological contracts. The study aimed to test: (i) whether future time perspective is related to employer psychological contract fulfillment and (ii) whether it moderates
Bal, P.M.; Jansen, P.G.W.; Velde, M.E.G. van der; Lange, A.H. de; Rousseau, D.M.
Using a sample of post-retirement workers (N = 176), this study investigated the role of future time perspective (FTP) in psychological contracts. The study aimed to test: (i) whether future time perspective is related to employer psychological contract fulfillment and (ii) whether it moderates
Kötteritzsch, Anna; Gerling, Kathrin
Growing numbers of older adults requiring aphasia therapy create challenges for the health care system. Information and communication technology (ICT) has the potential to provide computer-mediated, self-administered aphasia therapy that complements conventional therapy. We explore overlaps in ICT for older adults and aphasia therapy applications with the goal of integrating innovative ICT in aphasia therapy. Based on a case study, we explain how results of different disciplines developing IC...
Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S
The aim of this study was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. DESIGN, PARTICIPANTS AND MEASURES: A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75-85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women.
Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.
Aims The aim was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. Design, Participants, and Measures A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. Findings The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27% of women and 49% of men consumed more than 2 drinks per day or 7 drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than 2 drinks per day or 7 drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. Conclusions A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women. PMID:19438836
Serrano Sanchez, Teresa; Blanco Lezcano, Lisette; Garcia Minet, Rocio; Alberti Amador, Esteban; Diaz Armesto, Ivan and others
Huntington's disease (HD) is a degenerative dysfunction of hereditary origin. Up to date there is not, an effective treatment to the disease which having lapsed 15 or 20 years advances inexorably, in a slow form, toward the total inability or death. This paper reviews the clinical and morphological characteristics of Huntington's disease as well as the experimental models more commonly used to study this disease, having as source the articles indexed in Medline data base, published in the last 20 years. Advantages and disadvantages of all experimental models to reproduce the disease as well as the perspectives to therapeutic assay have been also considered. the consent of outline reported about the toxic models, those induced by neurotoxins such as quinolinic acid, appears to be the most appropriate to reproduce the neuropathologic characteristic of the disease, an genetic models contributing with more evidence to the knowledge of the disease etiology. Numerous treatments ameliorate clinical manifestations, but none of them has been able to stop or diminish the affectations derived from neuronal loss. At present time it is possible to reproduce, at least partially, the characteristics of the disease in experimentation animals that allow therapy evaluation in HD. from the treatment view point, the more promissory seems to be transplantation of no neuronal cells, taking into account ethical issues and factibility. On the other hand the new technology of interference RNA emerges as a potential therapeutic tool for treatment in HD, and to respond basic questions on the development of the disease.
Franke, Stefan; Meixensberger, Jürgen; Neumuth, Thomas
Surgical workflow management is expected to enable situation-aware adaptation and intelligent systems behavior in an integrated operating room (OR). The overall aim is to unburden the surgeon and OR staff from both manual maintenance and information seeking tasks. A major step toward intelligent systems behavior is a stable classification of the surgical situation from multiple perspectives based on performed low-level tasks. The present work proposes a method for the classification of surgical situations based on multi-perspective workflow modeling. A model network that interconnects different types of surgical process models is described. Various aspects of a surgical situation description were considered: low-level tasks, high-level tasks, patient status, and the use of medical devices. A study with sixty neurosurgical interventions was conducted to evaluate the performance of our approach and its robustness against incomplete workflow recognition input. A correct classification rate of over 90% was measured for high-level tasks and patient status. The device usage models for navigation and neurophysiology classified over 95% of the situations correctly, whereas the ultrasound usage was more difficult to predict. Overall, the classification rate decreased with an increasing level of input distortion. Autonomous adaptation of medical devices and intelligent systems behavior do not currently depend solely on low-level tasks. Instead, they require a more general type of understanding of the surgical condition. The integration of various surgical process models in a network provided a comprehensive representation of the interventions and allowed for the generation of extensive situation descriptions. Multi-perspective surgical workflow modeling and online situation models will be a significant pre-requisite for reliable and intelligent systems behavior. Hence, they will contribute to a cooperative OR environment. Copyright © 2015 Elsevier Inc. All rights reserved.
Abraham, Olufunmilola; Schleiden, Loren J; Brothers, Amanda L; Albert, Steven M
To examine older adults' perspectives regarding managing sleep problems through selection and use of non-prescription sleep aids, and the role of pharmacists. Telephone interviews were conducted from May to June 2015 with 116 individuals aged ≥60 years in Pittsburgh, Pennsylvania. Participants reported in a previous survey to have used at least one non-prescription sleep aid in the past 30 days and were willing to participate in a follow-up interview. Interview guides were designed to elicit perspectives of sleep problems, selection and use of non-prescription sleep aids, and consultation with healthcare professionals. Interview transcripts underwent content analysis. Four themes emerged as follows: experiences with sleep problems, selection of non-prescription sleep aids, non-prescription sleep aid use and interactions with healthcare professionals. Over half of participants reported using a non-prescription sleep aid for >1 year, were satisfied with its use and perceived it improved sleep quality. Participants commonly used an antihistamine-only sleep aid; 36% of participants self-recommended their sleep aid; and 16% of participants consulted healthcare professionals. Few participants read medication dosage labels (22%), side effects or warnings (19%), and many reported they disregarded directions. Participants did not typically consult pharmacists about sleep problems (65%) but perceived that they could assist with medication concerns. Although most participants had favourable perceptions of non-prescription sleep aids, older adults may be inappropriately using non-prescription sleep aids to self-manage sleep problems by frequently disregarding medication labels and directions for safe use. Also, few older adults are discussing their sleep aid selection and use with pharmacists. © 2017 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.
Bozzaro, Claudia; Boldt, Joachim; Schweda, Mark
The elderly are often considered a vulnerable group in public and academic bioethical debates and regulations. In this paper, we examine and challenge this assumption and its ethical implications. We begin by systematically delineating the different concepts of vulnerability commonly used in bioethics, before then examining whether these concepts can be applied to old age. We argue that old age should not, in and of itself, be used as a marker of vulnerability, since ageing is a process that can develop in a variety of different ways and is not always associated with particular experiences of vulnerability. We, therefore, turn to more fundamental phenomenological considerations in order to reconstruct from a first person perspective the intricate interconnections between the experiences of ageing and vulnerability. According to this account, ageing and old age are phenomena in which the basic anthropological vulnerability of human beings can manifest itself in an increased likelihood of harm and exploitation. Thus, we plead for a combined model of vulnerability that helps to avoid problems related to the current concepts of vulnerability. We conclude first that old age as such is not a sufficient criterion for being categorized as vulnerable in applied ethics, and second that reflections on ageing can help to develop a better understanding of the central role of vulnerability in human existence and in applied ethics. © 2018 John Wiley & Sons Ltd.
Miron, Anca M; McFadden, Susan H; Hermus, Nathan J; Buelow, Jennifer; Nazario, Amanda S; Seelman, Katarena
No empirical work has systematically explored perceptions of humanness of people with dementia and of older adults and the variables that could improve these perceptions. We thus investigated the role of contact and perspective taking in improving perceptions of humanness of these social groups. To do so, we developed a new concept, humanness standards, defined as the amount of evidence of ability impairment needed to conclude that elderly people and those with dementia have lost personhood. We used a cross-sectional survey design (n = 619) to assess participants' humanness standards and perceptions of uniquely human characteristics and human nature characteristics of two social groups (people with dementia and older adults). Half the participants (n = 311) completed a survey about people with dementia and half (n = 308) assessed older adults. People with dementia were perceived as possessing humanness characteristics to a lesser extent than were older adults. For both groups, contact predicted enhanced perceptions of humanness characteristics. Participants' degree of contact with individuals with dementia also predicted humanness standards, but only under low perspective-taking conditions. As predicted, for older adults, participants set the highest humanness impairment thresholds in the high contact/high perspective-taking condition. We conclude that while social programs that bring persons with dementia and other individuals in contact could change humanness standards and perceptions of humanness characteristics of people with dementia, in the case of elderly adults, the contact must be supplemented by variables that facilitate taking the perspective of the person.
A great deal of attention is given to the importance of communication in environmental remediation and radioactive waste management. However, very little attention is given to eliciting multiple perspectives so as to formulate high quality decisions. Plans that are based on a limited number of perspectives tend to be narrowly focused whereas those that are based on a wide variety of perspectives tend to be comprehensive, higher quality, and more apt to be put into application. In addition, existing methods of dialogue have built-in limitations in that they typically draw from the predominant thinking patterns which focus in some areas but ignore others. This can result in clarity but a lack of comprehensiveness. This paper presents a Perspective Awareness Model which helps groups such as partnering teams, interagency teams, steering committees, and working groups elicit a wide net of perspectives and viewpoints. The paper begins by describing five factors that makes cooperation among such groups challenging. Next, a Perspective Awareness Model that makes it possible to manage these five factors is presented. The two primary components of this model --- the eight 'Thinking Directions' and the 'Shared Documentation' --- are described in detail. Several examples are given to illustrate how the Perspective Awareness Model can be used to elicit multiple perspectives to formulate high quality decisions in the area of environmental remediation and radioactive waste management. (authors)
Hinton, Ladson; Sciolla, Andrés F; Unützer, Jürgen; Elizarraras, Edward; Kravitz, Richard L; Apesoa-Varano, Ester Carolina
Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges. A cross-sectional, qualitative descriptive interview study was conducted in a safety-net, Federally Qualified Health Center in California's Central Valley. A total of 37 stakeholders were recruited, including 15 depressed older (i.e. age ≥ 60) men, 12 family members, and 10 clinic staff. Depressed men were identified through mail outreach, waiting room screening, and referral. Depressed men identified family members who were later approached to participate. We also recruited a purposeful sample of clinic staff. Interviews explored stakeholder perspectives on family involvement in men's depression treatment as part of a primary care intervention. Interviews were conducted using a semi-structured interview guide, tape-recorded, transcribed verbatim, and translated if the interview was conducted in Spanish. Four themes were identified representing core challenges: engaging men at the right time; preserving men's sense of autonomy; managing privacy concerns; and navigating family tensions. Stakeholders also provided practical suggestions and advice about how each of these challenges might be addressed. While engaging family is a promising approach to strengthen depression care for older men in primary care settings, several potential challenges exist. Family- centered depression intervention development and clinical practice need to anticipate these challenges and to develop approaches and
Xiangren Yi; Rui Wang; Zachary Pope; Zan Gao; Shumei Wang; Fang Pan; Jingpeng Yan; Meng Liu; Peipei Wu; Jingjing Xu
Purpose: To examine, within a social–ecological framework, associations between multifaceted individual and environmental factors and habitual physical activity (HPA) among older Chinese adults. Methods: Through a mix of qualitative and quantitative methods, a survey instrument assessing various factors underlying 3 social–ecological dimensions of intrapersonal, interpersonal, and community and environmental resources was developed. Using a cross-sectional design, older adults (n=1580, aged 67 ± 7 years) recruited from 10 communities in Shandong province completed the social–ecological survey of HPA. Data were analyzed using Partial Least Squares Path Modeling. Results: Factors related to intrapersonal (medical knowledge, motivation, physical function, sport skills, socioeconomic status, and education), interpersonal (social support, social activity, and social norms), and community and physical environmental resources (safety, capacity, availability of and access to physical activity facilities) were found to be significantly associated with older adults’ participation in HPA. Conclusion: The findings provide an initial validation of a social–ecological approach to the study of HPA in China, suggesting that strategies aimed at promoting physical activity in older adults should address multiple levels of factors that may contribute to the likelihood of older Chinese adults being physically active. © 2016 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Belza, Basia; Walwick, Julie; Shiu-Thornton, Sharyne; Schwartz, Sheryl; Taylor, Mary; LoGerfo, James
Increasing physical activity is a goal of Healthy People 2010. Although the health benefits of physical activity are documented, older adults are less physically active than any other age group. The purpose of this study was to examine barriers and facilitators to physical activity and exercise among underserved, ethnically diverse older adults. Seventy-one older adults were recruited through community agencies to participate in seven ethnic-specific focus groups: American Indian/Alaska Native, African American, Filipino, Chinese, Latino, Korean, and Vietnamese. Groups were conducted in the participants' primary language and ranged in size from 7-13 participants. Mean age was 71.6 years (range from 52 to 85 years; SD +/- 7.39). Professional translators transcribed audiotapes into the language of the group and then translated the transcript into English. Transcripts were systematically reviewed using content analysis. Suggested features of physical activity programs to enhance participation among ethnically diverse minority older adults included fostering relationships among participants; providing culture-specific exercise; offering programs at residential sites; partnering with and offering classes prior to or after social service programs; educating families about the importance of physical activity for older adults and ways they could help; offering low- or no-cost classes; and involving older adults in program development. Walking was the exercise of choice across all ethnic groups. Health served as both a motivator and a barrier to physical activity. Other factors influencing physical activity were weather, transportation, and personal safety. Findings from this study suggest strategies for culture-specific programming of community-based physical activity programs.
Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors\\' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.
Ho, Andy Hau Yan; Chan, Cecilia Lai Wan; Leung, Pamela Pui Yu; Chochinov, Harvey Max; Neimeyer, Robert A; Pang, Samantha Mei Che; Tse, Doris Man Wah
the empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. to examine the concept of 'living and dying with dignity' in the Chinese context, and explore the generalisability of the Dignity Model to older terminal patients in Hong Kong. using qualitative interviews, the concept of dignity was explored among 16 older Chinese palliative care patients with terminal cancer. Framework analysis with both deductive and inductive methods was employed. the three major categories of themes of the Dignity Model were broadly supported. However, the subtheme of death anxiety was not supported, while two subthemes of generativity/legacy and resilience/fighting spirit manifested differently in the Chinese context. Furthermore, four new emergent themes have been identified. They include enduring pain, moral transcendence, spiritual surrender and transgenerational unity. these findings highlight both a cultural and a familial dimension in the construct of dignity, underline the paramount importance of cultural awareness and competence for working with ethnically diverse groups, and call for a culturally sensitive and family oriented approach to palliative care interventions with older Chinese terminal patients.
Erickson, Julie; Mackenzie, Corey S; Menec, Verena H; Bailis, Daniel S
Socioemotional selectivity theory posits that changes in time perspective over the lifespan are associated with distinct goals and motivations. Time perspectives and their associated socioemotional motivations have been shown to influence information processing and memory, such that motivation-consistent information is more likely to be remembered and evaluated more positively. The aim of this study was to examine the effect of motivation-consistent mental health information on memory for and evaluations of this information, as well as help-seeking attitudes and intentions to seek mental health services. We randomly assigned an Internet-based sample of 160 younger (18-25) and 175 older (60-89) adults to read a mental health information pamphlet that emphasized time perspectives and motivations relevant to either young adulthood (future-focused) or late adulthood (present-focused). Participants completed measures assessing their time perspective, memory for and subjective evaluation of the pamphlet, and help-seeking attitudes and intentions. The time perspective manipulation had no effect on memory for pamphlet information or help-seeking attitudes and intentions. There was, however, a significant interaction between time perspective and pamphlet version on the rated liking of the pamphlet. Although motivation-consistent information only affected perceptions of that information for present-focused (mostly older) individuals, this finding has important implications for enhancing older adults' mental health literacy.
Conclusions Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.
Kohn, Marlana; Belza, Basia; Petrescu-Prahova, Miruna; Miyawaki, Christina E.
This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and…
Johanna C. Badcock
Full Text Available KEY POINTS➢ Studies suggest a substantial minority of healthy older adults have hallucinatory experiences, in line with existing evidence on hallucinations in other age groups, though it is still unclear if hallucination prevalence increases or declines with age in older cohorts.➢ Stigma attached to both hallucinations and ageing leads to considerable under-reporting of these experiences in healthy older adults and may negatively bias how professionals, family members, and the public respond.➢ Why and when hallucinations in healthy older adults remit, persist, or progress to other clinical disorders remains poorly understood.➢ Current evidence points to a range of factors associated with hallucinations in older adults including decline in sensory or cognitive functioning, poor sleep, and psychosocial stressors (e.g., social isolation, loneliness, and bereavement, highlighting the need for accurate assessment and tailored interventions.Hallucinations, though common in youth and younger adults, are not the preserve of these age groups. Accumulating evidence shows that hallucinatory experiences are also present at surprisingly high rates in healthy older adults in the general community. Furthermore, stigma and misunderstanding of hallucinations, together with ageism, may lead to under-reporting of these experiences by older adults, and misdiagnosis or mismanagement by health and mental health practitioners. Consequently, improved public and professional knowledge is needed about the nature and significance of hallucinations with advancing age. The purpose of this review is to provide a comprehensive overview, and critical analysis, of research on the prevalence, psychosocial, and neurobiological factors associated with hallucinations in people aged 60 years and over. To the best of our knowledge, this is the first review of its kind in the literature. The evidence supports a dynamic conceptualization of hallucinations, in which the
Bowling, C Barrett; Vandenberg, Ann E; Phillips, Lawrence S; McClellan, William M; Johnson, Theodore M; Echt, Katharina V
Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups ( n =30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Participants had a mean age (range) of 75.1 (70.1-90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions ( e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity ( e.g. , focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens ( e.g. , protein restriction for both gout and CKD). Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be
Larsen, Stina Meyer; Mortensen, Rikke Falgreen; Kristensen, Hanne Kaae; Hounsgaard, Lise
To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT). A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13 th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur's theory of interpretation. Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A-B: Valued activities are threatened, from phase B-C: Obtaining the AT and from phase C-D: Trust in the AT. No transition was identified from phase D-E. The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult's perspective. This review advocates for using a client-centred approach throughout the entire delivery process. Implications for rehabilitation The process of the older adult becoming a user of AT involves an individualized time factor, and this supports the practice of individualized follow-up. The process of becoming a user of AT is closely related to self-image; healthcare professionals should support not only the use of AT but also the older adult's emotional adjustment to a new self-image. The process is highly influenced by the older
This study aimed to assess if a module on an undergraduate degree programme had challenged students' perspectives on ageing and older adults. Courses on gerontology are on the increase within the UK to support increasingly ageing populations, with agendas to promote ethical care and to challenge the incidence of elderly abuse. Research…
Spinney, Jamie E L; Millward, Hugh
This research uses four nationally representative samples of time diary data, spanning almost 30 yr, that are fused with energy expenditure information to enumerate the median daily duration of moderate or vigorous effort activity, quantify the prevalence of Canadians age 65 yr and older who are meeting recommended daily levels of physical activity, and explore the factors affecting rates of active living. Results indicate that 41.1% of older Canadians met recommended levels of physical activity in 1992, 40.6% in 1998, 43.5% in 2005, and 39.6% in 2010. Both rates of active living and daily duration of aerobic activity exhibit significant differences among sociodemographic groups, with age, sex, activity limitation, urban-rural, and season exhibiting the most significant influences. This study illustrates the potential for time diary data to provide detailed surveillance of physical activity patterns, active aging research, and program development, as well.
Thøgersen-Ntoumani, Cecilie; Papathomas, Anthony; Foster, Jonathan; Quested, Eleanor; Ntoumanis, Nikos
We explored perceptions of social dance as a possible intervention to improve cognitive functioning in older adults with subjective memory complaints. Thirty participants (19 female; M age = 72.6; SD=8.2) took part in the study. This included 21 participants who had self-reported subjective memory complaints and 9 spouses who noticed spousal memory loss. Semi-structured interviews were conducted and thematic analysis was used to analyze the data. Three main themes were constructed: 1) dance seen as a means of promoting social interaction; 2) chronic illness as a barrier and facilitator to participation; 3) social dance representing nostalgic connections to the past. Overall, the participants were positive about the potential attractiveness of social dance to improve cognitive and social functioning and other aspects of health. It is important in future research to examine the feasibility of a social dance intervention among older adults with subjective memory complaints.
Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin
Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…
Watkinson-Powell, Anna; Barnes, Sarah; Lovatt, Melanie; Wasielewska, Anna; Drummond, Barbara
Malnutrition is a significant cause of morbidity and mortality, particularly among older people. Attention has focused on the inadequacies of food provision in institutions, yet the majority suffering from malnutrition live in the community. The aim of this study was to explore barriers and facilitators to food provision for older people receiving home care. It was a qualitative exploratory study using semi-structured interviews with nine home-care workers in June 2013 employed by independent agencies in a large city in northern England. Data were analysed thematically, based on the principles of grounded theory. Findings showed that significant time pressures limited home-care workers in their ability to socially engage with service users at mealtimes, or provide them with anything other than ready meals. Enabling choice was considered more important than providing a healthy diet, but choice was limited by food availability and reliance on families for shopping. Despite their knowledge of service users and their central role in providing food, home-care workers received little nutritional training and were not involved by healthcare professionals in the management of malnutrition. Despite the rhetoric of individual choice and importance of social engagement and nutrition for health and well-being, nutritional care has been significantly compromised by cuts to social care budgets. The potential role for home-care workers in promoting good nutrition in older people is undervalued and undermined by the lack of recognition, training and time dedicated to food-related care. This has led to a situation whereby good quality food and enjoyable mealtimes are denied to many older people on the basis that they are unaffordable luxuries rather than an integral component of fundamental care. © 2014 John Wiley & Sons Ltd.
Residential homes encourage new residents to bring belongings with them, so that they can personalise their room and 'feel at home'. Existing literature on material culture in residential homes views objects as symbols and repositories of home and identity, which can facilitate a sense of belonging in residents through their display in residents' rooms. I suggest that this both misunderstands the processual and fluid nature of home and identity, and conceptualises objects as essentially passive. This article uses ethnographic data and theories of practice and relationality to argue that rather than the meaning of home being inherent in objects, or felt subjectively by residents, meaning is generated through ongoing, everyday interactions between the two. I show that residents became at home by acquiring new things -as well as displaying existing possessions - and also through interacting with mundane objects in everyday social and relational practices such as cleaning and hosting. I conclude that being at home in older people's residential homes need not be so different from being at home at other stages of the life course and in other settings. This challenges conceptualisations of older people's homes - and older age itself - as somehow unknowable and unfamiliar. © 2018 Foundation for the Sociology of Health & Illness.
Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S
This study focused on the associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 719 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption and this survey was followed 10 years and 20 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 20-year interval. Medical conditions, depressive symptoms, medication use, and acute health events were associated with a higher likelihood of abstinence; acute health events were also associated with less alcohol consumption. In contrast, reliance on alcohol to reduce pain was linked to more alcohol consumption. Moreover, an individual's overall health burden and reliance on alcohol to reduce pain were associated with more drinking problems. Reliance on alcohol to reduce pain potentiated the association between health burden, alcohol consumption and drinking problems. Older adults who have more health problems and rely on alcohol to manage pain are at elevated risk for drinking problems. Health care providers should target high-risk older adults, such as those who drink to reduce pain, for screening and brief interventions to help them identify new ways to cope with pain and curtail their drinking.
Northridge, Mary E; Schenkel, Andrew B; Birenz, Shirley; Estrada, Ivette; Metcalf, Sara S; Wolff, Mark S
To help eliminate reported racial/ethnic and socioeconomic inequities in oral health care, listening to the perspectives of racial/ethnic minority older adults on their experiences with dental school clinics is needed. The aim of this study was to examine the experiences of African American, Puerto Rican, and Dominican older adults who attend senior centers in upper Manhattan, New York City, regarding the care received at dental school clinics. Focus groups were conducted from 2013 to 2015 with 194 racial/ethnic minority men and women aged 50 years and older living in upper Manhattan. All of the 24 focus group sessions were digitally audiorecorded and transcribed for analysis. Groups conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Seven subthemes were manifest in the data related to these adults' positive experiences with dental school clinics: excellent outcomes and dentists, painless and safe treatment, affordable care, honest and reputable, benefits of student training, accepting and helpful, and recommended by family and friends. Negative experiences centered around four subthemes: multiple visits required for treatment, loss of interpersonal communication due to use of technology, inconvenient location, and perceived stigma with Medicaid. This study provided novel evidence of the largely positive experiences with dental schools of racial/ethnic minority senior center attendees. Interventions targeted at the organization and provider level, including organizational motivation, resources, staff attributes, climate, and teamwork plus payment programs and services, insurance and affordability, and provider- and system-level supports, may improve health care processes and patient experiences of care.
Page, Sharon; Coupe, Alastair; Barrett, Andrew
An increasing elderly population is leading to a change in the global demographics. This presents a new challenge to society and the pharmaceutical industry. This demographic shift is providing an opportunity for the pharmaceutical industry to meet the specific needs of the changing patient population. One issue that has been identified is defining what is meant by "an older patient", since this definition cannot be simply limited to chronological age. The fundamental purpose of the design and development process is to create a product that can be used by the patient group in a safe and efficacious manner. In the pharmaceutical industry ICH Q8 is used to guide the design and development of medicines. The process leads to the definition of the Quality Target Product Profile (QTPP) for a specific drug product and patient population. One can imagine a product with various presentations described in the QTPP which suit paediatrics, adults and older patients. It is recognised that designing medicines for smaller population groups will result in multiple presentations that could lead to smaller manufacturing batch sizes. In the short to medium term; dose flexibility, easy-to-swallow formulations, and easier access packaging are all factors under consideration. Dose flexibility could be achieved with various dosage forms such as oral liquids, mini-tablets, or multi-particulates. Whilst patient dosage preferences are beginning to be understood, further investigation is needed to balance the needs of the patient, care giver, prescriber, and payer. There also remain a number of challenges with the engineering solutions and delivery device for mini-tablets and multi-particulates (aside from filled capsules) to accurately and robustly deliver the dose, and issues with handling the device and the packaging for an older patient. It is also recognised that there are numerous challenges, not least of which is the definition of the older patient and a generic QTPP for an older
Zhang, Qiuyi; Northridge, Mary E; Jin, Zhu; Metcalf, Sara S
Increased lifespans and population growth have resulted in an older U.S. society that must reckon with the complex oral health needs that arise as adults age. Understanding accessibility to screening and treatment facilities for older adults is necessary in order to provide them with preventive and restorative services. This study uses an agent-based model to examine the accessibility of screening and treatment facilities via transportation networks for older adults living in the neighborhoods of northern Manhattan, New York City. Older adults are simulated as socioeconomically distinct agents who move along a GIS-based transportation network using transportation modes that mediate their access to screening and treatment facilities. This simulation model includes four types of mobile agents as a simplifying assumption: walk, by car, by bus, or by van (i.e., a form of transportation assistance for older adults). These mobile agents follow particular routes: older adults who travel by car, bus, and van follow street roads, whereas pedestrians follow walkways. The model enables the user to focus on one neighborhood at a time for analysis. The spatial dimension of an older adult's accessibility to screening and treatment facilities is simulated through the travel costs (indicated by travel time or distance) incurred in the GIS-based model environment, where lower travel costs to screening and treatment facilities imply better access. This model provides a framework for representing health-seeking behavior that is contextualized by a transportation network in a GIS environment.
Ehlman, Katie; Ligon, Mary
Generativity is a concept first introduced by Erik Erikson as a part of his psychosocial theory which outlines eight stages of development in the human life. Generativity versus stagnation is the main developmental concern of middle adulthood; however, generativity is also recognized as an important theme in the lives of older adults. Building on…
Mortenson, W Ben; Sixsmith, Andrew; Woolrych, Ryan
There is a long history of surveillance of older adults in institutional settings and it is becoming an increasingly common feature of modern society. New surveillance technologies that include activity monitoring, and ubiquitous computing, which are described as ambient assisted living (AAL) are being developed to provide unobtrusive monitoring and support of activities of daily living and to extend the quality and length of time older people can live in their homes. However, concerns have been raised with how these kinds of technologies may affect user's privacy and autonomy. The objectives of this paper are 1) to describe the development of home-based surveillance technologies; 2) to examine how surveillance is being restructured with the use of this technology; and 3) to explore the potential outcomes associated with the adoption of AAL as a means of surveillance by drawing upon the theoretical work of Foucault and Goffman. The discussion suggests that future research needs to consider two key areas beyond the current discourse on technology and ageing, specifically: 1) how the new technology will encroach upon the private lived space of the individual, and 2) how it will affect formal and informal caring relationships. This is critical to ensure that the introduction of AAL does not contribute to the disempowerment of residents who receive this technology.
Kulla, Gunilla; Ekman, Sirkka-Liisa; Sarvimäki, Anneli
Research has shown that immigrants and minority groups tend to have a lower health status compared to the majority population. The Finnish immigrants in Sweden are no exception. The Finland-Swedes, i.e., persons living in Finland who have Swedish as their mother language, seem to be an exception, however. They have been found to have better health and longer life expectancy compared to the Finnish majority. Research on health among migrated Finland-Swedes is scarce. The aim of this study was to describe and deepen the understanding of how older Finland-Swedes living as immigrants in Sweden, as well as re-migrants in Finland, experienced their health. Data was collected through 39 qualitative interviews with 29 older Finland-Swedes aged 65 or more. Data was analysed through qualitative thematic content analysis. The analysis resulted in five themes: Ageing means becoming frail and closer to death; Despite frailty and old age it is possible to feel well and experience peace; Being grateful for health as a source of life; Health comes from inner strength and external sources; Migration meant a mental and physical burden to health. Overall, both ageing and migration were experienced as jeopardising health.
Wang, Rosalie H; Korotchenko, Alexandra; Hurd Clarke, Laura; Mortenson, W Ben; Mihailidis, Alex
Collision avoidance technology has the capacity to facilitate safer mobility among older power mobility users with physical, sensory, and cognitive impairments, thus enabling independence for more users. Little is known about consumers' perceptions of collision avoidance. This article draws on interviews (29 users, 5 caregivers, and 10 prescribers) to examine views on design and utilization of this technology. Data analysis identified three themes: "useful situations or contexts," "technology design issues and real-life application," and "appropriateness of collision avoidance technology for a variety of users." Findings support ongoing development of collision avoidance for older adult users. The majority of participants supported the technology and felt that it might benefit current users and users with visual impairments, but might be unsuitable for people with significant cognitive impairments. Some participants voiced concerns regarding the risk for injury with power mobility use and some identified situations where collision avoidance might be beneficial (driving backward, avoiding dynamic obstacles, negotiating outdoor barriers, and learning power mobility use). Design issues include the need for context awareness, reliability, and user interface specifications. User desire to maintain driving autonomy supports development of collaboratively controlled systems. This research lays the groundwork for future development by illustrating consumer requirements for this technology.
Mortenson, W. Ben; Sixsmith, Andrew; Woolrych, Ryan
There is a long history of surveillance of older adults in institutional settings and it is becoming an increasingly common feature of modern society. New surveillance technologies that include activity monitoring, and ubiquitous computing, which are described as ambient assisted living (AAL) are being developed to provide unobtrusive monitoring and support of activities of daily living and to extend the quality and length of time older people can live in their homes. However, concerns have been raised with how these kinds of technologies may affect user’s privacy and autonomy. The objectives of this paper are 1) to describe the development of home-based surveillance technologies; 2) to examine how surveillance is being restructured with the use of this technology; and 3) to explore the potential outcomes associated with the adoption of AAL as a means of surveillance by drawing upon the theoretical work of Foucault and Goffman. The discussion suggests that future research needs to consider two key areas beyond the current discourse on technology and ageing, specifically: 1) how the new technology will encroach upon the private lived space of the individual, and 2) how it will affect formal and informal caring relationships. This is critical to ensure that the introduction of AAL does not contribute to the disempowerment of residents who receive this technology. PMID:29307944
Sherwin, Susan; Winsby, Meghan
To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.
Melo, Denise da Silva; Martins, René Duarte; Jesus, Renata Patrícia Freitas Soares de; Samico, Isabella Chagas; Santo, Antônio Carlos Gomes do Espírito
To assess the quality of health care of older adults using as a parameter the assessment of the responsiveness of the service. This is a descriptive cross-sectional study conducted in a reference unit of the Brazilian Unified Health System at the outpatient level. The sample was probabilistic and had 385 older adults; data collection occurred in 2014. The domains assessed were: choice, autonomy, confidentiality, dignity, communication, physical facilities, and fast service. To this end, we used Pearson correlation test and Fisher's exact test. The domains of dignity, confidentiality, and communication reached the highest level of adequate responsiveness. On the other hand, freedom of choice and fast service received the worst assessments. Participation in decision-making regarding treatment was significantly lower among the older adults who had no education. In addition, the older adults that self-reported as black receive a lower quality of care regarding clear explanation and respected privacy in the appointment, when compared to users of any other race. Although most domains studied have receive a positive assessment, we have found a need for an equal care by the health professionals, regardless of race, education level, or any other adjective characteristic of older adults, users of public health services. Avaliar a qualidade da atenção à saúde da população idosa usando como parâmetro a avaliação da responsividade do serviço. Trata-se de um estudo descritivo, de corte transversal, realizado em uma unidade de referência do Sistema Único de Saúde em nível ambulatorial. A amostra foi probabilística composta por 385 idosos e a coleta de dados ocorreu em 2014. Foram avaliados os domínios: escolha, autonomia, confidencialidade, dignidade, comunicação, instalações físicas e atendimento rápido. Para tanto, foram utilizados o teste de correlação de Pearson e o teste de Fisher. Os domínios dignidade, confidencialidade e comunicação atingiram o
Gibbs, Sheena Simpkins; Kulig, Judith C
The world's population is getting older, which will inevitably cause increased demands for nurses to provide high quality care to this demographic. Attitudes have been shown to influence the quality of care that older adults receive. It is therefore important to gain a better understanding of what influences nursing students' attitudes towards older adults. This article reports on one of three inter-connected research questions of a mixed methods study that explored the relationship between clinical instructors' attitudes and nursing students' attitudes towards older adults. Semi-structured interviews were conducted with 6 clinical instructors and 13 nursing students. Interview data was analyzed using thematic analysis. A conceptual model was developed from the research findings, which revealed that nursing instructors are seen as strong role models for their students, and as role models, they influence students through demonstrations, expectations and support. As a result, nursing students mirror the attitudes of their instructors towards older adults. Findings from this study highlight the strong connection between nursing instructors' and students' attitudes. This has important implications for nursing education including strategies that instructors can employ to enhance students' attitudes towards older adults. Insights from this study also have the potential to improve the quality of care that future nurses provide to older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.
Jeffery C. Goelz
Typically, when different forms of growth and yield models are considered, they are grouped into convenient discrete classes. As a heuristic device, I chose to use a contrasting perspective, that all growth and yield models are diameter distribution models that merely differ in regard to which diameter distribution is employed and how the distribution is projected to...
Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha
The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults. © The Author(s) 2014.
McKay, Roderick; McDonald, Regina; Lie, David; McGowan, Helen
The 'biopsychosocial', 'person-centred care' (PCC) and 'recovery' models of care can be seen as distinct and competing paradigms. This paper proposes an integration of these valuable perspectives and suggestions for effective implementation in health services for the elderly. An overview of PCC and recovery models, and their application for older people with mental health problems, is provided. Their overlap and contrast with the familiar 'biopsychosocial' model of mental health care is considered, together with obstacles to implementation. Utilisation of PCC and recovery concepts allow clinicians to avoid narrow application of the biopsychosocial approach and encourages clinicians to focus on the person's right to autonomy, their values and life goals. Service reform and development is required to embed these concepts into core clinical processes so as to improve outcomes and the quality of life for older people with mental health problems.
Grossmann, Mathis; Matsumoto, Alvin M
Middle-aged and older men (≥50 years), especially those who are obese and suffer from comorbidities, not uncommonly present with clinical features consistent with androgen deficiency and modestly reduced testosterone levels. Commonly, such men do not demonstrate anatomical hypothalamic-pituitary-testicular axis pathology but have functional hypogonadism that is potentially reversible. Literature review from 1970 to October 2016. Although definitive randomized controlled trials are lacking, evidence suggests that in such men, lifestyle measures to achieve weight loss and optimization of comorbidities, including discontinuation of offending medications, lead to clinical improvement and a modest increase in testosterone. Also, androgen deficiency-like symptoms and end-organ deficits respond to targeted treatments (such as phosphodiesterase-5 inhibitors for erectile dysfunction) without evidence that hypogonadal men are refractory. Unfortunately, lifestyle interventions remain difficult and may be insufficient even if successful. Testosterone therapy should be considered primarily for men who have significant clinical features of androgen deficiency and unequivocally low testosterone levels. Testosterone should be initiated either concomitantly with a trial of lifestyle measures, or after such a trial fails, after a tailored diagnostic work-up, exclusion of contraindications, and appropriate counseling. There is modest evidence that functional hypogonadism responds to lifestyle measures and optimization of comorbidities. If achievable, these interventions may have demonstrable health benefits beyond the potential for increasing testosterone levels. Therefore, treatment of underlying causes of functional hypogonadism and of symptoms should be used either as an initial or adjunctive approach to testosterone therapy.
Despite comprehensive school reform (CSR) model developers' best intentions to make school stakeholders adhere strictly to the implementation of model components, school stakeholders implementing CSR models inevitably make adaptations to the CSR model. Adaptations are made to CSR models because school stakeholders internalize CSR model practices…
This paper explores the foundation of the financial accounting model. We examine the properties of the accounting equation as the principal algorithm for the design and the development of a System Dynamics model. Key to the perspective is the foundational requirement that resolves the temporal
Matsumoto, Alvin M.
Abstract Context: Middle-aged and older men (≥50 years), especially those who are obese and suffer from comorbidities, not uncommonly present with clinical features consistent with androgen deficiency and modestly reduced testosterone levels. Commonly, such men do not demonstrate anatomical hypothalamic–pituitary–testicular axis pathology but have functional hypogonadism that is potentially reversible. Evidence Acquisition: Literature review from 1970 to October 2016. Evidence Synthesis: Although definitive randomized controlled trials are lacking, evidence suggests that in such men, lifestyle measures to achieve weight loss and optimization of comorbidities, including discontinuation of offending medications, lead to clinical improvement and a modest increase in testosterone. Also, androgen deficiency–like symptoms and end-organ deficits respond to targeted treatments (such as phosphodiesterase-5 inhibitors for erectile dysfunction) without evidence that hypogonadal men are refractory. Unfortunately, lifestyle interventions remain difficult and may be insufficient even if successful. Testosterone therapy should be considered primarily for men who have significant clinical features of androgen deficiency and unequivocally low testosterone levels. Testosterone should be initiated either concomitantly with a trial of lifestyle measures, or after such a trial fails, after a tailored diagnostic work-up, exclusion of contraindications, and appropriate counseling. Conclusions: There is modest evidence that functional hypogonadism responds to lifestyle measures and optimization of comorbidities. If achievable, these interventions may have demonstrable health benefits beyond the potential for increasing testosterone levels. Therefore, treatment of underlying causes of functional hypogonadism and of symptoms should be used either as an initial or adjunctive approach to testosterone therapy. PMID:28359097
This paper explores the foundation of the financial accounting model. We examine the properties of the accounting equation as the principal algorithm for the design and the development of a System Dynamics model. Key to the perspective is the foundational requirement that resolves the temporal conflict that resides in a stock and flow model. Through formal analysis the accounting equation is redefined as a cybernetic model by expressing the temporal and dynamic properties of its terms. Articu...
Abuzeinab, Amal; Arif, Mohammed
PhD study Business models describe the business logic of a particular company and green business model is when a company changes part(s) of its business model and thereby both captures economic value and reduces the ecological footprint in a life-cycle perspective. In this paper, business model literature is reviewed with the intention of promoting learning to understand the economic complexity of environmental sustainability in the construction context. Although the green construction lit...
Norberg, Ragnar; Planchet, Frédéric
Focussing on life insurance and pensions, this book addresses various aspects of modelling in modern insurance: insurance liabilities; asset-liability management; securitization, hedging, and investment strategies. With contributions from internationally renowned academics in actuarial science, finance, and management science and key people in major life insurance and reinsurance companies, there is expert coverage of a wide range of topics, for example: models in life insurance and their roles in decision making; an account of the contemporary history of insurance and life insurance mathematics; choice, calibration, and evaluation of models; documentation and quality checks of data; new insurance regulations and accounting rules; cash flow projection models; economic scenario generators; model uncertainty and model risk; model-based decision-making at line management level; models and behaviour of stakeholders. With author profiles ranging from highly specialized model builders to decision makers at chief ex...
Lyudmila A. Mikhailova
Purpose: the main goal of the article is to define the development perspectives of the new franchising models in Russia (specifically quasifranchising, freedom franchising and branchising). To achieve this the following tusks should be completed: to define the specific characteristics of the following models as well as the factors which influenced their occurrence; to question Russian franchisors in order to understand their desire to develop their business under the new franchising models; t...
Bärenfänger, Rieke; Otto, Boris
Business models comprehensively describe the functioning of businesses in contemporary economic, technological, and societal environments. This paper focuses on the characteristics of digital business models from the perspective of capability research and develops a capability model for digital businesses. Following the design science research (DSR) methodology, multiple evaluation and design iterations were performed. Contributions to the design process came from IS/IT practice and the resea...
Kosteli, Maria-Christina; Cumming, Jennifer; Williams, Sarah E
Limited research has investigated exercise imagery use in middle-aged and older adults and its relationship with affective and behavioral correlates. The study examined the association between self-regulatory imagery and physical activity (PA) through key social cognitive variables. Middle-aged and older adults (N = 299; M age = 59.73 years, SD = 7.73, range = 50 to 80) completed self-report measures assessing self-regulatory imagery use, self-efficacy, outcome expectations, perceived barriers, self-regulatory behavior, enjoyment, and PA levels. Path analysis supported a model (χ²  = 21.76, p = .08, CFI = .99, TLI = .97, SRMR = .03, RMSEA = .04) whereby self-regulatory imagery positively predicted self-efficacy, outcome expectations, and self-regulatory behaviors. Furthermore, self-regulatory imagery indirectly predicted barriers, outcome expectations, self-regulation, enjoyment, and PA. This research highlights self-regulatory imagery as an effective strategy in modifying exercise-related cognitions and behaviors. Incorporating social cognitive constructs into the design of imagery interventions may increase PA engagement.
Wong, Anna; Chau, Anson K C; Fang, Yang; Woo, Jean
Loneliness is a common experience among older people that is associated with health risks and negative well-being. As a psychological phenomenon, it has typically been defined in Western research literature as the discrepancy between desired and actual interpersonal relations. In our qualitative study in Hong Kong, we offer insight into ageing and loneliness in an urban environment of the non-Western world and propose to reconceptualise loneliness by exploring older people's experience of alienation at the societal level as an important but often neglected dimension of their loneliness. Thirty-seven community-dwelling, Chinese adults aged 65 and above were interviewed in focus groups and their accounts analysed and interpreted using a phenomenological approach. Findings revealed that focus group participants perceived insufficient care for older people, a growing distance between themselves and society, and their disintegrating identity in society to be primary sources of societal alienation. In response, older people adopted a more passive lifestyle, attributed marginalisation and inequality to old age, and developed negative feelings including unease towards ageing, vulnerability and helplessness, and anger. The emergence of these key components and underlying themes of societal alienation illuminated neglected facets of the psychological phenomenon of loneliness and highlighted new implications for policy, practice, and research from a societal perspective to address older people's loneliness in urban settings.
La Rosa, M.; Dumas, M.; Hofstede, ter A.H.M.; Mendling, J.
A configurable process model provides a consolidated view of a family of business processes. It promotes the reuse of proven practices by providing analysts with a generic modeling artifact from which to derive individual process models. Unfortunately, the scope of existing notations for
... tensor are taken into consideration, whereas the shear stresses are intentionally dropped with the purpose of providing a useful perspective, with which Winkler's model and its associated coefficient of subgrade reaction can be viewed. The formulation takes into account the variation of the elasticity modulus with depth.
Low, Gail; Molzahn, Anita E; Kalfoss, Mary
In this study, Glick and Tripp-Reimer's (1996) Iowa model for gerontological nursing serves as a guiding framework for a descriptive exploratory study of quality of life (QOL) of older adults. Using secondary data, the authors explored whether the effects of health appraisal, morbidities, social support transitions (SST), and the environment on QOL would be partly mediated by cognitive developmental transitions (CDT). Data sets were available from studies with random samples of community-dwelling older adults from Canada (n = 202) and Norway (n = 490). The partly and fully mediated effects found suggest positive CDT in older age might be significantly enhanced by the presence of intimate ties, positive perceptions of one's health limitations, and residence in a healthy, safe, and resource-rich physical environment. These findings represent a novel attempt at testing complex linkages between aspects of elder, environment, and nursing concepts within the Iowa model warranting further research.
Guizani, Mohsen; Khan, Bilal
Network Modeling and Simulation is a practical guide to using modeling and simulation to solve real-life problems. The authors give a comprehensive exposition of the core concepts in modeling and simulation, and then systematically address the many practical considerations faced by developers in modeling complex large-scale systems. The authors provide examples from computer and telecommunication networks and use these to illustrate the process of mapping generic simulation concepts to domain-specific problems in different industries and disciplines. Key features: Provides the tools and strate
Modelling-based health care management ought to become just as popular as evidence based medicine. Making managerial decisions based on evidence by modelling efforts is certainly a step forward. Examples can be given of many successful applications in different areas of decision making: disease
Full Text Available In Sweden there has been a move towards more cost reflective price models for district heating in order to reduce economic risks that comes with variable heat demand and high shares of fixed assets. The keywords in the new price models are higher shares of fixed cost, seasonal energy prices and charging for capacity. Also components that are meant to serve as incentives to affect behaviour are introduced, for example peak load components and flow components. In this study customer responses to these more complex price models have been investigated through focus group interviews and through interviews with companies that have changed their price models. The results show that several important customer requirements are suffering with the new price models. The most important ones are when energy savings do not provide financial savings, when costs are hard to predict and are perceived to be out of control.
Disclosure of information on strategies, business models, critical success factors, risk factors and value drivers in general has gained importance in recent years. Both policy makers and academics have argued that the demand for external communication of new types of value drivers is rising...... as companies increasingly base their competitive strengths and thus the value of the company on know-how, patents, skilled employees and other intangibles. In parallel with the focus on disclosure of value drivers, the concept of business models has gained popularity. However, business models in terms of “ways...
Yang, M; Evans, S; Vladimirova, D; Rana, P
Sustainability has become one of the key factors for long-term business success. Recent research and practice show that business model innovation is a promising approach for improving sustainability in manufacturing firms. To date business models have been examined mostly from the perspectives of value proposition, value capture, value creation and delivery. There is a need for a more comprehensive understanding of value in order to promote sustainability. This paper proposes value uncaptured...
Felicia Cornelia MACARIE; Octavian MOLDOVAN
The present paper explores the degree in which universities could/should serve as role models for communities from the perspective of gender integration. Although the theoretical/ moral answer would be affirmative (universities should be in such a position that would allow local communities to regard them as role models of gender integration), the primary empirical analysis leads to another conclusion. A brief theoretical review (that connects gender discrimination, sustainable development, u...
Shin, So Young
To evolve a management plan for rheumatoid arthritis, it is necessary to understand the patient's symptom experience and disablement process. This paper aims to introduce and critique two models as a conceptual foundation from which to construct a new model for arthritis care. A Disability Intervention Model for Older Adults with Arthritis includes three interrelated concepts of symptom experience, symptom management strategies, and symptom outcomes that correspond to the Theory of Symptom Management. These main concepts influence or are influenced by contextual factors that are situated within the domains of person, environment, and health/illness. It accepts the bidirectional, complex, dynamic interactions among all components within the model representing the comprehensive aspects of the disablement process and its interventions in older adults with rheumatoid arthritis. In spite of some limitations such as confusion or complexity within the model, the Disability Intervention Model for Older Adults with Arthritis has strengths in that it encompasses the majority of the concepts of the two models, attempts to compensate for the limitations of the two models, and aims to understand the impact of rheumatoid arthritis on a patient's physical, cognitive, and emotional health status, socioeconomic status, and well-being. Therefore, it can be utilized as a guiding theoretical framework for arthritis care and research to improve the functional status of older adults with rheumatoid arthritis. Copyright © 2014. Published by Elsevier B.V.
Pham, Tam N; Carrougher, Gretchen J; Martinez, Erin; Lezotte, Dennis; Rietschel, Carly; Holavanahalli, Radha; Kowalske, Karen; Esselman, Peter C
Older patients with burn injury have a greater likelihood for discharge to nursing facilities. Recent research indicates that older patients discharged to nursing facilities are two to three times as likely to die within a 3-year period relative to those discharged to home. In light of these poor long-term outcomes, we conducted this study to identify predictors for discharge to independent vs nonindependent living status in older patients hospitalized for burns. We retrospectively reviewed all older adults (age ≥ 55 years) who were prospectively enrolled in a longitudinal multicenter study of outcomes from 1993 to 2011. Patient, injury, and treatment outcomes data were analyzed. Recognizing that transfer to inpatient rehabilitation may have impacted final hospital discharge disposition: we assessed the likelihood of inpatient rehabilitation stay, based on identified predictors of inpatient rehabilitation. We subsequently performed a logistic regression analysis on the clustered, propensity-matched cohort to assess associations of burn and injury characteristics on the primary outcome of final discharge status. A total of 591 patients aged ≥55 years were treated and discharged alive from three participating U.S. burn centers during the study period. Mean burn size was 14.8% (SD 11.2%) and mean age was 66.7 years (SD 9.3 years). Ninety-three patients had an inpatient rehabilitation stay before discharge (15.7%). Significant factors predictive of inpatient rehabilitation included a burn >20% TBSA, mechanical ventilation, older age, range of motion deficits at acute care discharge, and study site. These factors were included in the propensity model. Four hundred seventy-one patients (80%) were discharged to independent living status. By matched propensity analysis, older age was significantly associated with a higher likelihood of discharge to nonindependent living (P burn centers need to be elucidated to better understand discharge disposition status in older
Arnautovska, Urska; Fleig, Lena; O'Callaghan, Frances; Hamilton, Kyra
To assess the effects of conscious and non-conscious processes for prediction of older adults' physical activity (PA), we tested a dual-process model that integrated motivational (behavioural intention) and volitional (action planning and coping planning) processes with non-conscious, automatic processes (habit). Participants (N = 215) comprised community-dwelling older adults (M = 73.8 years). A longitudinal design was adopted to investigate direct and indirect effects of intentions, habit strength (Time 1), and action planning and coping planning (Time 2) on PA behaviour (Time 3). Structural equation modelling was used to evaluate the model. The model provided a good fit to the data, accounting for 44% of the variance in PA behaviour at Time 3. PA was predicted by intentions, action planning, and habit strength, with action planning mediating the intention-behaviour relationship. An effect of sex was also found where males used fewer planning strategies and engaged in more PA than females. By investigating an integration of conscious and non-conscious processes, this study provides a novel understanding of older adults' PA. Interventions aiming to promote PA behaviour of older adults should target the combination of psychological processes.
Stiggelbout, M.; Hopman-Rock, M.; Crone, M.; Lechner, L.; Mechelen, W. van
Little is known about the predictors of maintenance in organized exercise programmes. The aim of this study was to investigate the behavioral predictors of maintenance of exercise participation in older adults, using an integrated social psychological model. To this end, we carried out a prospective
Gobbens, R.J.J.; Krans, A.; van Assen, M.A.L.M.
Objective The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Methods Between June 2013 and May 2014
Gobbens, Robbert J J; Krans, Anita; van Assen, Marcel A L M
Objective: The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Methods: Between June 2013 and May 2014
The Steering Committee for Nuclear Energy of the OECD-Nuclear Energy Agency decided in April 1981 to set up a Co-ordinated Research and Environmental Surveillance Programme relevant to sea disposal of radioactive waste (CRESP) with the objective of reinforcing the scientific basis of future assessments of the continued suitability of the North-East Atlantic site to be made under the NEA Multilateral Consultation and Surveillance Mechanism. A major component of the initial CRESP plan was the development of a site-specific model to predict radionuclide transfer rates and patterns in the marine environment. A new general approach to the design of such a site-specific model is discussed.Although this approach originates partly from methodologies presented in GESAMP partly from an approach put forward within the NEA Seabed Working Group/Geochemical and Physical Oceanography Task Group and partly from methods previously agreed by the CRESP Modelling Task Group, the modelling philosophy developed in the text expressed the personal viewpoint of the author. This text aims to state the present methods of modelling the marine transfer of radionuclides and to anticipate modelling strategies which may be adopted in the future (in France for example), but it does not necessarily meet present NEA viewpoints and the philosophy of other CRESP participating countries
Basic, David; Khoo, Angela
To examine the relationship between newly made medical diagnoses and length of stay (LOS) of acutely unwell older patients. Consecutive patients admitted under the care of four geriatricians were randomly allocated to a model development sample (n = 937) or a model validation sample (n = 855). Cox regression was used to model LOS. Variables considered for inclusion in the development model were established risk factors for LOS and univariate predictors from our dataset. Variables selected in the development sample were tested in the validation sample. A median of five new medical diagnoses were made during a median LOS of 10 days. New diagnoses predicted an increased LOS (hazard ratio 0.90, 95% confidence interval 0.88-0.92). Other significant predictors of increased LOS in both samples were malnutrition and frailty. Identification of new medical diagnoses may have implications for Diagnosis Related Groups-based funding models and may improve the care of older people. © 2015 AJA Inc.
Full Text Available Organizations inform stakeholders about their current and future activities, processes, created value, strategic intentions, and other information that may influence the established relationships. Organizations choose to communicate with stakeholders by different means and in varied ways. The annual report represents a way of communicating between companies and their stakeholders, and it is offering comprehensive information about how companies operates and creates value. The business model is an emerging concept in management literature and practice. The concept describes the logic by which a organization creates, maintains and delivers value for its stakeholders. Through annual reports organisations can communicate to stakeholders information about their business models.We investigated how information about business models is explicitly communicated through annual reports, and how this information is reffering to stakeholders. Our paper aims to reveal which stakeholders are more often mentioned when organizations are communicating about business models through annual reports. This approach shows the attention degree given by organizations to stakeholders. We perceived this from a strategic point of view, as a strategic signal. Thus, we considered if the stakeholder is mentioned more frequent in the communicated message it has a greater role in communication strategy about business model. We conducted an exploratory research and have realized a content analysis.The analysed data consist in over a thousand annual reports from 96 organizations. We analysed the informations transmitted by organizations through annual reports. The annual reports were for a time period of 12 years. Most of the selected companies are multi-business, and are operating in different industries. The results show the stakeholder’s hierarchy based on how often they were mentioned in the communicated messages about business models through annual reports. Based on our
Oliver, T. Emerson; Anzalone, Evan; Park, Thomas; Geohagan, Kevin
The SLS Program has implemented a Model-based Design (MBD) and Model-based Requirements approach for managing component design information and system requirements. This approach differs from previous large-scale design efforts at Marshall Space Flight Center where design documentation alone conveyed information required for vehicle design and analysis and where extensive requirements sets were used to scope and constrain the design. The SLS Navigation Team is responsible for the Program-controlled Design Math Models (DMMs) which describe and represent the performance of the Inertial Navigation System (INS) and the Rate Gyro Assemblies (RGAs) used by Guidance, Navigation, and Controls (GN&C). The SLS Navigation Team is also responsible for navigation algorithms. The navigation algorithms are delivered for implementation on the flight hardware as a DMM. For the SLS Block 1B design, the additional GPS Receiver hardware model is managed as a DMM at the vehicle design level. This paper describes the models, and discusses the processes and methods used to engineer, design, and coordinate engineering trades and performance assessments using SLS practices as applied to the GN&C system, with a particular focus on the navigation components.
Potter, G.L.; Corsetti, L.; Slingo, J.M.
Radiation fields from a perpetual July integration of a T106 version of the ECM-WF operational model are used to identify the most appropriate way to diagnose cloud radiative forcing in a general circulation model, for the purposes of intercomparison between models. Differences between the Methods I and II of Cess and Potter (1987) and a variant method are addressed. Method I is shown to be the least robust of all methods, due to the potential uncertainties related to persistent cloudiness, length of the sampling period and biases in retrieved clear-sky quantities due to insufficient sampling of the diurnal cycle. Method II is proposed as an unambiguous way to produce consistent radiative diagnostics for intercomparing model results. The impact of the three methods on the derived sensitivities and cloud feedbacks following an imposed change in sea surface temperature is discussed. The sensitivity of the results to horizontal resolution is considered by using the diagnostics from parallel integrations with T21 version of the model
Full Text Available This paper proposes a model of country brand equity that incorporates the issue of sustainability in determining destination brand equity. In particular, the model includes elements of sustainability as its core dimensions and promotes the concept of the country sustainability promise that transforms destination resources into the positive perception and experience. The theoretical model is empirically tested using global secondary data confirming that country image is the most important element followed by sustainability and loyalty. Also, the analysis suggests the existence of the higher order construct confirming the country brand equity concept. Based on the research findings, the article offers some implications to the destination managers by suggesting the direction for further development and strategy implementation.
Howard, Elizabeth P; Schreiber, Robert; Morris, John N; Russotto, Aline; Flashner-Fineman, Susan
Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, COLLAGE 360 , a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.
Macucci, M.; Lannaccone, G.; Greer, J.
During the meetings of the theory and modelling working group, within the MEL-ARI (Microelectronics Advanced Research Initiative) and NID-FET (Nanotechnology information Devices-Future and Emerging Technologies) initiatives of the European Commission, we have been discussing the current status...
Blaszczyk, Michael I.
We consider the compactification of heterotic string theory on toroidal orbifolds and their resolutions. In the framework of gauged linear sigma models we develop realizations of such spaces, allowing to continously vary the moduli and thus smoothly interpolate between different corners of the theory. This way all factorizable orbifold resolutions as well as some non-factorizable ones can be obtained. We find that for a given geometry there are many model which realize it as a target space, differing in their complexity. We explore regions of moduli space which otherwise would not be accessible. In particular we are interested in the orbifold regime, where exact string calculations are possible, and the large volume regime, where techniques of supergravity compactification can be applied. By comparing these two theories and matching the spectra we find evidence for non-perturbative effects which interpolate between these regimes.
Svee , Eric-Oluf; Giannoulis , Constantinos; Zdravkovic , Jelena
Part 3: Business Modeling; International audience; Business strategy lays out the plan of an enterprise to achieve its vision by providing value to its customers. Typically, business strategy focuses on economic value and its relevant exchanges with customers and does not directly address consumer values. However, consumer values drive customers’ choices and decisions to use a product or service, and therefore should have a direct impact on business strategy. This paper explores whether and h...
Leutwyler, Heather; Hubbard, Erin M.; Jeste, Dilip V.; Vinogradov, Sophia
Targeted physical activity interventions to improve the poor physical function of older adults with schizophrenia are necessary but currently not available. Given disordered thought processes and institutionalization, it is likely that older adults with schizophrenia have unique barriers and facilitators to physical activity. It is necessary to…
Conclusion: The findings provide an initial validation of a social–ecological approach to the study of HPA in China, suggesting that strategies aimed at promoting physical activity in older adults should address multiple levels of factors that may contribute to the likelihood of older Chinese adults being physically active.
Objective To explore what might encourage older people to exercise at home after falls rehabilitation. Design: Qualitative research methods were used based on a grounded theory approach, to provide insights into older adults' experiences following a fall, of both rehabilitation and home exercise. Setting: Community dwellings. Method: Nine…
Regterschot, G. Ruben H.; Morat, Tobias; Folkersma, Marjanne; Zijlstra, Wiebren
Leg muscle strength (LMS) and leg muscle power (LMP) are determinants of aspects of functional status and important parameters for measuring intervention effects in older adults. Field tests are often used for the evaluation of LMS and LMP in older persons. However, criteria important for the
In most areas of the world the record of historical seismicity is too short or uncertain to accurately characterize the future distribution of earthquakes of different sizes in time and space. Most faults have not ruptured once, let alone repeatedly. Ultimately, the ability to correctly forecast the magnitude, location, and probability of future earthquakes depends on how well one can quantify the past behavior of earthquake sources. Paleoseismological trenching of active faults, historical surface ruptures, liquefaction features, and shaking-induced ground deformation structures provides fundamental information on the past behavior of earthquake sources. These studies quantify (a) the timing of individual past earthquakes and fault slip rates, which lead to estimates of recurrence intervals and the development of recurrence models and (b) the amount of displacement during individual events, which allows estimates of the sizes of past earthquakes on a fault. When timing and slip per event are combined with information on fault zone geometry and structure, models that define individual rupture segments can be developed. Paleoseismicity data, in the form of timing and size of past events, provide a window into the driving mechanism of the earthquake engine--the cycle of stress build-up and release
Ferris, Rosie; Blaum, Caroline; Kiwak, Eliza; Austin, Janet; Esterson, Jessica; Harkless, Gene; Oftedahl, Gary; Parchman, Michael; Van Ness, Peter H; Tinetti, Mary E
To ascertain perspectives of multiple stakeholders on contributors to inappropriate care for older adults with multiple chronic conditions. Perspectives of 36 purposively sampled patients, clinicians, health systems, and payers were elicited. Data analysis followed a constant comparative method. Structural factors triggering burden and fragmentation include disease-based quality metrics and need to interact with multiple clinicians. The key cultural barrier identified is the assumption that "physicians know best." Inappropriate decision making may result from inattention to trade-offs and adherence to multiple disease guidelines. Stakeholders recommended changes in culture, structure, and decision making. Care options and quality metrics should reflect a focus on patients' priorities. Clinician-patient partnerships should reflect patients knowing their health goals and clinicians knowing how to achieve them. Access to specialty expertise should not require visits. Stakeholders' recommendations suggest health care redesigns that incorporate patients' health priorities into care decisions and realign relationships across patients and clinicians.
Lagacé, Martine; Nahon-Serfaty, Isaac; Laplante, Joelle
Public representations of ageing can influence how individuals perceive their own experience of ageing. Results of studies on the OECD (Organisation for Economic Co-operation and Development)'s governmental messages on older workers suggest that they are mainly constructed around economic productivity and personal responsibility. The goal of this study is to examine how the Canadian government frames issues around ageing, work and older workers. Canada is facing a rapidly ageing workforce, hence the importance of examining how the government discusses ageing at work. A thematic content analysis was conducted on a total of 154 government web pages. Results revealed that predominant themes revolve around economic challenges resulting from an ageing workforce. Older workers are depicted as a key component for the (economic) management of an ageing workforce. More specifically, older workers who intend to continue working are highly valued in the government's messages which present them as productive citizens and role models for "ageing well". Canada's response to the challenges of an ageing workforce echoes the underlying standards of positive ageing models, which may generate, perhaps inadvertently, a new form of ageism by creating intra-and intergenerational divides in the workplace.
Lars Willem Chatrou
Full Text Available The Annonaceae includes cultivated species of economic interest and represents an important source of information for better understanding the evolution of tropical rainforests. In phylogenetic analyses of DNA sequence data that are used to address evolutionary questions, it is imperative to use appropriate statistical models. Annonaceae are cases in point: Two sister clades, the subfamilies Annonoideae and Malmeoideae, contain the majority of Annonaceae species diversity. The Annonoideae generally show a greater degree of sequence divergence compared to the Malmeoideae, resulting in stark differences in branch lengths in phylogenetic trees. Uncertainty in how to interpret and analyse these differences has led to inconsistent results when estimating the ages of clades in Annonaceae using molecular dating techniques. We ask whether these differences may be attributed to inappropriate modelling assumptions in the phylogenetic analyses. Specifically, we test for (clade-specific differences in rates of non-synonymous and synonymous substitutions. A high ratio of nonsynonymous to synonymous substitutions may lead to similarity of DNA sequences due to convergence instead of common ancestry, and as a result confound phylogenetic analyses. We use a dataset of three chloroplast genes (rbcL, matK, ndhF for 129 species representative of the family. We find that differences in branch lengths between major clades are not attributable to different rates of non-synonymous and synonymous substitutions. The differences in evolutionary rate between the major clades of Annonaceae pose a challenge for current molecular dating techniques that should be seen as a warning for the interpretation of such results in other organisms.
Stakeholder literature has acknowledged the need to complement the extant theory on stakeholder management by more dynamic perspectives. This article makes use of the recent terminology of stakewatcher and stakeseeker to illustrate the dynamic aspect of stakeholder theory transposed in the graphical representation of Freeman’s stakeholder model. Presenting a few selected case studies, it applies the scheme on the concept of value responsibility chain; it exemplifies the role of stakeseekers i...
The Shuttle Radar Topography Mission (SRTM) has produced the first high-resolution, near-global elevation dataset of Earth. In recognition of this achievement, and as an illustration of the data, the United States Library of Congress now displays a 'solid terrain model' of Los Angeles and adjacent mountainous terrain. The model was created by carving a high-density foam block using computer-guided drills that referenced the SRTM dataset. The block was then covered with a Landsat satellite image using computer-guided paint guns that referenced both the Landsat image and the SRTM dataset. The view shown here mimics the actual model on display at the Library of Congress and was generated from the same satellite image and elevation data sets. The model shows the Pacific Ocean and Santa Monica Mountains along the Malibu Coast (lower left), San Fernando Valley (left center), downtown Los Angeles (bottom center), San Gabriel and Pomona Valleys (lower right), San Gabriel Mountains (right center to far right), and part of the Mojave Desert (upper right). Colors are enhanced true color with added topographic shading, and elevation differences are exaggerated 1.5 times. The view is toward the north-northwest. The Los Angeles region was chosen for the Library of Congress model because it illustrates so many ways that topography affects the daily lives of people. The region consists of a coastal plain, inland valleys, mountains up to 3068 meters (10,064 feet), and a desert interior. Topography blocks the landward influence of marine airmasses here such that summer temperatures often differ by 40 degrees Fahrenheit (22 C) across this region at a given moment even at similar elevations. Temperatures also typically cool with rising elevation, and winter storms drop most of their moisture in the mountains, leaving little rainfall for areas further inland, thus creating the deserts. Topography also controls the land use pattern. The mountains are mostly very rugged, which greatly
Full Text Available Wearable sensors have potential for quantitative, gait-based, point-of-care fall risk assessment that can be easily and quickly implemented in clinical-care and older-adult living environments. This investigation generated models for wearable-sensor based fall-risk classification in older adults and identified the optimal sensor type, location, combination, and modelling method; for walking with and without a cognitive load task. A convenience sample of 100 older individuals (75.5 ± 6.7 years; 76 non-fallers, 24 fallers based on 6 month retrospective fall occurrence walked 7.62 m under single-task and dual-task conditions while wearing pressure-sensing insoles and tri-axial accelerometers at the head, pelvis, and left and right shanks. Participants also completed the Activities-specific Balance Confidence scale, Community Health Activities Model Program for Seniors questionnaire, six minute walk test, and ranked their fear of falling. Fall risk classification models were assessed for all sensor combinations and three model types: multi-layer perceptron neural network, naïve Bayesian, and support vector machine. The best performing model was a multi-layer perceptron neural network with input parameters from pressure-sensing insoles and head, pelvis, and left shank accelerometers (accuracy = 84%, F1 score = 0.600, MCC score = 0.521. Head sensor-based models had the best performance of the single-sensor models for single-task gait assessment. Single-task gait assessment models outperformed models based on dual-task walking or clinical assessment data. Support vector machines and neural networks were the best modelling technique for fall risk classification. Fall risk classification models developed for point-of-care environments should be developed using support vector machines and neural networks, with a multi-sensor single-task gait assessment.
Lee, Hsin-Tzu Sophie; Cheng, Shu-Chen; Dai, Yu-Tzu; Chang, Mei; Hu, Wen-Yu
Chinese tradition and culture developed from Taoism, Confucianism, and Buddhism and have influenced ethnic Chinese for thousands of years, particularly thoughts on death. Many ethnic Chinese, particularly older people, refrain from discussing death-related concerns, making it difficult to obtain advance directives, including do-not-resuscitate (DNR) directives, signed independently by older people. This study explored the attitudes of older nursing home residents in Taiwan toward signing their own DNR directives. This study adopted purposive sampling and collected data through in-depth interviews. The data were analysed using qualitative inductive content analysis, and the study location was a nursing home in Eastern Taiwan. A total of 11participants were recruited from a sample of 12 eligible participants. Most of the older residents in this study refused to make decisions independently regarding DNR directives. Content analysis of the interviews revealed four themes concerning refusing to sign DNR directives independently: not going against nature, accepting the results of cause and effect, viewing the family as a decision-making system, and practising self-effacement. Chinese cultural aspects, including Taoist, Buddhist, and Confucian philosophy, affected the autonomy of the older residents, and they relied on others to make decisions for them. Professionals must respect this family-oriented decision-making thinking of older residents because it reflects personal choice. Otherwise, healthcare providers may play a mediating role in coordinating and communicating between older residents and their families regarding EOL-care-related concerns, replacing the traditional practice of holding a family meeting.
Venkatasalu, Munikumar Ramasamy
To investigate older British South Asians' views on dying at acute hospitals. Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study. Data were collected using gender-based focus groups (n=5) and in-depth, semi-structured interviews (n=29). Transcripts were analysed using Nvivo 9. Three key themes were identified: 'mistrust', 'let him not be alone' and 'family as a protective shield'. The theme 'mistrust' is explored through examination of beliefs, attitudes and expectations about 'hospital' as a place in the care of the dying. The theme of 'let him not be alone' draws the family's preferences and concerns in relation to leaving their older dying relative alone in the hospital. The final theme of 'family as a protective shield' describes the element of family care as a protective shield for their older one to have peaceful end-of-life care moments in the hospital. Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.
Tournier, Isabelle; Postal, Virginie
This review of the literature tackles the question of the psychological benefits linked to gardening in older adults. First, the current data on these benefits are reviewed, and the findings reveal that gardening is linked to feelings of accomplishment, well-being and peace, a decrease of depressive symptoms, a protective effect on cognitive functions as well as to the development of social links for community living older adults. In institutionalized older adults, gardening promotes internal locus of control and well-being, and is related to a decrease of sadness and anxiety. Second, several explanatory theories are discussed. All of them postulate an action on the cognitive and/or emotional spheres, which were included into a integrated model that must be tested in future research. In conclusion, gardening appears to be a beneficial activity for promoting older adults' functioning but the current knowledge still has to be extended to understand the specific mechanisms of action. This deeper understanding is necessary in order to improve the future actions depending on this activity.
Haveman, Robert H.; Wolfe, Barbara L.
This paper presents a decision-process model for explaining the growth in transfer recipiency (the receipt by working age people of disability income), the choice of work status, and the reduction in labor force participation of older workers. It is hypothesized that the attractiveness of disability income transfer options has led older male…
Akl, Ahmad; Snoek, Jasper; Mihailidis, Alex
With a globally aging population, the burden of care of cognitively impaired older adults is becoming increasingly concerning. Instances of Alzheimer’s disease and other forms of dementia are becoming ever more frequent. Earlier detection of cognitive impairment offers significant benefits, but remains difficult to do in practice. In this paper, we develop statistical models of the behavior of older adults within their homes using sensor data in order to detect the early onset of cognitive decline. Specifically, we use inhomogenous Poisson processes to model the presence of subjects within different rooms throughout the day in the home using unobtrusive sensing technologies. We compare the distributions learned from cognitively intact and impaired subjects using information theoretic tools and observe statistical differences between the two populations which we believe can be used to help detect the onset of cognitive decline. PMID:25570050
Akl, Ahmad; Snoek, Jasper; Mihailidis, Alex
With a globally aging population, the burden of care of cognitively impaired older adults is becoming increasingly concerning. Instances of Alzheimer's disease and other forms of dementia are becoming ever more frequent. Earlier detection of cognitive impairment offers significant benefits, but remains difficult to do in practice. In this paper, we develop statistical models of the behavior of older adults within their homes using sensor data in order to detect the early onset of cognitive decline. Specifically, we use inhomogenous Poisson processes to model the presence of subjects within different rooms throughout the day in the home using unobtrusive sensing technologies. We compare the distributions learned from cognitively intact and impaired subjects using information theoretic tools and observe statistical differences between the two populations which we believe can be used to help detect the onset of cognitive decline.
Ali, Saad; Manocha, Dinesh; Shah, Mubarak
Over the last several years there has been a growing interest in developing computational methodologies for modeling and analyzing movements and behaviors of 'crowds' of people. This interest spans several scientific areas that includes Computer Vision, Computer Graphics, and Pedestrian Evacuation Dynamics. Despite the fact that these different scientific fields are trying to model the same physical entity (i.e. a crowd of people), research ideas have evolved independently. As a result each discipline has developed techniques and perspectives that are characteristically their own.
Hammar, Lena Marmstål; Holmström, Inger K; Skoglund, Karin; Meranius, Martina Summer; Sundler, Annelie J
Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people. The aim of this study was to investigate student nurses' views on the care of and communication with older people. A descriptive study with a mixed-method approach was conducted. Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015. The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites. Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Menichetti, Julia; Graffigna, Guendalina
The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction , a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning). PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups
Full Text Available Quality is one of the main topics in current conceptual modelling research, as is the field of business process modelling. Yet, widely acknowledged academic contributions towards an understanding or measurement of business process model quality are limited at best. In this paper I argue that the development of methodical theories concerning the measurement or establishment of process model quality must be preceded by methodological elaborations on business process modelling. I further argue that existing epistemological foundations of process modelling are insufficient for describing all extrinsic and intrinsic traits of model quality. This in turn has led to a lack of holistic understanding of process modelling. Taking into account the inherent social and purpose-oriented character of process modelling in contemporary organizations I present a socio-pragmatic constructionist methodology of business process modelling and sketch out implications of this perspective towards an understanding of process model quality. I anticipate that, based on this research, theories can be developed that facilitate the evaluation of the ’goodness’ of a business process model.
A decline in Theory of Mind (ToM) perspective-taking abilities in old age is thought to result from an inability to inhibit the self-perspective. Such reduced inhibitory capacities in old age could also impact upon an attentional reorienting and selection processes thought to be required to successfully move from the self to the other perspective in a ToM task. We sought to investigate both of these hypotheses by administering modified versions of Samson et al.’s (2005) high and low inhibitio...
Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah
Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.
Full Text Available Introduction. The benefits of physical activity (PA have been so well documented that there is no doubt about the significance of PA for personal and social health. Several theoretical models have been proposed with a view to understanding the phenomenon of PA and other health behaviours. The purpose of this study was to evaluate if and how the variables suggested in the Health Belief Model (HBM determine physical activity stages of change in older adults. Material and methods. A total of 172 students of Universities of the Third Age aged 54 to 75 (mean = 62.89 ± 4.83 years agreed to participate in the study, filling out an anonymous survey measuring their stage of exercise change and determinants of health behaviours proposed by the HBM, including: perceived benefits of physical activity, perceived barriers to physical activity, perceived severity of diseases associated with sedentary lifestyle, perceived susceptibility to these diseases, and self-efficacy. Results. The results only partially support the hypothesis that the HBM predicts intentions and behaviours related to the physical activity of older adults. Only two variables were moderately-to-strongly related to stages of exercise change, namely perceived barriers and self-efficacy. Conclusion. Interventions aimed at informing older adults about the benefits of physical activity and the threats associated with sedentary lifestyle can be expected to have rather a weak influence on their readiness for physical activity.
Wann, Daniel L; Rogers, Kelly; Dooley, Keith; Foley, Mary
According to the Team Identification-Social Psychological Health Model (Wann, 2006b), team identification and social psychological health should be positively correlated because identification leads to important social connections which, in turn, facilitate well-being. Although past research substantiates the hypothesized positive relationship between team identification and well-being, earlier studies focused solely on college student populations. The current study extended past work in this area by investigating the team identification/well-being relationship among older sport fans. A sample of older adults (N = 96; M age = 70.82) completed scales assessing demographics, identification with a local college basketball team, and measures of social psychological well-being. As hypothesized, team identification accounted for a significant proportion of unique variance in two measures of social psychological health (collective self-esteem and loneliness).
Anker-Hansen, Camilla; Skovdahl, Kirsti; McCormack, Brendan; Tønnessen, Siri
To identify and synthesise the needs of care partners of older people living at home with assistance from home care services. "Ageing in place" is a promoted concept where care partners and home care services play significant roles. Identifying the needs of care partners and finding systematic ways of meeting them can help care partners to cope with their role. This study is based on the PRISMA reporting guidelines. The systematic review of qualitative and quantitative studies was guided by the Joanna Briggs Institute methodology. In total, 16 studies were included in the review, eleven qualitative and five quantitative. Three main categories were revealed in the analysis: the need for quality interaction, the need for a shared approach to care and the need to feel empowered. Care partners of older people have several, continuously unmet needs. A person-centred perspective can contribute new understandings of how to meet these needs. A knowledge gap has been identified regarding the needs of care partners of older people with mental health problems. There is a need to develop a tool for systematic collaboration between home care services and care partners, so that the identified needs can be met in a more thorough, systematic and person-centred way. The carers in home care services need competence to identify and meet the needs of care partners. The implementation of person-centred values in home care services can contribute to meet the needs of care partners to a greater extent than today. Future research on the needs of care partners of older people with mental health problems needs to be undertaken. © 2017 John Wiley & Sons Ltd.
Evans, Ellen W; Redmond, Elizabeth C
The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.
Roppolo, Mattia; Kunnen, E Saskia; van Geert, Paul L; Mulasso, Anna; Rabaglietti, Emanuela
Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population. PMID:26604722
Matusiak Bożena Ewa
Full Text Available The paper presents an overall view of the business model (BM for the e-balance system for: balancing energy production and consumption in energy efficient, smart neighbourhoods (the e-balance project, FP7-SMARTCITIES-2013 along with its functionalities, based upon the Osterwalder’s canvas methodology. Additionally, this is the second, after two years of work, more incisive evaluation of the BM from the user’s and demo site’s perspective (Bronsbergen, the Netherlands. The aim of this paper is to present results and assess the above mentioned BM in the face its commercialisation and applicability to Europe.
Shiyanbola, Olayinka O; Mott, David A; Croes, Kenneth D
To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies. Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done. 6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA. 60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days. During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain. The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication about health and medicines is perceived important and likely
The paper considers electronic governmental activities from a business perspective, resulting in a so-called governmental value chain model. This model aims to support practitioners for better understanding and realisation of joint organisational and information system innovations in the public
Zhao, Xufeng; Al-Khalifa, Khalifa N.; Magid Hamouda, Abdel; Nakagawa, Toshio
Age replacement models are fundamental to maintenance theory. This paper summarizes our new perspectives and hods in age replacement models: First, we optimize the expected cost rate for a required availability level and vice versa. Second, an asymptotic model with simple calculation is proposed by using the cumulative hazard function skillfully. Third, we challenge the established theory such that preventive replacement should be non-random and only corrective replacement should be made for the unit with exponential failure. Fourth, three replacement policies with random working cycles are discussed, which are called overtime replacement, replacement first, and replacement last, respectively. Fifth, the policies of replacement first and last are formulated with general models. Sixth, age replacement is modified for the situation when the economical life cycle of the unit is a random variable with probability distribution. Finally, models of a parallel system with constant and random number of units are taken into considerations. The models of expected cost rates are obtained and optimal replacement times to minimize them are discussed analytically and computed numerically. Further studies and potential applications are also indicated at the end of discussions of the above models. - Highlights: • Optimization of cost rate for availability level is discussed and vice versa. • Asymptotic and random replacement models are discussed. • Overtime replacement, replacement first and replacement last are surveyed. • Replacement policy with random life cycle is given. • A parallel system with random number of units is modeled.
Schwantes, C. R.; McGibbon, R. T. [Department of Chemistry, Stanford University, Stanford, California 94305 (United States); Pande, V. S., E-mail: email@example.com [Department of Chemistry, Stanford University, Stanford, California 94305 (United States); Department of Computer Science, Stanford University, Stanford, California 94305 (United States); Department of Structural Biology, Stanford University, Stanford, California 94305 (United States); Biophysics Program, Stanford University, Stanford, California 94305 (United States)
Molecular dynamics simulations have the potential to provide atomic-level detail and insight to important questions in chemical physics that cannot be observed in typical experiments. However, simply generating a long trajectory is insufficient, as researchers must be able to transform the data in a simulation trajectory into specific scientific insights. Although this analysis step has often been taken for granted, it deserves further attention as large-scale simulations become increasingly routine. In this perspective, we discuss the application of Markov models to the analysis of large-scale biomolecular simulations. We draw attention to recent improvements in the construction of these models as well as several important open issues. In addition, we highlight recent theoretical advances that pave the way for a new generation of models of molecular kinetics.
Full Text Available Additive manufacturing, that is 3D printing technology, may change the way companies operate their businesses. This article adopts a business model perspective to create an understanding of what we know about these changes. It summarizes current knowledge on additive manufacturing within management and business research, and it discusses future research directions in relation to business models for additive manufacturing. Using the scientific database Web of Science, 116 journal articles were identified. The literature review reveals that most research concerns manufacturing optimization. A more holistic view of the changes that additive manufacturing may bring about for firms is needed, as is more research on changed value propositions, and customer/sales-related issues. The article contributes to previous research by systematically summarizing additive manufacturing research in the business and management literature, and by highlighting areas for further investigation related to the business models of individual firms.
Schwantes, C. R.; McGibbon, R. T.; Pande, V. S.
Molecular dynamics simulations have the potential to provide atomic-level detail and insight to important questions in chemical physics that cannot be observed in typical experiments. However, simply generating a long trajectory is insufficient, as researchers must be able to transform the data in a simulation trajectory into specific scientific insights. Although this analysis step has often been taken for granted, it deserves further attention as large-scale simulations become increasingly routine. In this perspective, we discuss the application of Markov models to the analysis of large-scale biomolecular simulations. We draw attention to recent improvements in the construction of these models as well as several important open issues. In addition, we highlight recent theoretical advances that pave the way for a new generation of models of molecular kinetics
Bergsteiner, Harald; Avery, Gayle C.; Neumann, Ruth
Kolb's experiential learning theory has been widely influential in adult learning. The theory and associated instruments continue to be criticized, but rarely is the graphical model itself examined. This is significant because models can aid scientific understanding and progress, as well as theory development and research. Applying accepted…
Full Text Available Introduction: There is a need for integrated care and smooth collaboration between care-providing organisations and professions to create a continuum of care for frail older people. However, collaboration between organisations and professions is often problematic. The aim of this study was to examine the process of implementing a new continuum of care model in a complex organisational context, and illuminate some of the challenges involved. The introduced model strived to connect three organisations responsible for delivering health and social care to older people: the regional hospital, primary health care and municipal eldercare.Methods: The actions of the actors involved in the process of implementing the model were understood to be shaped by the actors' understanding, commitment and ability. This article is based on 44 qualitative interviews performed on four occasions with 26 key actors at three organisational levels within these three organisations.Results and conclusions: The results point to the importance of paying regard to the different cultures of the organisations when implementing a new model. The role of upper management emerged as very important. Furthermore, to be accepted, the model has to be experienced as effectively dealing with real problems in the everyday practice of the actors in the organisations, from the bottom to the top.
Full Text Available Introduction: There is a need for integrated care and smooth collaboration between care-providing organisations and professions to create a continuum of care for frail older people. However, collaboration between organisations and professions is often problematic. The aim of this study was to examine the process of implementing a new continuum of care model in a complex organisational context, and illuminate some of the challenges involved. The introduced model strived to connect three organisations responsible for delivering health and social care to older people: the regional hospital, primary health care and municipal eldercare. Methods: The actions of the actors involved in the process of implementing the model were understood to be shaped by the actors' understanding, commitment and ability. This article is based on 44 qualitative interviews performed on four occasions with 26 key actors at three organisational levels within these three organisations. Results and conclusions: The results point to the importance of paying regard to the different cultures of the organisations when implementing a new model. The role of upper management emerged as very important. Furthermore, to be accepted, the model has to be experienced as effectively dealing with real problems in the everyday practice of the actors in the organisations, from the bottom to the top.
Lyudmila A. Mikhailova
Full Text Available Purpose: the main goal of the article is to define the development perspectives of the new franchising models in Russia (specifically quasifranchising, freedom franchising and branchising. To achieve this the following tusks should be completed: to define the specific characteristics of the following models as well as the factors which influenced their occurrence; to question Russian franchisors in order to understand their desire to develop their business under the new franchising models; to identify the key development possibilities of the new franchising models in Russia based on the gathered data. Methods: the article was prepared with the help of theoretical as well as economic analysis. Moreover, the series of the formalized telephone interviews with the Russian businessmen were conducted by the author. Based on the results gathered the conclusions on the development perspectives of the new franchising models in Russia were drawn. Results: currently new franchising models are conquering the Russian market. In comparison to the classical franchising model new franchising models are riskier for the franchisor due to the certain freedom available to franchisees. Quasifranchising, which is based on the business model transfer without the brand transfer, is suitable for the young concepts and for the franchisors seeking for the increasing number of franchisees. Freedom franchising enabling assortment and outlook variety of the point of contact is a good alternative for the franchisees who struggle for individuality even in the boundaries of the franchise as well as for the franchisors looking for the franchisees of that kind. Finally, branchising, which means franchisor’s and franchisee’s co-investment, is applicable for the franchises with high level of investments needed. Conclusions and Relevance: the materials of the article show the certain place of the new franchising models on the Russian market. They make it possible to adjust the
Long-term unemployment of older people can have severe consequences for individuals, communities and ultimately economies, and is therefore a serious concern in countries with an ageing population. However, the interplay of chronological age and other individual difference characteristics in
Eck, D. van; Pijpers, R.A.H.
The phenomenological tradition within human geography continues to inspire research on everyday city life. This paper draws on David Seamon's notion of place ballet to understand the meaning of encounters between older people visiting an urban park in the city of Eindhoven, the Netherlands. The
Broome, Kieran; McKenna, Kryss; Fleming, Jennifer; Worrall, Linda
The same reasons that prompt older people to give up driving can also result in difficulties with accessing public transport. Difficulties using public transport can limit older people's participation in society, thereby impacting negatively on their health. Focusing on public buses, this review explicates the link between bus usability and the health of older people and frames existing evidence on bus usability issues. The Person-Environment-Occupation (PEO) model offers a framework by which bus usability can be assessed. A combination of person-centred, environmental, and occupation-related factors, including bus design, service provision and performance, information, and the attitudes of staff and the community, impact on older people's ability to catch buses. More systematic research needs to take place in order to develop a comprehensive understanding of bus usability. Occupational therapy has a key role to play in conceptualizing, implementing, and evaluating improvements in bus usability for older people.
Ottmann, Goetz; Allen, Jacqui; Feldman, Peter
Consumer-directed care is increasingly becoming a mainstream option in community-based aged care. However, a systematic review describing how the current evaluation research translates into practise has not been published to date. This review aimed to systematically establish an evidence base of user preferences for and satisfaction with services associated with consumer-directed care programmes for older people. Twelve databases were searched, including MedLine, BioMed Central, Cinahl, Expanded Academic ASAP, PsychInfo, ProQuest, Age Line, Science Direct, Social Citation Index, Sociological Abstracts, Web of Science and the Cochrane Library. Google Scholar and Google were also searched. Eligible studies were those reporting on choice, user preferences and service satisfaction outcomes regarding a programme or model of home-based care in the United States or United Kingdom. This systematic narrative review retrieved literature published from January 1992 to August 2011. A total of 277 references were identified. Of these 17 met the selection criteria and were reviewed. Findings indicate that older people report varying preferences for consumer-directed care with some demonstrating limited interest. Clients and carers reported good service satisfaction. However, research comparing user preferences across countries or investigating how ecological factors shape user preferences has received limited attention. Policy-makers and practitioners need to carefully consider the diverse contexts, needs and preferences of older adults in adopting consumer-directed care approaches in community aged care. The review calls for the development of consumer-directed care programmes offering a broad range of options that allow for personalisation and greater control over services without necessarily transferring the responsibility for administrative responsibilities to service users. Review findings suggest that consumer-directed care approaches have the potential to empower older
James B Aimone
Full Text Available Mathematical modeling of anatomically-constrained neural networks has provided significant insights regarding the response of networks to neurological disorders or injury. A logical extension of these models is to incorporate treatment regimens to investigate network responses to intervention. The addition of nascent neurons from stem cell precursors into damaged or diseased tissue has been used as a successful therapeutic tool in recent decades. Interestingly, models have been developed to examine the incorporation of new neurons into intact adult structures, particularly the dentate granule neurons of the hippocampus. These studies suggest that the unique properties of maturing neurons can impact circuit behavior in unanticipated ways. In this perspective, we review the current status of models used to examine damaged CNS structures with particular focus on cortical damage due to stroke. Secondly, we suggest that computational modeling of cell replacement therapies can be made feasible by implementing approaches taken by current models of adult neurogenesis. The development of these models is critical for generating hypotheses regarding transplant therapies and improving outcomes by tailoring transplants to desired effects.
Full Text Available Integrated within neural circuits, astrocytes have recently been shown to modulate brain rhythms thought to mediate sleep function. Experimental evidence suggests that local impact of astrocytes on single synapses translates into global modulation of neuronal networks and behavior. We discuss these findings in the context of current conceptual models of sleep generation and function, each of which have historically focused on neural mechanisms. We highlight the implications and the challenges introduced by these results from a conceptual and computational perspective. We further provide modeling directions on how these data might extend our knowledge of astrocytic properties and sleep function. Given our evolving understanding of how local cellular activities during sleep lead to functional outcomes for the brain, further mechanistic and theoretical understanding of astrocytic contribution to these dynamics will undoubtedly be of great basic and translational benefit.
Alberts, Berend Thomas; Meertens, Lucas Onno; Iacob, Maria Eugenia; Nieuwenhuis, Lambertus Johannes Maria; Shishkov, Boris
The business model field of research is a young and emerging discipline that finds itself confronted with the need for a common language, lack of conceptual consolidation, and without adequate theoretical development. This not only slows down research, but also undermines business model’s usefulness
Evans, Jenna M; Baker, G Ross
Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter-organizational and inter-professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration. The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief. The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory-based framework of psychological factors that may influence inter-organizational and inter-professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care. MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care. Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.
Chaawa, Mohamed; Thabet, Inès; Hanachi, Chihab; Ben Said, Lamjed
Crises are complex situations due to the dynamism of the environment, its unpredictability and the complexity of the interactions among several different and autonomous involved organisations. In such a context, establishing an organisational view as well as structuring organisations' communications and their functioning is a crucial requirement. In this article, we propose a multi-agent organisational model (OM) to abstract, simulate and analyse a crisis management system (CMS). The objective is to evaluate the CMS from an organisational view, to assess its strength as well as its weakness and to provide deciders with some recommendations for a more flexible and reactive CMS. The proposed OM is illustrated through a real case study: a snowstorm in a Tunisian region. More precisely, we made the following contribution: firstly, we provide an environmental model that identifies the concepts involved in the crisis. Then, we define a role model that copes with the involved actors. In addition, we specify the organisational structure and the interaction model that rule communications and structure actors' functioning. Those models, built following the GAIA methodology, abstract the CMS from an organisational perspective. Finally, we implemented a customisable multi-agent simulator based on the Janus platform to analyse, through several performed simulations, the organisational model.
Conte, Kathleen P; Schure, Marc B; Goins, R Turner
Despite the high prevalence of arthritis and physical disability among older American Indians, few evidence-based interventions that improve arthritis self-management via physical activity have been adapted for use in this population. The purpose of this study was to identify beliefs about health, arthritis, and physical activity among older American Indians living in a rural area in Oregon to help select and adapt an arthritis self-management program. In partnership with a tribal health program, we conducted surveys, a focus group, and individual interviews with older American Indians with arthritis. Our sample comprised 6 focus group participants and 18 interviewees. The 24 participants were aged 48 to 82 years, of whom 67% were women. Forms B and C of the Multidimensional Health Locus of Control (MHLC) instrument, modified for arthritis, measured MHLC. The concepts of health, arthritis, and physical activity overlapped in that health was a holistic concept informed by cultural teachings that included living a healthy lifestyle, socializing, and being functionally independent. Arthritis inhibited health and healthy behaviors. Participants identified barriers such as unreliable transportation and recruiting challenges that would make existing interventions challenging to implement in this setting. The Doctor subscale had the highest MHLC (mean = 4.4 [standard deviation (SD), 1.0]), followed by the Internal subscale (3.9 [SD, 1.4]) and the Other People subscale (2.8 [SD, 1.1]). Existing evidence-based programs for arthritis should be adapted to address implementation factors, such as access to transportation, and incorporate cultural values that emphasize holistic wellness and social interconnectedness. Culturally sensitive programs that build on indigenous values and practices to promote active coping strategies for older American Indians with arthritis are needed.
Emile, Mélanie; Chalabaev, Aina; Colson, Serge S; Vaulerin, Jerome; Falzon, Charlene; D'Arripe-Longueville, Fabienne
This study examined whether stereotype-inconsistent information interacts with implicit theories of ability to affect handgrip strength in older adults. Eighty-two retired older adults (13 men and 69 women) from 61 to 89 years old (M age = 75.8 years; SD = 6.9) performed maximum voluntary contractions (MVC) during a handgrip task in a design manipulating implicit theories of ability and stereotype-inconsistent information related to physical decline with aging. Participants were randomly assigned to one of three groups: incremental condition, entity condition, or control group. The results showed that in the incremental condition the stereotype-inconsistent information improved the peak MVC, the average MVC, the peak rate of force development (RFD), and RFD in the initial 50 ms of the MVC. This study therefore demonstrated that individuals with an incremental mindset who are exposed to stereotype-inconsistent information can boost their physical performance. These findings are discussed from the perspective of regulatory fit (i.e., when task framing is congruent with the individual's goal). © 2016 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.
Vijay K Bhatia
Full Text Available Genre analysis can be viewed from two different perspectives: it may be seen as a reflection of the complex realities of the world of institutionalised communication, or it may be seen as a pedagogically effective and convenient tool for the design of language teaching programmes, often situated within simulated contexts of classroom activities. This paper makes an attempt to understand and resolve the tension between these two seemingly contentious perspectives to answer the question: "Is generic description a reflection of reality, or a convenient fiction invented by applied linguists?". The paper also discusses issues related to the nature and use of linguistic description in a genre-based educational enterprise, claiming that instead of using generic descriptions as models for linguistic reproduction of conventional forms to respond to recurring social contexts, as is often the case in many communication based curriculum contexts, they can be used as analytical resource to understand and manipulate complex inter-generic and multicultural realisations of professional discourse, which will enable learners to use generic knowledge to respond to novel social contexts and also to create new forms of discourse to achieve pragmatic success as well as other powerful human agendas.
Muntinga Maaike E
Full Text Available Abstract Background Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care professionals. We aim to address these challenges by introducing the geriatric care model, based on the chronic care model, and to evaluate its effects on the quality of life of community-dwelling frail older adults. Methods/design In a 2-year stepped-wedge cluster randomised clinical trial with 6-monthly measurements, the chronic care model will be compared with usual care. The trial will be carried out among 35 primary care practices in two regions in the Netherlands. Per region, practices will be randomly allocated to four allocation arms designating the starting point of the intervention. Participants: 1200 community-dwelling older adults aged 65 or over and their primary informal caregivers. Primary care physicians will identify frail individuals based on a composite definition of frailty and a polypharmacy criterion. Final inclusion criterion: scoring 3 or more on a disability case-finding tool. Intervention: Every 6 months patients will receive a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Expert teams will manage and train practice nurses. Patients with complex care needs will be reviewed in interdisciplinary consultations. Evaluation: We will perform an effect evaluation, an economic evaluation, and a process evaluation. Primary outcome is quality of life as measured with the Short Form-12 questionnaire. Effect analyses will be based on the “intention-to-treat” principle, using multilevel regression analysis. Cost measurements will be administered continually during the study period. A cost-effectiveness analysis and cost-utility analysis will be conducted comparing mean total costs to functional
Hirsch, Christian R., Ed.; McDuffie, Amy Roth, Ed.
Mathematical modeling plays an increasingly important role both in real-life applications--in engineering, business, the social sciences, climate study, advanced design, and more--and within mathematics education itself. This 2016 volume of "Annual Perspectives in Mathematics Education" ("APME") focuses on this key topic from a…
Ndoda, Gladys Ruvimbo; Sikwila, Mike Nyamazana
The authors design the innovation and learning perspective of the Balanced Scorecard (BSC) of "Ubuntu and client service charter nexus." This article borrows and advances the research carried out by Khomba, Vermaak and Gouws (2011). The point of departure is on praxis of ubuntu/unhu as a holistic approach in the re-modelling of the BSC…
Full Text Available In recent years, GIS systems have evolved because of technological advancements that make possible the simultaneous management of multiple amount of information.Interesting aspects in their application concern the site documentation at the territorial scale taking advantage of CAD/BIM systems, usually working at the building scale instead.In this sense, the survey using sophisticated equipment such as laser scanners or UAV drones quickly captures data that can be enjoyed across even through new “mobile” technologies, operating in the web-based information systems context. This paper aims to investigate use and perspectives pertaining to geographic information technologies, analysis and design tools meant for modeling at different scales, referring to results of research experiences conducted at the University of Bologna.
Voergaard Poulsen, Bettina; Vibholm Persson, Stine; Skriver, Mette
Clinical decision-making is important in patient-centred nursing, which is known in nursing education and research (1) The Pedagogical Reflection Model (PRM) can provide a framework that supports students’ decision-making in patient-specific situations. PRM is based on the assumption that clinical......) The aims of this study were to explore how nurse students and clinical supervisors use PRM as method to reflect before, during and after PRM guidance in relation to clinical decisions in the first year of clinical practice...... decision-making needs to take into account; 1) clinical experiences, 2) the perspective of the patient, 3) clinical observations and investigations, 4) knowledge about patients experiences of being a patient and ill, 5) medical knowledge about diseases, and 6) the organizational framework (2,3,4)(Figure 1...
Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wei, Juan
Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances. © 2013 Wiley Publishing Asia Pty Ltd.
Gobbens, Robbert J J; Krans, Anita; van Assen, Marcel A L M
The aim of this cross-sectional study was to examine the validity of an integral model of the associations between life-course determinants, disease(s), frailty, and adverse outcomes in older persons who are resident in assisted living facilities. Between June 2013 and May 2014 seven assisted living facilities were contacted. A total of 221 persons completed the questionnaire on life-course determinants, frailty (using the Tilburg Frailty Indicator), self-reported chronic diseases, and adverse outcomes disability, quality of life, health care utilization, and falls. Adverse outcomes were analyzed with sequential (logistic) regression analyses. The integral model is partially validated. Life-course determinants and disease(s) affected only physical frailty. All three frailty domains (physical, psychological, social) together affected disability, quality of life, visits to a general practitioner, and falls. Contrary to the model, disease(s) had no effect on adverse outcomes after controlling for frailty. Life-course determinants affected adverse outcomes, with unhealthy lifestyle having consistent negative effects, and women had more disability, scored lower on physical health, and received more personal and informal care after controlling for all other predictors. The integral model of frailty is less useful for predicting adverse outcomes of residents of assisted living facilities than for community-dwelling older persons, because these residents are much frailer and already have access to healthcare facilities. The present study showed that a multidimensional assessment of frailty, distinguishing three domains of frailty (physical, psychological, social), is beneficial with respect to predicting adverse outcomes in residents of assisted living facilities. Copyright © 2015. Published by Elsevier Ireland Ltd.
Kussmann, Martin; Morine, Melissa J; Hager, Jörg
We review here the status of human type 2 diabetes studies from a genetic, epidemiological, and clinical (intervention) perspective. Most studies limit analyses to one or a few omic technologies providing data of components of physiological processes. Since all chronic diseases are multifactorial...... at different time points along this longitudinal investigation are performed with a comprehensive set of omics platforms. These data sets are generated in a biological context, rather than biochemical compound class-driven manner, which we term "systems omics."...
Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E
To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.
Anderson, Elizabeth Susan; Pollard, Lorraine; Conroy, Simon; Clague-Baker, Nicola
Integrated services which utilise the expertise of team members along care pathways are evolving. Changes in service structure and subsequent team working arrangements can be a challenge for practitioners expected to redefine how they work with one another. These services are particularly important for the care of frail older people. This exploratory study of one newly forming team presents the views of staff involved in establishing an interprofessional healthcare advisory team for older people within an acute hospital admissions unit. Staff experiences of forming a new service are aligned to a model of team development. The findings are presented as themes relating to the stages of team development and identify the challenges of setting up an integrated service alongside existing services. In particular, team process issues relating to the clarity of goals, role clarification, leadership, team culture and identity. Managers must allow time to ensure new services evolve before setting up evaluation studies for efficiency and effectiveness which might prove against the potential for interprofessional teamworking.
Renggli, Dominik; Buettner, Annemarie; Scherb, Anke; Straub, Daniel; Zimmerli, Peter
The storm series over Europe in 1990 (Daria, Vivian, Wiebke, Herta) and 1999 (Anatol, Lothar, Martin) are very well known. Such clusters of severe events strongly affect the seasonally accumulated damage statistics. The (re)insurance industry has quantified clustering by using distribution assumptions deduced from the historical storm activity of the last 30 to 40 years. The use of storm series simulated by climate models has only started recently. Climate model runs can potentially represent 100s to 1000s of years, allowing a more detailed quantification of clustering than the history of the last few decades. However, it is unknown how sensitive the representation of clustering is to systematic biases. Using a multi-model ensemble allows quantifying that uncertainty. This work uses CMIP5 decadal ensemble hindcasts to study clustering of European winter storms from a multi-model perspective. An objective identification algorithm extracts winter storms (September to April) in the gridded 6-hourly wind data. Since the skill of European storm predictions is very limited on the decadal scale, the different hindcast runs are interpreted as independent realizations. As a consequence, the available hindcast ensemble represents several 1000 simulated storm seasons. The seasonal clustering of winter storms is quantified using the dispersion coefficient. The benchmark for the decadal prediction models is the 20th Century Reanalysis. The decadal prediction models are able to reproduce typical features of the clustering characteristics observed in the reanalysis data. Clustering occurs in all analyzed models over the North Atlantic and European region, in particular over Great Britain and Scandinavia as well as over Iberia (i.e. the exit regions of the North Atlantic storm track). Clustering is generally weaker in the models compared to reanalysis, although the differences between different models are substantial. In contrast to existing studies, clustering is driven by weak
Lee, Youjung; Jang, Kyeonghee; Lockhart, Naorah C
Depression among older adults is a challenging public health concern in Korea. Using panel data from the Korea Institute for Health and Social Affairs on Korean older adults and their family caregivers, this study explores significant predictors of depression among Korean older adults as well as the moderating effect of living arrangements on the association between social integration and depression. A multivariate logistic regression analysis showed that preexisting depression was the most significant predictor of Korean older adults' current depression, followed by health status and family support. In addition, social integration significantly decreased Korean older adults' depression. Importantly, a significant moderation effect of living arrangements between Korean older adults' social integration and depression was observed. This study implies the development of individually tailored and culturally responsive programs to engage marginalized Korean older adults living alone, helping foster their well-being and optimal aging.
van Eechoud, Ineke J; Piers, Ruth D; Van Camp, Sigrid; Grypdonck, Mieke; Van Den Noortgate, Nele J; Deveugele, Myriam; Verbeke, Natacha C; Verhaeghe, Sofie
Advance care planning (ACP) is the process by which patients, together with their physician and loved ones, establish preferences for future care. Because previous research has shown that relatives play a considerable role in end-of-life care decisions, it is important to understand how family members are involved in this process. To gain understanding of the involvement of family members in ACP for older people near the end of life by exploring their views and experiences concerning this process. This was a qualitative research study, done with semistructured interviews. Twenty-one family members were recruited from three geriatric settings in Flanders, Belgium. The data were analyzed using the constant comparative method as proposed by the grounded theory. Family members took different positions in the ACP process depending on how much responsibility the family member wanted to take and to what extent the family member felt the patient expected him/her to play a part. The position of family members on these two dimensions was influenced by several factors, namely acknowledgment of the imminent death, experiences with death and dying, opinion about the benefits of ACP, burden of initiating conversations about death and dying, and trust in health care providers. Furthermore, the role of family members in ACP was embedded in the existing relationship patterns. This study provides insight into the different positions of family members in the end-of-life care planning of older patients with a short life expectancy. It is important for health care providers to understand the position of a family member in the ACP of the patient, take into account that family members may experience an active role in ACP as burdensome, and consider existing relationship patterns. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Lynch, Brighide M; McCormack, Brendan; McCance, Tanya
The aim of the present study was to present the process used to develop a composite model of situational leadership enacted within a person-centred nursing framework in residential care. Transforming the culture of the residential unit from a restrictive institution to a vibrant community of older adults requires transformational leadership. Situational leadership is one form of transformational leadership, which claims that there is not one leadership style that works in all situations. A model of situational leadership in residential care was developed through a series of systematic steps that identified direct linkages between situational leadership and the main constructs of the Person-Centred Nursing Framework. The process included reviewing the evidence, undertaking a comparative analysis, identifying key concepts, connecting the concepts and developing a model. A conceptual model is presented which integrates person-centredness with leadership thinking in order to effectively impact on the follower's performance in managing the care environment and delivering person-centred care. Currently the model is being utilized in an action research study to evaluate the role of leaders in the practice setting of long-term care. While some of the connecting concepts have been identified in the present study, more work needs to be done to unravel these connections in further study of leaders in practice. © 2011 Blackwell Publishing Ltd.
Felicia Cornelia MACARIE
Full Text Available The present paper explores the degree in which universities could/should serve as role models for communities from the perspective of gender integration. Although the theoretical/ moral answer would be affirmative (universities should be in such a position that would allow local communities to regard them as role models of gender integration, the primary empirical analysis leads to another conclusion. A brief theoretical review (that connects gender discrimination, sustainable development, universities and local communities is followed by an empirical analysis that compares the management structures of 12 Romanian Universities of Advanced Research and Education (the best Romanian universities according to a national ranking with those of four local communities where they are located (as geographic proximity would lead to a better diffusion of best practices. Contrary to initial expectations, even in higher education institutions, women are underrepresented both in executive and legislative positions. Since universities are subject to the same major patterns of gender discrimination (such as role theory, glass ceiling and glass elevator as private and public organizations, they lose the moral high ground that theory would suggest. However, medicine and pharmacy universities that can be connected with the traditional roles attributed to women provide better gender integration, but glass escalator phenomena remain present even in these limited fields.
Full Text Available This article builds on a paper by Stein and Heikkinen (2009, and suggestsways to expand and improve our measurement of the quality of the developmentalmodels, metrics and instruments and the results we get in collaborating with clients. Wesuggest that this dialogue needs to be about more than stage development measured by(even calibrated stage development-focused, linguistic-based, developmental psychologymetrics that produce lead indicators and are shown to be reliable and valid bypsychometric qualities alone. The article first provides a brief overview of ourbackground and biases, and an applied version of Ken Wilber’s Integral OperatingSystem that has provided increased development, client satisfaction, and contribution toour communities measured by verifiable, tangible results (as well as intangible resultssuch as increased ability to cope with complex surroundings, reduced stress and growthin developmental stages to better fit to the environment in which our clients wereengaged at that time. It then addresses four key points raised by Stein and Heikkinen(need for quality control, defining and deciding on appropriate metrics, building a systemto evaluate models and metrics, and clarifying and increasing the reliability and validityof the models and metrics we use by providing initial concrete steps to:• Adopt a systemic value-chain approach• Measure results in addition to language• Build on the evaluation system for instruments, models and metrics suggested byStein & Heikkinen• Clarify and improve the reliability and validity of the instruments, models andmetrics we useWe complete the article with an echoing call for the community of AppliedDevelopmental Theory suggested by Ross (2008 and Stein and Heikkinen, a briefdescription of that community (from our perspective, and a table that builds on Table 2proposed by Stein and Heikkinen.
Full Text Available Currently, the intensity of enterprise competition has increased as a result of a greater diversity of customer needs as well as the persistence of a long-term recession. The results of competition are becoming severe enough to determine the survival of company. To survive global competition, each firm must focus on achieving innovation excellence and operational excellence as core competency for sustainable competitive advantage. Supply chain management is now regarded as one of the most effective innovation initiatives to achieve operational excellence, and its importance has become ever more apparent. However, few companies effectively manage their supply chains, and the greatest difficulty is in achieving supply chain visibility. Many companies still suffer from a lack of visibility, and in spite of extensive research and the availability of modern technologies, the concepts and quantification methods to increase supply chain visibility are still ambiguous. Based on the extant researches in supply chain visibility, this study proposes an extended visibility concept focusing on a process capability perspective and suggests a more quantitative model using Z score in Six Sigma methodology to evaluate and improve the level of supply chain visibility.
Menz, Hylton B; Lord, Stephen R; Fitzpatrick, Richard C
Many falls in older people occur while walking, however the mechanisms responsible for gait instability are poorly understood. Therefore, the aim of this study was to develop a plausible model describing the relationships between impaired sensorimotor function, fear of falling and gait patterns in older people. Temporo-spatial gait parameters and acceleration patterns of the head and pelvis were obtained from 100 community-dwelling older people aged between 75 and 93 years while walking on an irregular walkway. A theoretical model was developed to explain the relationships between these variables, assuming that head stability is a primary output of the postural control system when walking. This model was then tested using structural equation modeling, a statistical technique which enables the testing of a set of regression equations simultaneously. The structural equation model indicated that: (i) reduced step length has a significant direct and indirect association with reduced head stability; (ii) impaired sensorimotor function is significantly associated with reduced head stability, but this effect is largely indirect, mediated by reduced step length, and; (iii) fear of falling is significantly associated with reduced step length, but has little direct influence on head stability. These findings provide useful insights into the possible mechanisms underlying gait characteristics and risk of falling in older people. Particularly important is the indication that fear-related step length shortening may be maladaptive.
Full Text Available Purpose. The purpose of this study was to identify variables that influenced completion of advanced directives in the context of adaptation from national data in older adults. Knowledge gained from this study would help us identify factors that might influence end of life discussions and shed light on strategies on effective communication on advance care planning. Design and Method. A model-testing design and path analysis were used to examine secondary data from 938 participants. Items were extracted from the data set to correspond to variables for this study. Scales were constructed and reliabilities were tested. Results. The final path model showed that physical impairment, self-rated health, continuing to work, and family structure had direct and indirect effects on completion of advanced directives. Five percent of the variance was accounted for by the path analysis. Conclusion. The variance accounted for by the model was small. This could have been due to the use of secondary data and limitations imposed for measurement. However, health care providers and families should explore patient’s perception of self-health as well as their family and work situation in order to strategize a motivational discussion on advance directive or end of life care planning.
Ward, David D; Summers, Mathew J; Saunders, Nichole L; Vickers, James C
Cognitive reserve (CR) is a protective factor that supports cognition by increasing the resilience of an individual's cognitive function to the deleterious effects of cerebral lesions. A single environmental proxy indicator is often used to estimate CR (e.g. education), possibly resulting in a loss of the accuracy and predictive power of the investigation. Furthermore, while estimates of an individual's prior CR can be made, no operational measure exists to estimate dynamic change in CR resulting from exposure to new life experiences. We aimed to develop two latent measures of CR through factor analysis: prior and current, in a sample of 467 healthy older adults. The prior CR measure combined proxy measures traditionally associated with CR, while the current CR measure combined variables that had the potential to reflect dynamic change in CR due to new life experiences. Our main finding was that the analyses uncovered latent variables in hypothesized prior and current models of CR. The prior CR model supports multivariate estimation of pre-existing CR and may be applied to more accurately estimate CR in the absence of neuropathological data. The current CR model may be applied to evaluate and explore the potential benefits of CR-based interventions prior to dementia onset.
Simon, Jessica; Porterfield, Pat; Bouchal, Shelley Raffin; Heyland, Daren
To explore seriously ill, older hospitalised patients' and their family members' perspectives on the barriers and facilitators of advance care planning (ACP). We used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population. Three main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor). Based on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors' education includes ACP communication skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Current leadership models are based largely on concepts and explanations, which provide limited access to the being and actions of an effective leader in health care. Rather than teaching leadership from a theoretical vantage point, the ontological perspective teaches leadership as it is lived and experienced. When one exercises leadership "as lived," concurrently informed by theories, one performs at one's best. A distinctive feature of the ontological approach resides in its capacity to disclose human ways of being and acting that limit our freedom to lead effectively as our natural self-expression. Ontological leadership maintains that our worldviews and mental maps affect the way we lead and are shaped by and accessible through language--hence, to lead more effectively, mastery of a new conversational domain of leadership is required. This emerging model of leadership performance reveals that (1) our actions as leaders are correlated with the way in which the leadership situation we are dealing with occurs for us, and (2) this "occurring" is shaped by the context we bring to that situation. Master leaders use language to recontextualize their leadership challenges so that their naturally correlated ways of being and acting can emerge, resulting in effective leadership. When leaders linguistically unveil limiting contexts, they are freed up to create new contexts that shift the way leadership challenges occur for them. This provides leaders--physicians, scientists, educators, executives--with new opportunity sets (previously unavailable) for exercising exemplary leadership. The ontological approach to leadership offers a powerful framework for tackling health care's toughest challenges.
Steeg, L. van de; Langelaan, M.; Wagner, C.
Objective: To develop and validate a predictive model for preventable adverse events (AEs) in hospitalized older patients, using clinically important risk factors that are readily available on admission. Design: Data from two retrospective patient record review studies on AEs were used. Risk factors
Healy, Michael R; Light, Leah L; Chung, Christie
In 3 experiments, young and older adults studied lists of unrelated word pairs and were given confidence-rated item and associative recognition tests. Several different models of recognition were fit to the confidence-rating data using techniques described by S. Macho (2002, 2004). Concordant with previous findings, item recognition data were best fit by an unequal-variance signal detection theory model for both young and older adults. For both age groups, associative recognition performance was best explained by models incorporating both recollection and familiarity components. Examination of parameter estimates supported the conclusion that recollection is reduced in old age, but inferences about age differences in familiarity were highly model dependent. Implications for dual-process models of memory in old age are discussed. ((c) 2005 APA, all rights reserved).
Setti, Ilaria; Dordoni, Paola; Piccoli, Beatrice; Bellotto, Massimo; Argentero, Piergiorgio
Purpose: This paper aims at examining the relationship between proactive personality and training motivation among older workers (aged over 55 years) in a context characterized by the growing ageing of the global population. First, the authors hypothesized that proactive personality predicts the motivation to learn among older workers and that…
Stevens, M; Lemmink, KAPM; de Greef, NHG; Rispens, P; de Greef, M.H.G.
Background A significant number of Dutch older adults can be considered sedentary when it comes to regular participation in leisure-time physical activity. Sedentariness is considered a potential public health burden-all the more reason to develop a strategy for stimulating older adults toward
Víctor T. Pérez Martínez
Full Text Available Las personas no pueden ser fragmentadas en determinados períodos de existencia, nacen y llegan al final de sus vidas como seres sexuales. La sexualidad humana es un fenómeno sociocultural que está influido por la calidad de las relaciones interpersonales, el contexto en que nos desenvolvemos y por la integración que hemos hecho de las experiencias vividas. La identidad, el deseo y comportamiento sexuales son componentes esenciales de nuestra sexualidad. El disfrute de una relación amorosa no cambia por el paso de los años. El placer sexual es una experiencia deseable y válida para los adultos mayores porque genera gran bienestar. Una menor cantidad de contactos sexuales, los mismos deseos y una mayor calidad en la relación de pareja, conforman las características más notables de la sexualidad en la edad geriátrica. La información sobre los temas sexuales en la senectud es aún insuficiente. Solo una educación sexual desde la temprana infancia permitirá que las futuras generaciones de ancianos accedan a una realidad sexual más justa, en un ambiente carente de prejuicios.Persons cannot be fragmented in certain periods of existence; they are born and reach the end of their lives as sexual beings. Human sexuality is a sociocultural phenomenon that is influenced by the quality of the interpersonal relations, by the context in which we develop, and by the integration of the lived experiences. The sexual identity, the desire and the behavior are essential components of our sexuality. The enjoyment of a love relationship does not change as times goes by. Sexual pleasure is a desirable and valid experience for older adults, since it generates a great wellbeing. Less sexual contacts, the same desires and a higher quality in the couple's relation are the most significant characteristics of sexuality at geriatric age. The information on sexual topics in senescence is still insufficient. Only a sexual education received in early childhood will
complex teaching methodology requires in-depth thinking about the role of the teacher, the role of the learner, the nature of the classroom culture, the nature of the negotiation of meaning between the teacher and individuals or groups, the nature of selected problems and material, as well as the kind of integrative assessment used in the mathematics classroom. Modelling is closely related to the problem-centred teaching approach, but it also smoothly relates to bigger and longer mathematical tasks. This article gives a theoretical exposition of the scope and depth of mathematical modelling. It is possible to introduce modelling at every school phase in our educational sytem. Modelling in school mathematics seems to make the learning of mathematics more effective. The mastering of problem solving and modelling strategies has deﬁnitely changed the orientation, the competencies and performances of learners at each school level. It would appear from research that learners like the application side of mathematics and that they want to see it in action. Genuine real life problems should be selected, which is why a modelling perspective is so important for the teaching and mastering of mathematics. Modelling should be integrated into the present curriculum because learners will then get full access to involvement in the classroom, to mathematisation, to doing problems, to criticising arguments, to ﬁnding proofs, to recognising concepts and to obtaining the ability to abstract these from the realistic situation. Modelling should be given a full opportunity in mathematics teacher education so that our learners can get the full beneﬁt of it. This will put the mathematical performances of learners in our country on a more solid base, which will make our learners more competitive at all levels in the future.
Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A
Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.
Peterson, Shari L.
This article sets forth the Organizational Model of Employee Persistence, influenced by traditional turnover models and a student attrition model. The model was developed to clarify the impact of organizational practices on employee turnover from a human resource development (HRD) perspective and provide a theoretical foundation for research on…
Claire J Foldi
Full Text Available Offspring of older fathers have an increased risk of various adverse health outcomes, including autism and schizophrenia. With respect to biological mechanisms for this association, there are many more germline cell divisions in the life history of a sperm relative to that of an oocyte. This leads to more opportunities for copy error mutations in germ cells from older fathers. Evidence also suggests that epigenetic patterning in the sperm from older men is altered. Rodent models provide an experimental platform to examine the association between paternal age and brain development. Several rodent models of advanced paternal age (APA have been published with relevance to intermediate phenotypes related to autism. All four published APA models vary in key features creating a lack of consistency with respect to behavioural phenotypes. A consideration of common phenotypes that emerge from these APA-related mouse models may be informative in the exploration of the molecular and neurobiological correlates of APA.
Chiao, Chia-Yi; Schepp, Karen G
This article is a report of a study of predicting the factors that influence depression in the older people in Taiwan. Background. In 1991, Taiwan opened the labour market to foreign caregivers for the older people who needed long-term care. With the differences in language, culture and lifestyle between foreign caregivers and older people in Taiwan, it was hypothesized that the older people would not be able to relate to them, and therefore become depressed. The data were collected from 116 Taiwanese older people from July to September, 2005. Path analysis using multiple regression analyses was conducted to estimate the direct and indirect effects of caregiving communication, activities of daily living, income and social support on depression among older people in Taiwan. To evaluate the hypotheses for this research, bi-variate linear regression and multiple regression analyses were used. The results indicated that the level of activities of daily living (β = -0·201, P = 0·010), care-giving communication (β = -0·272, P = 0·002) income (β = -0·305, P = 0·000) and social support (β = -0·276, P = 0·002) were the predictors of depression in older people in Taiwan. Social support was a mediating factor for caregiving communication and depression. Furthermore, foreign caregiver care was not correlated with depression among older people in Taiwan. The findings influence the public awareness of depression in older people, and provide the foundational information to influence the policy makers of Taiwan to evaluate the foreign caregiver policy. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Finfgeld-Connett, Deborah L
Alcohol and benzodiazepine misuse is a significant problem in older women for a number of reasons such as physiological changes, outdated prescribing practices, and failure to identify hazardous use. In addition, treatment barriers involving the health-care system, conflicting information, and ageism also exist. Substance misuse among older women is predicted to become a bigger problem as the baby boom generation ages. Brief interventions that consist of assessment, feedback, responsibility, advice, menu, empathy, and self-efficacy, or A-FRAMES, have the potential to reduce alcohol and benzodiazepine misuse among older women in a cost-effective manner.
Payne, Brennan R.; Gross, Alden L.; Parisi, Jeanine M.; Sisco, Shannon M.; Stine-Morrow, Elizabeth A. L.; Marsiske, Michael; Rebok, George W.
Episodic memory shows substantial declines with advancing age, but research on longitudinal trajectories of spoken discourse memory (SDM) in older adulthood is limited. Using parallel process latent growth curve models, we examined 10 years of longitudinal data from the no-contact control group (N = 698) of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial in order to test (a) the degree to which SDM declines with advancing age, (b) predictors of these age-related declines, and (c) the within-person relationship between longitudinal changes in SDM and longitudinal changes in fluid reasoning and verbal ability over 10 years, independent of age. Individuals who were younger, White, had more years of formal education, were male, and had better global cognitive function and episodic memory performance at baseline demonstrated greater levels of SDM on average. However, only age at baseline uniquely predicted longitudinal changes in SDM, such that declines accelerated with greater age. Independent of age, within-person decline in reasoning ability over the 10-year study period was substantially correlated with decline in SDM (r = .87). An analogous association with SDM did not hold for verbal ability. The findings suggest that longitudinal declines in fluid cognition are associated with reduced spoken language comprehension. Unlike findings from memory for written prose, preserved verbal ability may not protect against developmental declines in memory for speech. PMID:24304364
Shimada, Hiroyuki; Tiedemann, Anne; Lord, Stephen R; Suzukawa, Megumi; Makizako, Hyuma; Kobayashi, Kumiko; Suzuki, Takao
The purpose of this study was to determine the interrelationships between lower limb muscle performance, balance, gait and falls in older people using structural equation modeling. Study participants were two hundred and thirteen people aged 65 years and older (mean age, 80.0 ± 7.1 years), who used day-care services in Japan. The outcome measures were the history of falls three months retrospectively and physical risk factors for falling, including performance in the chair stand test (CST), one-leg standing test (OLS), tandem walk test, 6m walking time, and the timed up-and-go (TUG) test. Thirty-nine (18.3%) of the 213 participants had fallen at least one or more times during the preceding 3 months. The fall group had significantly slower 6m walking speed and took significantly longer to undertake the TUG test than the non-fall group. In a structural equation model, performance in the CST contributed significantly to gait function, and low gait function was significantly and directly associated with falls in older people. This suggests that task-specific strength exercise as well as general mobility retraining should be important components of exercise programs designed to reduce falls in older people. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Carrio, G. G.; Cotton, W. R.; Massie, S. T.
This modeling study examines the response of tropical convection to the enhancement of CCN concentrations from a statistical perspective. The sensitivity runs were performed using RAMS version 6.0, covering almost the entire Amazonian Aerosol Characterization Experiment period (AMAZE, wet season of 2008). The main focus of the analysis was the indirect aerosol effects on the probability density functions (PDFs) of various cloud properties. RAMS was configured to work with four two-way interactive nested grids with 42 vertical levels and horizontal grid spacing of 150, 37.5, 7.5, and 1.5 km. Grids 2 and 3 were used to simulate the synoptic and mesoscale environments, while grid 4 was used to resolve deep convection. Comparisons were made using the finest grid with a domain size of 300 X 300km, approximately centered on the city of Manaus (3.1S, 60.01W). The vertical grid was stretched using with 75m spacing at the finest levels to provide better resolution within the first 1.5 km, and the model top extended to approximately 22 km above ground level. RAMS was initialized on February 10 2008 (00:00 UTC), the length of simulations was 32 days, and GSF data were used for initialization and nudging of the coarser-grid boundaries. The control run considered a CCN concentration of 300cm-3 while other several other simulations considered an influx of higher CCN concentrations (up to 1300/cc) . The latter concentration was observed near the end of the AMAZE project period. Both direct and indirect effects of these CCN particles were considered. Model output data (finest grid) every 15 min were used to compute the PDFs for each model level. When increasing aerosol concentrations, significant impacts were simulated for the PDFs of the water contents of various hydrometeors, vertical motions, area with precipitation, latent heat releases, among other quantities. In most cases, they exhibited a peculiar non-monotonic response similar to that seen in two previous studies of ours
Aherne, Cian; Coughlan, Barry; Surgenor, Paul
A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists' ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. Psychotherapists (N = 12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of "psychotherapy" when trying to save someone's life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal. Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion
I draw attention to the perceptions of and interactions between molecular biologists and scientists engaged in plant breeding in India, ..... needed on the other hand is a demand-pull model of tech- ..... holdings constitute the majority), risk-bearing capacity, ... Flexible networks of actors – the private sector, scientists, farmers ...
of surgery – a surgeon is more than an operator, does more ... the role of secondary hyperaldosteronism in the perpetuation of cirrhotic ... a canine model of experimental ascites and wrote my thesis ... us to spot this syndrome in Chandigarh and hold discussions ... heparin (GBH) surface owed its thrombo resistance to the.
Capelo, Carlos; Dias, Joao Ferreira
This study aims to be a contribution to a theoretical model that explains the effectiveness of the learning and decision-making processes by means of a feedback and mental models perspective. With appropriate mental models, managers should be able to improve their capacity to deal with dynamically complex contexts, in order to achieve long-term…
Muntinga, Maaike E; Hoogendijk, Emiel O; van Leeuwen, Karen M; van Hout, Hein P J; Twisk, Jos W R; van der Horst, Henriette E; Nijpels, Giel; Jansen, Aaltje P D
BACKGROUND: Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care
Muntinga, M.E.; Hoogendijk, E.O.; van Leeuwen, K.M.; van Hout, H.P.J.; Twisk, J.W.R.; van der Horst, H.E.; Nijpels, G.; Jansen, A.P.D.
Background: Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care
Full Text Available This article examines political participation among older adults in Österbotten, Finland, and Västerbotten, Sweden. Two specific hypotheses are tested. First, we anticipate that older adults are loyal voters but less avid in engaging in politics between elections. Second, we expect individuallevel resources to explain why older people participate in politics. The article offers two contributions to the literature on political participation of older adults. First, it corroborates earlier findings by showing that older adults indeed have a higher inclination to vote than to engage in political activities between elections, but it also shows that the latter engagement is more diversified than one could expect. Second, although the findings largely support the resource model, they suggest that we need to consider also other factors such as the overall attitude towards older people.
Assistance at mealtimes in hospital settings and rehabilitation units for older adults from the perspective of patients, families and healthcare professionals: a mixed methods systematic review protocol.
Edwards, Deborah; Carrier, Judith; Hopkinson, Jane
to snacks, and cultural or religious food preferences.In the UK, national reports have shown some older patients with good appetites were not receiving sufficient nourishment because of inadequate feeding assistance. An initial search of literature has found that this problem has also been identified in Australia, New Zealand, Sweden, and the USA.A variety of initiatives have been developed to try to ensure that patients receive mealtime assistance if required, and include, for example:Mealtime assistance has the potential to enhance nutritional intake, clinical outcomes, and patient experience. Four reviews and one scoping review have previously been conducted in this area. All of the reviews included adult patients over 18 years of age. The focus of the systematic review by Green et al. was volunteers providing feeding assistance in any institutional setting; it included a narrative analysis of 10 empirical studies from a limited number of database searches. Weekes et al. conducted a structured literature review focusing on improving nutritional care for patients in any healthcare setting, with specific emphasis on feeding assistance and the dining environment. The review was limited to quantitative study designs (randomized controlled trials, controlled trials and observational studies and audits). A systematic review by Wade et al. investigated nutritional models of care (feeding assistance, protected mealtimes, red tray initiative and communal dining) for hospitalized and rehabilitation inpatients. This review focused on data from trials only and only three databases were searched. A Joanna Briggs Institute (JBI) systematic review has also been published on the topic of mealtime assistance. A comprehensive search strategy was outlined and the review included six randomized controlled trials and quasi experimental designs covering a range of outcomes, but was limited to inpatients in acute care hospitals. The scoping review by Cheung et al. included intervention
Hughes, Anne K; Rostant, Ola S; Curran, Paul G
Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.
Chong, Mei Sian; Empensando, Esmiller F; Ding, Yew Yoong; Tan, Thai Lian
The subacute care unit in Tan Tock Seng Hospital (TTSH) was set up in May 2009. We examined its impact on the transitions at the nexus between hospital and community sectors, patients' discharge destination and functional performance. We studied patients admitted during the initial 6-month period (May to October 2009). Differences in demographics, length of stay (LOS), comorbidity and severity of illness measures, functional outcomes (modified Barthel Index (MBI)) according to discharge destinations were obtained. We also studied the impact of LOS on the geriatric department and the bill size over the pre- and post-subacute implementation periods. Majority of the subacute patients' hospital stay was in subacute care. Of these patients, 44.9% were discharged home, 24.2% to a slow stream rehabilitation (SSR) setting and 29.2% to nursing homes. 16.9% consisted of a subgroup of dementia patients requiring further behavioural and functional interventions, of which 50% managed to be discharged home. Functional gains were seen during subacute stay; with greatest gains observed in the SSR group. There were no differences in overall LOS nor total bill size (DRG-adjusted) for the geriatric medicine department during the first 6 months of operating this new subacute model compared with the prior 4-month period. We propose this subacute model of geriatric care, which allows right-siting of care and improved functional outcomes. It fulfills the role easing transitions between acute hospital and community sectors. In particular, it provides specialised care to a subgroup of dementia patients with challenging behaviours and is fiscally sound from the wider hospital perspective.
Full Text Available AHP and the Kano model are such prevalent TQM tools that it may be surprising that a true hybrid decision-making model has so far eluded researchers. The quest for a hybrid approach is complicated by the differing output perspective of each model, namely discrete ranking (AHP versus a multi-dimensional picture (Kano. This paper presents a hybrid model of AHP and Kano model, so called two-dimension AHP (2D-AHP.
Lopes, Helder; Rocha, Isabel
Over the last 15 years, several genome-scale metabolic models (GSMMs) were developed for different yeast species, aiding both the elucidation of new biological processes and the shift toward a bio-based economy, through the design of in silico inspired cell factories. Here, an historical perspective of the GSMMs built over time for several yeast species is presented and the main inheritance patterns among the metabolic reconstructions are highlighted. We additionally provide a critical perspective on the overall genome-scale modeling procedure, underlining incomplete model validation and evaluation approaches and the quest for the integration of regulatory and kinetic information into yeast GSMMs. A summary of experimentally validated model-based metabolic engineering applications of yeast species is further emphasized, while the main challenges and future perspectives for the field are finally addressed. © FEMS 2017.
Full Text Available The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients towards their health management. This study describes the design, development, and optimization of PHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations, and, consequently, to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council’s (MRC guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program’s feasibility, acceptability and comprehension.The result was a user-endorsed intervention designed to improve older patients’ engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE model. The intervention program, which emerged from this process, consisted of two monthly face-to-face 1-hour sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning. PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it
Menichetti, Julia; Graffigna, Guendalina
The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning). PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups
Niranjan, Soumya J; Huang, Chao-Hui S; Dionne-Odom, J Nicholas; Halilova, Karina I; Pisu, Maria; Drentea, Patricia; Kvale, Elizabeth A; Bevis, Kerri S; Butler, Thomas W; Partridge, Edward E; Rocque, Gabrielle B
Respecting Choices is an evidence-based model of facilitating advance care planning (ACP) conversations between health-care professionals and patients. However, the effectiveness of whether lay patient navigators can successfully initiate Respecting Choices ACP conversations is unknown. As part of a large demonstration project (Patient Care Connect [PCC]), a cohort of lay patient navigators underwent Respecting Choices training and were tasked to initiate ACP conversations with Medicare beneficiaries diagnosed with cancer. This article explores PCC lay navigators' perceived barriers and facilitators in initiating Respecting Choices ACP conversations with older patients with cancer in order to inform implementation enhancements to lay navigator-facilitated ACP. Twenty-six lay navigators from 11 PCC cancer centers in 4 states (Alabama, George, Tennessee, and Florida) completed in-depth, one-on-one semistructured interviews between June 2015 and August 2015. Data were analyzed using a thematic analysis approach. This evaluation identifies 3 levels-patient, lay navigator, and organizational factors in addition to training needs that influence ACP implementation. Key facilitators included physician buy-in, patient readiness, and navigators' prior experience with end-of-life decision-making. Lay navigators' perceived challenges to initiating ACP conversations included timing of the conversation and social and personal taboos about discussing dying. Our results suggest that further training and health system support are needed for lay navigators playing a vital role in improving the implementation of ACP among older patients with cancer. The lived expertise of lay navigators along with flexible longitudinal relationships with patients and caregivers may uniquely position this workforce to promote ACP.
Full Text Available The perspective on integration of two mathematical formalisms, i.e., Colored Petri Nets (CPNs and Topological Functioning Model (TFM, is discussed in the paper. The roots of CPNs are in modeling system functionality. The TFM joins principles of system theory and algebraic topology, and formally bridges the solution domain with the problem domain. It is a base for further automated construction of software design models. The paper discusses a perspective on check of control and data flows in the TFM by CPNs formalism. The research result is definition of mappings from TFMs to CPNs.
Göransson, Carina; Wengström, Yvonne; Ziegert, Kristina; Langius-Eklöf, Ann; Eriksson, Irene; Kihlgren, Annica; Blomberg, Karin
To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves. The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals. Descriptive qualitative design. This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis. Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons. The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research. Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing. © 2017 John Wiley & Sons Ltd.
Maier, Anja; Wynn, David C.; Howard, Thomas J.
The creation and use of models is central to engineering design, to the extent that designing might be perceived as a propagation from model to model and modelling may be described as the language of the designer (the terms product model and artefact model are used synonymously throughout this ch...
Bosse, T.; Jonker, C.M.; Treur, J.
This paper explores how the dynamics of complex biological processes can be modelled and simulated as an organisation of multiple agents. This modelling perspective identifies organisational structure occurring in complex decentralised processes and handles complexity of the analysis of the dynamics
Bu, Huabai; Bu, Shizhen
Gradual integration of synergetic technology, P2P technology and online learning community furnishes a new research field for innovation of teacher training model in a knowledge economy era. This article proposes the innovative model of "whole of three lines" in teacher training in basic education from the perspective of "blended…
Janssen, A.B.G.; Gerla, D.J.
Here, we present a community perspective on how to explore, exploit and evolve the diversity in aquatic ecosystem models. These models play an important role in understanding the functioning of aquatic ecosystems, filling in observation gaps and developing effective strategies for water quality
Ligthart, Suzanne A.; van den Eerenbeemt, Karin D. M.; Pols, Jeanette; van Bussel, Emma F.; Richard, Edo; Moll van Charante, Eric P.
Cardiovascular prevention programmes are increasingly being offered to older people. To achieve the proposed benefits, adherence is crucial. Understanding the reasons for adherence and non-adherence can improve preventive care. To gain insight into what motivates older people living in the community
Ligthart, S.A.; Eerenbeemt, K.D. van den; Pols, J.; Bussel, E.F. van; Richard, E.; Moll van Charante, E.P.
BACKGROUND: Cardiovascular prevention programmes are increasingly being offered to older people. To achieve the proposed benefits, adherence is crucial. Understanding the reasons for adherence and non-adherence can improve preventive care. AIM: To gain insight into what motivates older people living
Eveline J.M. Wouters; Sil Aarts; Sebastiaan T. M. Peek
Expectations are high with regards to smart home technology. In particular, smart home technology is expected to support or enable independent living by older adults. This raises the question: can smart home technology contribute to independent living, according to older adults themselves? This
Ouwehand, Kim; van Gog, Tamara|info:eu-repo/dai/nl/294304975; Paas, Fred
This study investigated whether the positive effects of gestures on learning by decreasing working memory load, found in children and young adults, also apply to older adults, who might especially benefit from gestures given memory deficits associated with aging. Participants learned a
Begum, Aysha; Whitley, Rob; Banerjee, Sube; Matthews, David; Stewart, Robert; Morgan, Craig
Purpose: Subjective memory complaint is a term used to refer older adults who report memory problems. Extensive literature exists on its etiology and impact on long-term cognitive decline, and some physicians consider it important in the early detection of dementia. Despite the salient features reported by both patients and clinicians, few people…
The population of older Americans is increasing due to the aging of the Baby Boomers as well as an increase in the average life span. A number of physiological and biochemical changes occur during aging that could influence the relationship between exposure, dose, and response to...
Claassens, L; Widdershoven, G A; Van Rhijn, S C; Van Nes, F; Broese van Groenou, M I; Deeg, D J H; Huisman, M
Frail older adults are increasingly encouraged to be in control of their health care, in Western societies. However, little is known about how they themselves perceive control in health care. Therefore, this study aims to investigate the concept of health care-related perceived control from the
Melis, R.J.F.; Adang, E.M.M.; Teerenstra, S.; Eijken, M.I.J. van; Wimo, A.; Achterberg, T. van; Lisdonk, E.H. van de; Olde Rikkert, M.G.M.
BACKGROUND: There is growing interest in geriatric care for community-dwelling older people. There are, however, relatively few reports on the economics of this type of care. This article reports about the cost-effectiveness of the Dutch Geriatric Intervention Program (DGIP) compared to usual care
Capelo, Carlos; Dias, João Ferreira
This study aims to be a contribution to a theoretical model that explains the effectiveness of the learning and decision-making processes by means of a feedback and mental models perspective. With appropriate mental models, managers should be able to improve their capacity to deal with dynamically complex contexts, in order to achieve long-term success. We present a set of hypotheses about the influence of feedback information and systems thinking facilitation on mental models and manag...
Julius Francis Gomes; Sara Moqaddemerad
Purpose: To facilitate futures business research by proposing a novel way to combine business models as a conceptual tool with futures research techniques. Design: A futures perspective is adopted to foresight business models of the Internet of Things (IoT) enabled healthcare sector by using business models as a futures business research tool. In doing so, business models is coupled with one of the most prominent foresight methodologies, Causal Layered Analysis (CLA). Qualitative analysis...
van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje P D; Hoogendijk, Emiel O; Muntinga, Maaike E; van Hout, Hein P J; Nijpels, Giel; van der Horst, Henriette E; van Tulder, Maurits W
To evaluate the cost-effectiveness of the Geriatric Care Model (GCM), an integrated care model for frail older adults based on the Chronic Care Model, with that of usual care. Economic evaluation alongside a 24-month stepped-wedge cluster-randomized controlled trial. Primary care (35 practices) in two regions in the Netherlands. Community-dwelling older adults who were frail according to their primary care physicians and the Program on Research for Integrating Services for the Maintenance of Autonomy case-finding tool questionnaire (N = 1,147). The GCM consisted of the following components: a regularly scheduled in-home comprehensive geriatric assessment by a practice nurse followed by a customized care plan, management and training of practice nurses by a geriatric expert team, and coordination of care through community network meetings and multidisciplinary team consultations of individuals with complex care needs. Outcomes were measured every 6 months and included costs from a societal perspective, health-related quality of life (Medical Outcomes Study 12-item Short-Form Survey (SF-12) physical (PCS) and mental component summary (MCS) scales), functional limitations (Katz activities of daily living and instrumental activities of daily living), and quality-adjusted life years based on the EQ-5D. Multilevel regression models adjusted for time and baseline confounders showed no significant differences in costs ($356, 95% confidence interval = -$488-1,134) and outcomes between intervention and usual care phases. Cost-effectiveness acceptability curves showed that, for the SF-12 PCS and MCS, the probability of the intervention being cost-effective was 0.76 if decision-makers are willing to pay $30,000 per point improvement on the SF-12 scales (range 0-100). For all other outcomes the probability of the intervention being cost-effective was low. Because the GCM was not cost-effective compared to usual care after 24 months of follow-up, widespread implementation
Chandra Shekhar Bhatnagar
Full Text Available The Sharpe (1964, Lintner (1965 and Black (1972 Capital Asset Pricing Model (CAPM postulates that the equilibrium rates of return on all risky assets are a linear function of their covariance with the market portfolio. Recent work by Fama and French (1996, 2006 introduce a Three Factor Model that questions the “real world application” of the CAPM Theorem and its ability to explain stock returns as well as value premium effects in the United States market. This paper provides an out-of-sample perspective to the work of Fama and French (1996, 2006. Multiple regression is used to compare the performance of the CAPM, a split sample CAPM and the Three Factor Model in explaining observed stock returns and value premium effects in the United Kingdom market. The methodology of Fama and French (2006 was used as the framework for this study. The findings show that the Three Factor Model holds for the United Kingdom Market and is superior to the CAPM and the split sample CAPM in explaining both stock returns and value premium effects. The “real world application” of the CAPM is therefore not supported by the United Kingdom data.
Goertz, Christine M; Salsbury, Stacie A; Long, Cynthia R; Vining, Robert D; Andresen, Andrew A; Hondras, Maria A; Lyons, Kevin J; Killinger, Lisa Z; Wolinsky, Fredric D; Wallace, Robert B
Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of this study was to compare clinical outcomes of older adults receiving back pain treatment under 3 professional practice models that included primary medical care with or without chiropractic care. We conducted a pilot randomized controlled trial with 131 community-dwelling, ambulatory older adults with subacute or chronic low back pain. Participants were randomly allocated to 12 weeks of individualized primary medical care (Medical Care), concurrent medical and chiropractic care (Dual Care), or medical and chiropractic care with enhanced interprofessional collaboration (Shared Care). Primary outcomes were low back pain intensity rated on the numerical rating scale and back-related disability measured with the Roland-Morris Disability Questionnaire. Secondary outcomes included clinical measures, adverse events, and patient satisfaction. Statistical analyses included mixed-effects regression models and general estimating equations. At 12 weeks, participants in all three treatment groups reported improvements in mean average low back pain intensity [Shared Care: 1.8; 95% confidence interval (CI) 1.0 to 2.6; Dual Care: 3.0; 95% CI 2.3 to 3.8; Medical Care: 2.3; 95% CI 1.5 to 3.2)] and back-related disability (Shared Care: 2.8; 95% CI 1.6 to 4.0; Dual Care: 2.5; 95% CI 1.3 to 3.7; Medical Care: 1.5; 95% CI 0.2 to 2.8). No statistically significant differences were noted between the three groups on the primary measures. Participants in both models that included chiropractic reported significantly better perceived low back pain improvement, overall health and quality of life, and greater satisfaction with healthcare services than patients who received medical care alone. Professional practice models that included primary care and
In the public mind, later life is being transformed by the emerging possibility of a flourishing third age with sustained quality of life. We draw trajectories of life quality measured using CASP-19 over eight years. We refine these trajectories by jointly modelling attrition, since older people tend to leave longitudinal studies (attrite) not at random. Growth curve models are applied to the English Longitudinal Study of Ageing waves 1 to 5. Then joint model is estimated where attrition is considered. Extensive predictors are entered including demographic attributes, social and economic status, health conditions, and behaviours. Strong non-linear age trajectory of life quality is revealed by the growth curve models where the peak is achieved in the late 60s. Then the joint model uncovers the peak somewhat later in time, and also reveals secular improvement in life quality experienced by recent cohorts. Sharp estimates for many predictors of higher levels of life quality are also found. For the first time, the trajectories of life quality in the third age are drawn and improvement across cohorts is demonstrated. The contributions are estimated for predictors amenable to intervention such as social capital. This can help in policy discussion on improving the lives of older people in the third age.
Bruun, Inge H; Maribo, Thomas; Nørgaard, Birgitte
of discharge, health systems could offer these patients additional therapy to maintain or improve health and prevent institutionalisation or readmission. The principle aim of this study was to identify predictors for persisting, reduced physical performance in older adults following acute hospitalisation......BACKGROUND: Identifying older adults with reduced physical performance at the time of hospital admission can significantly affect patient management and trajectory. For example, such patients could receive targeted hospital interventions such as routine mobilisation. Furthermore, at the time...... admission, falls, physical activity level, self-rated health, use of a walking aid before admission, number of prescribed medications, 30s-CST, and the De Morton Mobility Index. RESULTS: A total of 78 (67%) patients improved in physical performance in the interval between admission and follow-up assessment...
Full Text Available The common small animal disease models for Zika virus (ZIKV are mice lacking the interferon responses, but infection of interferon receptor α/β knock out (IFNAR−/− mice is not uniformly lethal particularly in older animals. Here we sought to advance this model in regard to lethality for future countermeasure efficacy testing against more recent ZIKV strains from the Asian lineage, preferably the American sublineage. We first infected IFNAR−/− mice subcutaneously with the contemporary ZIKV-Paraiba strain resulting in predominantly neurological disease with ~50% lethality. Infection with ZIKV-Paraiba by different routes established a uniformly lethal model only in young mice (4-week old upon intraperitoneal infection. However, intraperitoneal inoculation of ZIKV-French Polynesia resulted in uniform lethality in older IFNAR−/− mice (10–12-weeks old. In conclusion, we have established uniformly lethal mouse disease models for efficacy testing of antivirals and vaccines against recent ZIKV strains representing the Asian lineage.
Overgaard , J.; Rosbjerg , D.; Butts , M. B.
International audience; The purpose of this paper is to provide a review of the different types of energy-based land-surface models (LSMs) and discuss some of the new possibilities that will arise when energy-based LSMs are combined with distributed hydrological modelling. We choose to focus on energy-based approaches, because in comparison to the traditional potential evapotranspiration models, these approaches allow for a stronger link to remote sensing and atmospheric modelling. New opport...
Van Hoecke, Ann-Sophie
Regular physical activity has been recognized as a major contributor to individuals health and well-being. Moreover, physical activity engagement has been shown to be crucial for healthy ageing and for improving (older) adults ability to perform daily activities. Nevertheless, only half of the Western population attains the recommended physical activity level for health, with decreasing participation rates with advanced age. Considering the continuously growing proportion of older adults as...
Levant, Ronald F.
Describes diagnostic perspectives for viewing dysfunctional families. Presents three general types of models (process, structural, and historical) and organized them along a continuum from most descriptive to most inferential. Presented at the 39th Annual Conference of the American Association for Marriage and Family Therapy, October-November…
In the interest of developing an adequate and consistent bioethical perspective for reflecting on the ethical issues raised by toxic wastes, this brief paper focuses on the question of whether or not public opposition to past and proposed methods for waste management has been induced as much by technical incompetance as by deficiencies in using risk models for bioethical problem definitions
Sigurdsson, Valdimar; Kahamseh, Saeed; Gunnarsson, Didrik; Larsen, Nils Magne; Foxall, Gordon R.
The behavioral perspective model's (BPM; Foxall, 1990) retailing literature is built on extensive empirical research and techniques that were originally refined in choice experiments in behavioral economics and behavior analysis, and then tested mostly on British consumer panel data. We test the BPM in the context of Norwegian retailing. This…
Sigurdsson, Valdimar; Menon, R. G. Vishnu; Sigurdarson, Johannes Pall; Kristjansson, Jon Skafti; Foxall, Gordon R.
An e-mail marketing experiment based on the behavioral perspective model was conducted to investigate consumer choice. Conversion e-mails were sent to two groups from the same marketing database of registered consumers interested in children's books. The experiment was based on A-B-A-C-A and A-C-A-B-A withdrawal designs and consisted of sending B…
Hartadiyati, E.; Rizqiyah, K.; Wiyanto; Rusilowati, A.; Prasetia, A. P. B.
In present condition, culture is diminished, the change of social order toward the generation that has no policy and pro-sustainability; As well as the advancement of science and technology are often treated unwisely so as to excite local wisdom. It is therefore necessary to explore intra-curricular local wisdom in schools. This study aims to produce an integration model of sustainability perspectives based on local wisdom on spermatophyta material that is feasible and effective. This research uses define, design and develop stages to an integration model of sustainability perspectives based on local wisdom on spermatophyta material. The resulting product is an integration model of socio-cultural, economic and environmental sustainability perspective and formulated with preventive, preserve and build action on spermatophyta material consisting of identification and classification, metagenesis and the role of spermatophyta for human life. The integration model of sustainability perspective in learning spermatophyta based on local wisdom is considered proven to be effective in raising sustainability’s awareness of high school students.
van Eck, M.L.; Sidorova, N.; van der Aalst, W.M.P.; La Rosa, M.; Loos, P.; Pastor, O.
Process mining provides fact-based insights into process behaviour captured in event data. In this work we aim to discover models for processes where different facets, or perspectives, of the process can be identified. Instead of focussing on the events or activities that are executed in the context
Full Text Available ABSTRACT The learning model is one of the enabling factors that influence the achievement of students. That students have a good learning outcomes the lecturer must choose appropriate learning models. But in fact not all lecturers choose the most appropriate learning model with the demands of learning outcomes and student characteristics.The study design was descriptive quantitative correlation. Total population of 785 the number of samples are 202 were taken by purposive sampling. Techniques of data collection is done by cross-sectional and then processed through the Spearman test. The results showed no significant relationship between classroom lecture method in the context of blended learning models to study the effectiveness perspective the p value of 0.001. There is a significant relationship between e-learning methods in the context of blended learning models with perspective of activities study of nursing students the p value of 0.028. There is a significant relationship between learning model of blended learning with the perspective of nursing students learning effectiveness p value 0.167. Researchers recommend to future researchers conduct more research on the comparison between the effectiveness of the learning model based on student learning centers with the e-learning models and its impact on student achievement of learning competencies as well as to the implications for other dimensions of learning outcomes and others.
One of the most serious impediments to further progress on the determination of specific impacts of climate change on relevant earth systems is the lack of precise and accurate scenarios of regional change. Spatial resolution of models is generally coarse (5-10 degree, corresponding to 550-1,100 km), and the modeling of physical processes is quite crude. Three main areas in which improvements in the modeling of physical processes are being made are modeling of surface processes, modeling of oceans and coupling of oceans and atmospheric models, and modeling of clouds. Improvements are required in the modeling of surface hydrology and vegetative effects, which have significant impact on the albedo scheme used. Oceans are important in climate modeling for the following reasons: delay of warming due to oceanic heat absorption; effect of mean meridional circulation; control of regional patterns of sea surface temperatures and sea ice by wind driven currents; absorption of atmospheric carbon dioxide by the oceans; and determination of interannual climatic variability via variability in sea surface temperature. The effects of clouds on radiation balance is highly significant. Clouds both reflect shortwave radiation and trap longwave radiation. Most cloud properties are sub-grid scale and thus difficult to include explicitly in models. 25 refs., 1 tab
Crespo, Luis Guillermo
This paper presents a framework for calibrating computational models using data from sev- eral and possibly dissimilar validation experiments. The offset between model predictions and observations, which might be caused by measurement noise, model-form uncertainty, and numerical error, drives the process by which uncertainty in the models parameters is characterized. The resulting description of uncertainty along with the computational model constitute a predictor model. Two types of predictor models are studied: Interval Predictor Models (IPMs) and Random Predictor Models (RPMs). IPMs use sets to characterize uncer- tainty, whereas RPMs use random vectors. The propagation of a set through a model makes the response an interval valued function of the state, whereas the propagation of a random vector yields a random process. Optimization-based strategies for calculating both types of predictor models are proposed. Whereas the formulations used to calculate IPMs target solutions leading to the interval value function of minimal spread containing all observations, those for RPMs seek to maximize the models' ability to reproduce the distribution of obser- vations. Regarding RPMs, we choose a structure for the random vector (i.e., the assignment of probability to points in the parameter space) solely dependent on the prediction error. As such, the probabilistic description of uncertainty is not a subjective assignment of belief, nor is it expected to asymptotically converge to a fixed value, but instead it is a description of the model's ability to reproduce the experimental data. This framework enables evaluating the spread and distribution of the predicted response of target applications depending on the same parameters beyond the validation domain (i.e., roll-up and extrapolation).
Payne, Amanda N; Zihler, Annina; Chassard, Christophe; Lacroix, Christophe
The gut microbiota is a highly specialized organ containing host-specific assemblages of microbes whereby metabolic activity directly impacts human health and disease. In vitro gut fermentation models present an unmatched opportunity of performing studies frequently challenged in humans and animals owing to ethical concerns. Multidisciplinary systems biology analyses supported by '-omics' platforms remain widely neglected in the field of in vitro gut fermentation modeling but are key to advancing the significance of these models. Model-driven experimentation using a combination of in vitro gut fermentation and in vitro human cell models represent an advanced approach in identifying complex host-microbe interactions and niches central to gut fermentation processes. The aim of this review is to highlight the advances and challenges exhibited by in vitro human gut fermentation modeling. Copyright © 2011 Elsevier Ltd. All rights reserved.
Manickam, L S S
Different psychotherapeutic approaches claim positive changes in patients as a result of therapy. Explanations related to the change process led to different change models. Some of the change models are experimentally oriented whereas some are theoretical. Apart from the core models of behavioral, psychodynamic, humanistic, cognitive and spiritually oriented models there are specific models, within psychotherapy that explains the change process. Integrative theory of a person as depicted in Indian thought provides a common ground for the integration of various therapies. Integrative model of change based on Indian thought, with specific reference to psychological concepts in Upanishads, Ayurveda, Bhagavad Gita and Yoga are presented. Appropriate psychological tools may be developed in order to help the clinicians to choose the techniques that match the problem and the origin of the dimension. Explorations have to be conducted to develop more techniques that are culturally appropriate and clinically useful. Research has to be initiated to validate the identified concepts.
Clouzot, Ludiwine; Cloutier, Frédéric; Vanrolleghem, Peter A.
Models for predicting the fate of micropollutants (MPs) in wastewater treatment plants (WWTPs) have been developed to provide engineers and decision-makers with tools that they can use to improve their understanding of, and evaluate how to optimize, the removal of MPs and determine their impact......) addressing advancements in WWTP treatment technologies, (iii) making use of common approaches to data acquisition for model calibration and (iv) integrating ecotoxicological effects of MPs in receiving waters....... on the receiving waters. This paper provides an overview of such models, and discusses the impact of regulation, engineering practice and research on model development. A review of the current status of MP models reveals that a single model cannot represent the wide range of MPs that are present in wastewaters...
Roh, Soonhee; Burnette, Catherine E; Lee, Kyoung Hag; Lee, Yeon-Shim; Martin, James I; Lawler, Michael J
American Indian (AI) older adults are vulnerable to mental health disparities, yet very little is known about the factors associated with help-seeking for mental health services among them. The purpose of this study was to investigate the utility of Andersen's Behavioral Model in explaining AI older adults' help-seeking attitudes toward professional mental health services. Hierarchical regression analysis was used to examine predisposing, enabling, and need variables as predictors of help-seeking attitudes toward mental health services in a sample of 233 AI older adults from the Midwest. The model was found to have limited utility in the context of older AI help-seeking attitudes, as the proportion of explained variance was low. Gender, perceived stigma, social support, and physical health were significant predictors, whereas age, perceived mental health, and health insurance were not. © The Author(s) 2014.
G.J. Rietveld (Joost)
textabstractThis paper develops a consumer-centric framework for creating value through the freemium business model. Goods that are commercialized through the freemium business model offer basic functionality for free and monetize users for extended use or complementary features. Compared to premium
Shaw, G.; Schell, W.; Linkov, I.
Ecological modeling is a powerful tool which can be used to synthesize information on the dynamic processes which occur in ecosystems. Models of radionuclide transport in forests were first constructed in the mid-1960's, when the consequences of global fallout from nuclear weapons tests and waste disposal in the environment were of great concern. Such models were developed based on site-specific experimental data and were designed to address local needs. These models had a limited applicability in evaluating distinct ecosystems and deposition scenarios. Given the scarcity of information, the same experimental data sets were often used both for model calibration and validation, an approach which clearly constitutes a methodological error. Even though the carry modeling attempts were far from being faultless, they established a useful conceptual approach in that they tried to capture general processes in ecosystems and thus had a holistic nature. Later, radioecological modeling attempted to reveal ecosystem properties by separating the component parts from the whole system, as an approach to simplification. This method worked well for radionuclide transport in agricultural ecosystems, in which the biogeochemistry of radionuclide cycling is relatively well understood and can be influenced by fertilization. Several models have been successfully developed and applied to human dose evaluation and emergency response to contaminating events in agricultural lands
Verweij, P.J.F.M.; Knapen, M.J.R.; Winter, de W.P.; Wien, J.J.F.; Roller, te J.A.; Sieber, S.; Jansen, J.M.L.
Policy makers have a growing interest in integrated assessments of policies. The Integrated Assessment Modelling (IAM) community is reacting to this interest by extending the application of model development from pure scientific analysis towards application in decision making or policy context by
P.J. Valkering (Pieter); Yücel, G. (Gönenç); Gebetsroither-Geringer, E. (Ernst); Markvica, K. (Karin); Meynaerts, E. (Erika); N. Frantzeskaki (Niki)
textabstractIn this article, we take stock of the findings from conceptual and empirical work on the role of transition initiatives for accelerating transitions as input for modeling acceleration dynamics. We applied the qualitative modeling approach of causal loop diagrams to capture the dynamics
Skovhus, Torben Lund; Taylor, Christopher; Eckert, Rickard
of corrosion relative to asset integrity, operators commonly use models to support decision-making. The models use qualitative, semi-quantitative or quantitative measures to help predict the rate of degradation caused by MIC and other threats. A new model that links MIC in topsides oil processing systems...... modeling tools to industry in the shortest development time. ICME development would couple our current understanding of MIC, as represented in models, with experimental data, to build a digital “twin” for optimizing performance of engineering systems, whether in the design phase or operations. Since...... functional groups of microorganisms on reaction kinetics or the significance of microbial growth kinetics on corrosion. The ability to accurately predict MIC initiation and growth is hampered by knowledge gaps regarding environmental conditions affect corrosion under biofilms. In order to manage the threat...
Dewar, Belinda; Nolan, Mike
This study actively involved older people, staff and relatives in agreeing a definition of compassionate relationship-centred care and identifying strategies to promote such care in acute hospital settings for older people. It was a major component of a three year programme (the Leadership in Compassionate Care Programme, LCCP) seeking to integrate compassionate care across practice and educational environments. Compassionate caring and promoting dignity are key priorities for policy, practice and research worldwide, being central to the quality of care for patients and families, and job satisfaction for staff. Therapeutic relationships are essential to achieving excellence in care but little is known about how to develop and sustain such relationships in a culture that increasingly focuses on throughput and rapid turnover. The study used appreciative inquiry and a range of methods including participant observation, interviews, story telling and group discussions to actively engage older people, relatives and staff. A process of immersion crystallization was used to analyze data with staff as co-analysts. The study adds considerably to the conceptualization of compassionate, relationship-centred care and provides a model to aid staff deliver such care in practice, based on 'appreciative caring conversations' that enable all parties to gain two forms of 'person and relational knowledge' about 'who people are and what matters to them' and 'how people feel about their experience'. Such knowledge enables staff, patients and carers to 'work together to shape the way things are done'. The study generated a model called the 7 'C's that captures in detail the factors necessary to promote 'appreciative caring conversations'. The study demonstrates that engaging in 'appreciative caring conversations' promotes compassionate, relationship-centred care but that these conversations involve practitioners taking risks. Such 'relational practices' must therefore be valued and
Bravo, F.; Alvarez-Gonzalez, J. G.; Rio, M. del; Barrio, M.; Bonet, J. a.; Bravo-Oviedo, A.; Calama, R.; Castedo-Dorado, F.; Crecente-Campo, F.; Condes, S.; Dieguez-Aranda, U.; Gonzalez-Martinez, S. C.; Lizarralde, I.; Nanos, N.; Madrigal, A.; Martinez-Millan, F. J.; Montero, G.; Ordonez, C.; Palahi, M.; Pique, M.; Rodriguez, F.; Rodriguez-Soalleiro, R.; Rojo, A.; Ruiz-Peinado, R.; Sanchez-Gonzalez, M.; Trasobares, A.; Vazquez-Pique, J.
In this paper we present a review of forest models developed in Spain in recent years for both timber and non timber production and forest dynamics (regeneration, mortality,..). Models developed are whole stand, size (diameter) class and individual-tree. The models developed to date have been developed using data from permanent plots, experimental sites and the National Forest Inventory. In this paper we show the different sub-models developed so far and the friendly use software. Main perspectives of forest modelling in Spain are presented. (Author) 107 refs.
van Leeuwen, K.M.; Bosmans, J.E.; Jansen, A.P.D.; Hoogendijk, E.O.; Muntinga, M.E.; van Hout, H.P.J.; Nijpels, G.; van der Horst, H.E.; van Tulder, M.W.
Objectives To evaluate the cost-effectiveness of the Geriatric Care Model (GCM), an integrated care model for frail older adults based on the Chronic Care Model, with that of usual care. Design Economic evaluation alongside a 24-month stepped-wedge cluster-randomized controlled trial. Setting
van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje P D; Hoogendijk, Emiel O; Muntinga, Maaike E; van Hout, Hein P J; Nijpels, Giel; van der Horst, Henriette E; van Tulder, Maurits W
OBJECTIVES: To evaluate the cost-effectiveness of the Geriatric Care Model (GCM), an integrated care model for frail older adults based on the Chronic Care Model, with that of usual care. DESIGN: Economic evaluation alongside a 24-month stepped-wedge cluster-randomized controlled trial. SETTING:
Arnold, Corey W; Oh, Andrea; Chen, Shawn; Speier, William
Probabilistic topic models provide an unsupervised method for analyzing unstructured text. These models discover semantically coherent combinations of words (topics) that could be integrated in a clinical automatic summarization system for primary care physicians performing chart review. However, the human interpretability of topics discovered from clinical reports is unknown. Our objective is to assess the coherence of topics and their ability to represent the contents of clinical reports from a primary care physician's point of view. Three latent Dirichlet allocation models (50 topics, 100 topics, and 150 topics) were fit to a large collection of clinical reports. Topics were manually evaluated by primary care physicians and graduate students. Wilcoxon Signed-Rank Tests for Paired Samples were used to evaluate differences between different topic models, while differences in performance between students and primary care physicians (PCPs) were tested using Mann-Whitney U tests for each of the tasks. While the 150-topic model produced the best log likelihood, participants were most accurate at identifying words that did not belong in topics learned by the 100-topic model, suggesting that 100 topics provides better relative granularity of discovered semantic themes for the data set used in this study. Models were comparable in their ability to represent the contents of documents. Primary care physicians significantly outperformed students in both tasks. This work establishes a baseline of interpretability for topic models trained with clinical reports, and provides insights on the appropriateness of using topic models for informatics applications. Our results indicate that PCPs find discovered topics more coherent and representative of clinical reports relative to students, warranting further research into their use for automatic summarization. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Jones, Patricia M.
The design of interactive systems, including levels of automation, displays, and controls, is usually based on design guidelines and iterative empirical prototyping. A complementary approach is to use computational human performance models to evaluate designs. An integrated strategy of model-based and empirical test and evaluation activities is particularly attractive as a methodology for verification and validation of human-rated systems for commercial space. This talk will review several computational human performance modeling approaches and their applicability to design of display and control requirements.
Ziaee Bigdeli, Ali; Li, Feng; Shi, Xiaohui
Most previous studies of university spinouts (USOs) have focused on what determines their formation from the perspectives of the entrepreneurs or of their parent universities. However, few studies have investigated how these entrepreneurial businesses actually grow and how their business models evolve in the process. This paper examines the evolution of USOs' business models over their different development phases. Using empirical evidence gathered from three comprehensive case studies, we ex...
This study was conducted to theoretically develop and empirically test a structural equation model of tourism destination competitiveness from the tourism stakeholders'perspective. The proposed hypotheses that attempted to identify the structural relationships among the five constructs in the model were examined through a series of analyses in LISREL: 1) perceived tourism development impacts, 2) environmental attitudes, 3) place attachment, 4) development preferences about destination attract...
Buehler, Markus J.; Genin, Guy M.
Advances in multiscale models and computational power have enabled a broad toolset to predict how molecules, cells, tissues and organs behave and develop. A key theme in biological systems is the emergence of macroscale behaviour from collective behaviours across a range of length and timescales, and a key element of these models is therefore hierarchical simulation. However, this predictive capacity has far outstripped our ability to validate predictions experimentally, particularly when multiple hierarchical levels are involved. The state of the art represents careful integration of multiscale experiment and modelling, and yields not only validation, but also insights into deformation and relaxation mechanisms across scales. We present here a sampling of key results that highlight both challenges and opportunities for integrated multiscale experiment and modelling in biological systems. PMID:28981126
Cebrat, Stanis l̶aw
Penna model of ageing predicts many phenomena in population dynamics. Since the model assumes that all genes in genomes are switched on chronologically and that there are no structural differences between male and female genomes, it cannot explain genetic death before birth and differences in mortality rates of men and women. I suggest adding the set of housekeeping genes, which are switched on during the embryo development, to the “death genes” of Penna model. Taking into account the large fraction of genes located on X chromosome whose deleterious mutations exert dominant effect on the male phenotype and recessive on the female phenotype would make it possible to avoid introducing somatic mutations as a cause of higher mortality of men. The modelling of linkage disequilibrium and its implications on eugenics have also been suggested.
Gompper, Gerhard; Fedosov, Dmitry A
Microvascular blood flow determines a number of important physiological processes of an organism in health and disease. Therefore, a detailed understanding of microvascular blood flow would significantly advance biophysical and biomedical research and its applications. Current developments in modeling of microcirculatory blood flow already allow to go beyond available experimental measurements and have a large potential to elucidate blood flow behavior in normal and diseased microvascular networks. There exist detailed models of blood flow on a single cell level as well as simplified models of the flow through microcirculatory networks, which are reviewed and discussed here. The combination of these models provides promising prospects for better understanding of blood flow behavior and transport properties locally as well as globally within large microvascular networks. © 2015 Wiley Periodicals, Inc.
Devereaux, Thomas Peter
A microscopic understanding of the strongly correlated physics of the cuprates must account for the translational and rotational symmetry breaking that is present across all cuprate families, commonly in the form of stripes. Here we investigate emergence of stripes in the Hubbard model, a minimal model believed to be relevant to the cuprate superconductors, using determinant quantum Monte Carlo (DQMC) simulations at finite temperatures and density matrix renormalization group (DMRG) ground state calculations. By varying temperature, doping, and model parameters, we characterize the extent of stripes throughout the phase diagram of the Hubbard model. Our results show that including the often neglected next-nearest-neighbor hopping leads to the absence of spin incommensurability upon electron-doping and nearly half-filled stripes upon hole-doping. The similarities of these findings to experimental results on both electron and hole-doped cuprate families support a unified description across a large portion of the cuprate phase diagram.
textabstractThis paper develops a consumer-centric framework for creating value through the freemium business model. Goods that are commercialized through the freemium business model offer basic functionality for free and monetize users for extended use or complementary features. Compared to premium goods, freemium goods have lower barriers to adoption and allow end-users to accurately assess and act on their willingness to pay. On the other hand, convincing users to spend money on freemium g...
Brinks, Ralph; Hoyer, Annika
The aim of this work is to relate the theory of stochastic processes with the differential equations associated with multistate (compartment) models. We show that the Kolmogorov Forward Differential Equations can be used to derive a relation between the prevalence and the transition rates in the illness-death model. Then, we prove mathematical well-definedness and epidemiological meaningfulness of the prevalence of the disease. As an application, we derive the incidence of diabetes from a series of cross-sections.
Hiteva, Ralitsa; Sovacool, Benjamin
This paper uses a business model framework to discuss how principles of energy justice - in particular, equitable distribution of costs and benefits, affordability, due process and greater participation in decision-making - can be embedded in business model innovations for energy, through social innovation. The paper discusses four cases at different scales (local, subnational, regional and global) to highlight opportunities for introducing principles of energy justice into the core of busine...
Li, Linna; Loo, Becky P Y
Revealing the relationship between mobility impairment and life satisfaction can help to propose effective interventions to secure mobility and life satisfaction. However, the relationship remains unclear and lacks quantitative evidence in China. This study therefore assesses the association of mobility impairment, social engagement, and life satisfaction among the older population in China. Based on the sample of China Health and Retirement Longitudinal Survey database in 2013, a structural equation modeling is established. The sample size is 4245 with 55.9% with mobility impairment. The model shows that the length of suffering from disability is significantly related to mobility impairment (β = 0.058, p life satisfaction (β = -0.311, p life satisfaction (β = 0.211, p life satisfaction partly because they usually participate less in social activities. Different strategies are suggested to be adopted to improve the life satisfaction of the older population from the aspects of promoting mobility and social engagement, including improving the design of transport facilitates, providing assistive facilities for the seniors with severe mobility impairment, promoting the accessibility of community leisure and healthcare services, and constructing more community senior activity centers.
Pachepsky, Yakov; Romano, Nunzio
Pedotransfer functions (PTFs) are empirical relationships between parameters of soil models and more easily obtainable data on soil properties. PTFs have become an indispensable tool in modeling soil processes. As alternative methods to direct measurements, they bridge the data we have and data we need by using soil survey and monitoring data to enable modeling for real-world applications. Pedotransfer is extensively used in soil models addressing the most pressing environmental issues. The following is an attempt to provoke a discussion by listing current issues that are faced by PTF development. 1. As more intricate biogeochemical processes are being modeled, development of PTFs for parameters of those processes becomes essential. 2. Since the equations to express PTF relationships are essentially unknown, there has been a trend to employ highly nonlinear equations, e.g. neural networks, which in theory are flexible enough to simulate any dependence. This, however, comes with the penalty of large number of coefficients that are difficult to estimate reliably. A preliminary classification applied to PTF inputs and PTF development for each of the resulting groups may provide simple, transparent, and more reliable pedotransfer equations. 3. The multiplicity of models, i.e. presence of several models producing the same output variables, is commonly found in soil modeling, and is a typical feature in the PTF research field. However, PTF intercomparisons are lagging behind PTF development. This is aggravated by the fact that coefficients of PTF based on machine-learning methods are usually not reported. 4. The existence of PTFs is the result of some soil processes. Using models of those processes to generate PTFs, and more general, developing physics-based PTFs remains to be explored. 5. Estimating the variability of soil model parameters becomes increasingly important, as the newer modeling technologies such as data assimilation, ensemble modeling, and model
Full Text Available Today’s supply chains (SCs are more than ever prone to disruptions caused by natural and man-made events with water scarcity identified as one of the highest impact events among these. Leading businesses, understanding that natural resource scarcity (NRS has become a critical supply chain risk factor, extensively incorporate sustainable water management programmes into their corporate social responsibility and environmental management agenda. The question of how industries can efficiently evaluate the progress of these water scarcity mitigation practices, however, remains open. In order to address this question, the present study proposes a conceptual maturity model. The model is rooted in strategies for water scarcity mitigation using a framework developed by Yatskovskaya and Srai and develops an extensive literature review of recent publications on maturity frameworks in the fields of sustainability and operations management. In order to test the proposed proposed, model an exploratory case study with a leading pharmaceutical company was conducted. The proposed maturity model presents an evaluation tool that allows systematic assessment and visualisation of organisational routines and practices relevant to sustainable manufacturing in the context of water scarcity. This model was designed to help illustrate mitigation capabilities evolution over time, where future state desired capabilities were considered through alternative supply network (SN configurations, network structure, process flow, product architecture, and supply partnerships.
Maltsev, Victor A.; Yaniv, Yael; Maltsev, Anna V.; Stern, Michael D.; Lakatta, Edward G.
Cardiac pacemaking is a complex phenomenon that is still not completely understood. Together with experimental studies, numerical modeling has been traditionally used to acquire mechanistic insights in this research area. This review summarizes the present state of numerical modeling of the cardiac pacemaker, including approaches to resolve present paradoxes and controversies. Specifically we discuss the requirement for realistic modeling to consider symmetrical importance of both intracellular and cell membrane processes (within a recent “coupled-clock” theory). Promising future developments of the complex pacemaker system models include the introduction of local calcium control, mitochondria function, and biochemical regulation of protein phosphorylation and cAMP production. Modern numerical and theoretical methods such as multi-parameter sensitivity analyses within extended populations of models and bifurcation analyses are also important for the definition of the most realistic parameters that describe a robust, yet simultaneously flexible operation of the coupled-clock pacemaker cell system. The systems approach to exploring cardiac pacemaker function will guide development of new therapies, such as biological pacemakers for treating insufficient cardiac pacemaker function that becomes especially prevalent with advancing age. PMID:24748434
Wang, Jue; Luo, Sheng
Mixed effects Beta regression models based on Beta distributions have been widely used to analyze longitudinal percentage or proportional data ranging between zero and one. However, Beta distributions are not flexible to extreme outliers or excessive events around tail areas, and they do not account for the presence of the boundary values zeros and ones because these values are not in the support of the Beta distributions. To address these issues, we propose a mixed effects model using Beta rectangular distribution and augment it with the probabilities of zero and one. We conduct extensive simulation studies to assess the performance of mixed effects models based on both the Beta and Beta rectangular distributions under various scenarios. The simulation studies suggest that the regression models based on Beta rectangular distributions improve the accuracy of parameter estimates in the presence of outliers and heavy tails. The proposed models are applied to the motivating Neuroprotection Exploratory Trials in Parkinson's Disease (PD) Long-term Study-1 (LS-1 study, n = 1741), developed by The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson's Disease (NINDS NET-PD) network. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Bustos-Vázquez, Eduardo; Fernández-Niño, Julián Alfredo; Astudillo-Garcia, Claudia Iveth
Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.
Temporal and spatiotemporal data form an inherent fabric of the society as we are faced with streams of data coming from numerous sensors, data feeds, recordings associated with numerous areas of application embracing physical and human-generated phenomena (environmental data, financial markets, Internet activities, etc.). A quest for a thorough analysis, interpretation, modeling and prediction of time series comes with an ongoing challenge for developing models that are both accurate and user-friendly (interpretable). The volume is aimed to exploit the conceptual and algorithmic framework of Computational Intelligence (CI) to form a cohesive and comprehensive environment for building models of time series. The contributions covered in the volume are fully reflective of the wealth of the CI technologies by bringing together ideas, algorithms, and numeric studies, which convincingly demonstrate their relevance, maturity and visible usefulness. It reflects upon the truly remarkable diversity of methodological a...
Turbulent combustion sits at the interface of two important nonlinear, multiscale phenomena: chemistry and turbulence. Its study is extremely timely in view of the need to develop new combustion technologies in order to address challenges associated with climate change, energy source uncertainty, and air pollution. Despite the fact that modeling of turbulent combustion is a subject that has been researched for a number of years, its complexity implies that key issues are still eluding, and a theoretical description that is accurate enough to make turbulent combustion models rigorous and quantitative for industrial use is still lacking. In this book, prominent experts review most of the available approaches in modeling turbulent combustion, with particular focus on the exploding increase in computational resources that has allowed the simulation of increasingly detailed phenomena. The relevant algorithms are presented, the theoretical methods are explained, and various application examples are given. The book ...
Development of a full-system boiling water reactor core model started in 1982. The model included a two-region reactor core, one with and one without boiling. Key design parameters consider variable dose rates in a three-layer liquid downcomer. Dose rates in the core and downcomer include both generation and recombination reactions of species. Agreement is good between calculations and experimental data of oxygen concentration as a function of hydrogen concentration for different bubble sizes. Oxygen concentration is reduced in the reactor pressure vessel (RPV) by increasing bubble size. The multilayer model follows the oxygen data better than a single-layered model at high concentrations of hydrogen. Key reactions are reduced to five radiolysis reactions and four decomposition reactions for hydrogen peroxide. Calculations by the DOT 3 code showed dose rates from neutrons and gamma rays in various parts of the core. Concentrations of oxygen, hydrogen peroxide, and hydrogen were calculated by the model as a function of time from core inlet. Similar calculations for NWC and HWC were made as a function of height from core inlet both in the boiling channel an the bypass channel. Finally the model was applied to calculate the oxygen plus half the hydrogen peroxide concentrations as a function of hydrogen concentration to compare with data from five plants. Power density distribution with core height was given for an early stage and an end stage of a cycle. Increases of dose rates in the turbine for seven plants were shown as a function of increased hydrogen concentration in the reactor water
Maxwell, Scott E
Through this book's unique model comparison approach, students and researchers are introduced to a set of fundamental principles for analyzing data. After seeing how these principles can be applied in simple designs, students are shown how these same principles also apply in more complicated designs. Drs. Maxwell and Delaney believe that the model comparison approach better prepares students to understand the logic behind a general strategy of data analysis appropriate for various designs; and builds a stronger foundation, which allows for the introduction of more complex topics omitt
The design space of information services evolved from seminal works through a set of prototypical hypermedia systems and matured in open and widely accessible web-based systems. The original concepts of hypermedia systems are now expressed in different forms and shapes. The first works on hypertext invented the term itself, laid out the foundational concept of association or link, and highlighted navigation as the core paradigm for the future information systems. The first engineered systems demonstrated architectural requirements and models and fostered the emergence of the conceptual model r
Ward, S A
Models of the exercise hyperpnoea have classically incorporated elements of proportional feedback (carotid and medullary chemosensory) and feedforward (central and/or peripheral neurogenic) control. However, the precise details of the control process remain unresolved, reflecting in part both technical and interpretational limitations inherent in isolating putative control mechanisms in the intact human, and also the challenges to linear control theory presented by multiple-input integration, especially with regard to the ventilatory and gas-exchange complexities encountered at work rates which engender a metabolic acidosis. While some combination of neurogenic, chemoreflex and circulatory-coupled processes are likely to contribute to the control, the system appears to evidence considerable redundancy. This, coupled with the lack of appreciable error signals in the mean levels of arterial blood gas tensions and pH over a wide range of work rates, has motivated the formulation of innovative control models that reflect not only spatial interactions but also temporal interactions (i.e. memory). The challenge is to discriminate between robust competing control models that: (a) integrate such processes within plausible physiological equivalents; and (b) account for both the dynamic and steady-state system response over a range of exercise intensities. Such models are not yet available.
Daan, S.; Hut, R. A.; Beersma, D.
In the two-process model as developed in the early 1980's sleep is controlled by a process-S, representing the rise and fall of sleep demand resulting from prior sleep-wake history, interacting with a process-C representing circadian variation in sleep propensity. S and C together optimize sleep
de Fruyt, F.; Denollet, J.K.L.
This study investigated the position of Type D (high Negative Affectivity and high Social Inhibition) within the Five-Factor Model (FFM) of personality. A sample of 155 healthy subjects were administered the Type D Scale and the NEO-FFI, assessing the FFM traits. Subjects also filled out the General
Reeder, Blaine; Zaslavksy, Oleg; Wilamowska, Katarzyna M.; Demiris, George; Thompson, Hilaire J
There is a recognized need to develop information technology for the delivery of care services to older adults. However, little attention has been paid to the design of information technology for the oldest old demographic. We made novel use of data from observations, focus groups and cluster analysis of oldest old participant characteristics from a pilot study in a community setting to iteratively construct personas for the design of information technology for the oldest old. The resulting two personas, “Hazel” and “Rose”, capture different abilities of members of the oldest old demographic group. In addition, we provide a list of eleven design recommendations to guide the design of technology that supports the abilities of people like Hazel and Rose. The resulting personas, design recommendations and persona construction method can be useful tools for informaticians and designers of new systems for the oldest old. PMID:22195177
Dealing with timely and interesting issues in strong laser physics. Illustrates complex strong field atomic ionization with the simple semiclassical model of classical trajectory perspective for the first time. Provides a theoretical model that can be used to account for recent experiments. The ionization of atoms and molecules in strong laser fields is an active field in modern physics and has versatile applications in such as attosecond physics, X-ray generation, inertial confined fusion (ICF), medical science and so on. Classical Trajectory Perspective of Atomic Ionization in Strong Laser Fields covers the basic concepts in this field and discusses many interesting topics using the semiclassical model of classical trajectory ensemble simulation, which is one of the most successful ionization models and has the advantages of a clear picture, feasible computing and accounting for many exquisite experiments quantitatively. The book also presents many applications of the model in such topics as the single ionization, double ionization, neutral atom acceleration and other timely issues in strong field physics, and delivers useful messages to readers with presenting the classical trajectory perspective on the strong field atomic ionization. The book is intended for graduate students and researchers in the field of laser physics, atom molecule physics and theoretical physics. Dr. Jie Liu is a professor of Institute of Applied Physics and Computational Mathematics, China and Peking University.
Stephen De La Harpe
Full Text Available In Africa, economic integration, realised through regional integration, is seen as one of the driving factors that will improve the lives of its people. To enable regionalisation, economic growth and to unlock the potential of Africa its infrastructure will have to be improved. Infrastructure will on the whole be realised through public procurement. The stages for opening up procurement markets, referred to by Yukins and Schooner, is discussed and it is concluded that the states in SADC is still in the initial stages of opening its public procurement markets for regional competition. Although COMESA is not yet in full compliance with all four the stages great strides have been made and have elements of all stages been addressed. Because of the influence the Model Law has already played in COMESA, and the rest of Africa, it would be contra productive should SADC not take the same route as COMESA. If regard is had to the four categories of procurement rules that serves as barriers to national procurement markets, as set out by Arrowsmith it is clear that all of these are present in most SADC member states. Also in the case of COMESA these barriers still exist albeit to a lesser extent. What is necessary is a phased approach to address all of these barriers. This will be possible under the UNCITRAL Model Law as the 2011 Model Law does provide for the possibility of complying with international obligations and for states to allow for socio economic objectives in their procurement regimes. There can be little doubt that the 1994 Model Law has already had a marked influence on public procurement regulation in Africa and that the 2011 Model Law will in future continue to do so. Public procurement is essential for economic development and is the integration and harmonisation thereof on a regional basis the first step In this regard SADC, and especially South Africa, has an important role to play.
Full Text Available A physically based model of soil surface scaling is proposed. The governing equations are formulated on the principle of conservation of mass assuming Darcy's law applies to suspension flowing through the soil surface. The model incorporates the physics of surface sealing by mechanisms that capture suspended particles moving with infiltrating water. As a result of particle retention in the soil system, the intrinsic porosity is reduced and hulk density is increased, resulting in changes to soil hydraulic properties such as moisture retention and hydraulic conductivity. Empirical functions are developed to describe the changes of these properties as the seal develops. With this approach, the seal can be mathematically described by well defined initial and boundary conditions and transient seal properties can be simulated in a physically realistic manner.
Crossa, José; Pérez-Rodríguez, Paulino; Cuevas, Jaime; Montesinos-López, Osval; Jarquín, Diego; de Los Campos, Gustavo; Burgueño, Juan; González-Camacho, Juan M; Pérez-Elizalde, Sergio; Beyene, Yoseph; Dreisigacker, Susanne; Singh, Ravi; Zhang, Xuecai; Gowda, Manje; Roorkiwal, Manish; Rutkoski, Jessica; Varshney, Rajeev K
Genomic selection (GS) facilitates the rapid selection of superior genotypes and accelerates the breeding cycle. In this review, we discuss the history, principles, and basis of GS and genomic-enabled prediction (GP) as well as the genetics and statistical complexities of GP models, including genomic genotype×environment (G×E) interactions. We also examine the accuracy of GP models and methods for two cereal crops and two legume crops based on random cross-validation. GS applied to maize breeding has shown tangible genetic gains. Based on GP results, we speculate how GS in germplasm enhancement (i.e., prebreeding) programs could accelerate the flow of genes from gene bank accessions to elite lines. Recent advances in hyperspectral image technology could be combined with GS and pedigree-assisted breeding. Copyright © 2017 Elsevier Ltd. All rights reserved.
Teachers' instructional practices are greatly shaped by their own learning experiences as students in K-12 and college classrooms, which for most teachers was traditional, teacher-centered instruction. One of the challenges facing mathematics education reform is that, traditional teaching is in contrast to reform student- centered instruction. If teachers learn from their experiences as mathematics students, mathematics teacher educators are encouraged to model practices they would like teach...
Godar, Sean C; Mosher, Laura J; Di Giovanni, Giuseppe; Bortolato, Marco
Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders. Copyright © 2014 Elsevier B.V. All rights reserved.
Godar, Sean C.; Mosher, Laura J.; Di Giovanni, Giuseppe; Bortolato, Marco
Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders. PMID:25244952
Fiorella, Logan; van Gog, Tamara; Hoogerheide, Vincent; Mayer, Richard E.
The present study tests whether presenting video modeling examples from the learner's (first-person) perspective promotes learning of an assembly task, compared to presenting video examples from a third-person perspective. Across 2 experiments conducted in different labs, university students viewed a video showing how to assemble an 8-component…
Venables, N C; Hall, J R; Patrick, C J
The triarchic model of psychopathy characterizes the disorder in terms of three distinguishable phenotypic facets: disinhibition, meanness and boldness. The present study sought to (1) inform current debates regarding the role of boldness in the definition of psychopathy and (2) clarify boundaries between psychopathy and antisocial personality disorder (ASPD). This study evaluated the degree to which facets of the triarchic model are represented in the most widely used clinical inventory for psychopathy, the Psychopathy Checklist - Revised (PCL-R), in comparison with ASPD as defined by DSM-IV criteria. Adult male offenders from two distinct correctional settings (n = 157 and 169) were investigated to ensure replicability of findings across samples exhibiting high base rates of psychopathy and antisocial behavior. We found evidence for convergent and discriminant validity of the three triarchic facets in predicting symptomatic components of psychopathy as assessed by the PCL-R. Additionally, and crucially vis-à-vis current debates in the field, we found that boldness contributed incrementally (over and above disinhibition and meanness) to prediction of PCL-R psychopathy, in particular its interpersonal style component, but not ASPD. The three distinct facets of the triarchic model of psychopathy are represented clearly and distinctly in the PCL-R, with boldness through its interpersonal facet, but not in DSM-defined ASPD. Our findings suggest that boldness is central to diagnostic conceptions of psychopathy and distinguishes psychopathy from the more prevalent diagnosis of ASPD.
This work is devoted to the theoretical and numerical study of Hartree-Fock-Bogoliubov (HFB) theory for attractive quantum systems, which is one of the main methods in nuclear physics. We first present the model and its main properties, and then explain how to get numerical solutions. We prove some convergence results, in particular for the simple fixed point algorithm (sometimes called Roothaan). We show that it converges, or oscillates between two states, none of them being a solution. This generalizes to the HFB case previous results of Cances and Le Bris for the simpler Hartree-Fock model in the repulsive case. Following these authors, we also propose a relaxed constraint algorithm for which convergence is guaranteed. In the last part of the thesis, we illustrate the behavior of these algorithms by some numerical experiments. We first consider a system where the particles only interact through the Newton potential. Our numerical results show that the pairing matrix never vanishes, a fact that has not yet been proved rigorously. We then study a very simplified model for protons and neutrons in a nucleus. (author)
Weng, Shuo-Chun; Chen, Yu-Chi; Chen, Ching-Yu; Cheng, Yuan-Yang; Tang, Yih-Jing; Yang, Shu-Hui; Lin, Jwu-Rong
The effect of health depreciation in older people on medical care demand is not well understood. We tried to assess the medical care demand with length of hospitalization and their impact on profits as a result of health depreciation. All participants who underwent comprehensive geriatric assessment were from a prospective cohort study at a tertiary hospital. A total of 1191 cases between September 2008 to October 2012 were investigated. Three sets of qualitative response models were constructed to estimate the impact of older adults' health depreciation on multidisciplinary geriatric care services. Furthermore, we analyzed the factors affecting the composite end-point of rehospitalization within 14 days, re-admission to the emergency department within 3 days and patient death. Greater health depreciation in elderly patients was positively correlated with greater medical care demand. Three major components were defined as health depreciation: elderly adaptation function, geriatric syndromes and multiple chronic diseases. On admission, the better the basic living functions, the shorter the length of hospitalization (coefficient = -0.35, P age and length of hospitalization. However, factors that correlated with relatively good outcome were functional improvement after medical care services and level of disease education. An optimal allocation system for selection of cases into multidisciplinary geriatric care is required because of limited resources. Outcomes will improve with health promotion and preventive care services. Geriatr Gerontol Int 2017; 17: 645-652. © 2016 Japan Geriatrics Society.
Mishnaevsky, Leon; Zhou, H.W.; Peng, R.D.
Strength and reliability of wind blades produced from polymer composites are the important preconditions for the successful development of wind energy. One of the ways to increase the reliability and lifetime of polymer matrix composites is the nanoengineering of matrix or fiber/matrix interfaces...... in these composites. The potential and results of nanoclay reinforcements for the improvement of the mechanical properties of polymer composites are investigated using continuum mechanics and micromechanics methods and effective phase model. It is demonstrated that nanoreinforcement allows to increase the stiffness...
Weiner, Neal Jonathan
In 1934 Fermi postulated a theory for weak interactions containing a dimensionful coupling with a size of roughly 250 GeV. Only now are we finally exploring this energy regime. What arises is an open question: supersymmetry and large extra dimensions are two possible scenarios. Meanwhile, other experiments will begin providing definitive information into the nature of neutrino masses and CP violation. In this paper, we explore features of possible theoretical scenarios, and study the phenomenological implications of various models addressing the open questions surrounding these issues
Weiner, Neal Jonathan [Univ. of California, Berkeley, CA (United States)
In 1934 Fermi postulated a theory for weak interactions containing a dimensionful coupling with a size of roughly 250 GeV. Only now are we finally exploring this energy regime. What arises is an open question: supersymmetry and large extra dimensions are two possible scenarios. Meanwhile, other experiments will begin providing definitive information into the nature of neutrino masses and CP violation. In this paper, we explore features of possible theoretical scenarios, and study the phenomenological implications of various models addressing the open questions surrounding these issues.
Gliozzi, A S; Scalerandi, M
Materials possessing micro-inhomogeneities often display a nonlinear response to mechanical solicitations, which is sensitive to the confining pressure acting on the sample. Dynamic acoustoelastic testing allows measurement of the instantaneous variations in the elastic modulus due to the change of the dynamic pressure induced by a low-frequency wave. This paper shows that a Preisach-Mayergoyz space based hysteretic multi-state elastic model provides an explanation for experimental observations in consolidated granular media and predicts memory and nonlinear effects comparable to those measured in rocks.
Full Text Available BIM-enabled estimating processes do not replace or provide a substitute for the traditional approaches used in the architecture, engineering and construction industries. This paper explores the impact of BIM on these traditional processes. It identifies differences between the approaches used with BIM and other conventional methods, and between the various construction professionals that prepare estimates. We interviewed 17 construction professionals from client organizations, contracting organizations, consulting practices and specialist-project firms. Our analyses highlight several logical relationships between estimating processes and BIM attributes. Estimators need to respond to the challenges BIM poses to traditional estimating practices. BIM-enabled estimating circumvents long-established conventions and traditional approaches, and focuses on data management. Consideration needs to be given to the model data required for estimating, to the means by which these data may be harnessed when exported, to the means by which the integrity of model data are protected, to the creation and management of tools that work effectively and efficiently in multi-disciplinary settings, and to approaches that narrow the gap between virtual reality and actual reality. Areas for future research are also identified in the paper.
Capuano, Edoardo; Oliviero, Teresa; van Boekel, Martinus A J S
The same chemical reaction may be different in terms of its position of the equilibrium (i.e., thermodynamics) and its kinetics when studied in different foods. The diversity in the chemical composition of food and in its structural organization at macro-, meso-, and microscopic levels, that is, the food matrix, is responsible for this difference. In this viewpoint paper, the multiple, and interconnected ways the food matrix can affect chemical reactivity are summarized. Moreover, mechanistic and empirical approaches to explain and predict the effect of food matrix on chemical reactivity are described. Mechanistic models aim to quantify the effect of food matrix based on a detailed understanding of the chemical and physical phenomena occurring in food. Their applicability is limited at the moment to very simple food systems. Empirical modeling based on machine learning combined with data-mining techniques may represent an alternative, useful option to predict the effect of the food matrix on chemical reactivity and to identify chemical and physical properties to be further tested. In such a way the mechanistic understanding of the effect of the food matrix on chemical reactions can be improved.
Heffernan, John M.; Sirianni, Rachael W.
Following diagnosis of a glioblastoma (GBM) brain tumor, surgical resection, chemotherapy and radiation together yield a median patient survival of only 15 months. Importantly, standard treatments fail to address the dynamic regulation of the brain tumor microenvironment that actively supports tumor progression and treatment resistance. It is becoming increasingly recognized that specialized niches within the tumor microenvironment maintain a population of highly malignant glioblastoma stem-like cells (GSCs). GSCs are resistant to traditional chemotherapy and radiation therapy, suggesting that they may be responsible for the near universal rates of tumor recurrence and associated morbidity in GBM. Thus, disrupting microenvironmental support for GSCs could be critical to developing more effective GBM therapies. Three-dimensional (3D) culture models of the tumor microenvironment are powerful tools for identifying key biochemical and biophysical inputs that impact malignant behaviors. Such systems have been used effectively to identify conditions that regulate GSC proliferation, invasion, stem-specific phenotypes, and treatment resistance. Considering the significant role that GSC microenvironments play in regulating this tumorigenic sub-population, these models may be essential for uncovering mechanisms that limit GSCs malignancy.
Chakraborty, Kunal; Kar, T K
The present paper describes a prey-predator type fishery model with prey dispersal in a two-patch environment, one of which is a free fishing zone and other is protected zone. The objective of the paper is to maximize the net economic revenue earn from the fishery through implementing the sustainable properties of the fishery to keep the ecological balance. Biological measures are introduced to increase the understanding of the mechanisms in the bioeconomic system. The importance of marine reserve is analyzed through the obtained results of the numerical simulations of proposed model system. The results depict that reserves will be most effective when coupled with harvesting controls in adjacent fisheries. The paper also incorporates the induced cost and premium from establishing a marine protected area in a fishery. It is found that premium of marine protected area (MPA) increases with the increasing size of the reserve. Results are analyzed with the help of graphical illustrations. Copyright © 2012 Elsevier Inc. All rights reserved.
On 1 April 1991 a new regime for industrial pollution control was introduced in England and Wales: Integrated Pollution Regulation (IPR). For those industrial processes which involve releases of pollutants into the atmosphere, the relevant primary legislation includes: the Environmental Protection Act 1990, which established a system of Integrated Pollution Control for those industries which have the greatest potential to cause pollution, and the Radioactive Substances Act 1960, which is concerned with the regulation of radioactive releases. There is a requirement for the operator of a process to make an application to HMIP for authorization to operate the process and dispose of waste arisings, and an environmental impact assessment must form part of that application. HMIP does not prescribe the type of assessment techniques that the applicant should use. But the Inspectorate will audit the applicant's assessment, and also carry out its own calculations if appropriate. The assessment standards used by HMIP are being published in the form of ''Chief Inspector's Guidance to Inspectors'', which can be referred to by applicants. HMIP makes use of both short-range and longer-range atmospheric dispersion models to fulfill its regulatory duties. Within the former category, the Inspectorate is one of the UK organisations which is sponsoring the development of the UK-ADMS model. (AB)
Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic
Confidence in 3D multi-segment foot models has been limited by a lack of repeatability data, particularly in older populations that may display unique functional foot characteristics. This study aimed to determine the intra and inter-observer repeatability of stance phase kinematic data from a multi-segment foot model described by Leardini et al.  in people aged 50 years or older. Twenty healthy adults participated (mean age 65.4 years SD 8.4). A repeated measures study design was used with data collected from four testing sessions on two days from two observers. Intra (within-day and between-day) and inter-observer coefficient of multiple correlations revealed moderate to excellent similarity of stance phase joint range of motion (0.621-0.975). Relative to the joint range of motion (ROM), mean differences (MD) between sessions were highest for the within-day comparison for all planar ROM at the metatarsus-midfoot articulation (sagittal plane ROM 5.2° vs. 3.9°, MD 3.1°; coronal plane ROM 3.9 vs. 3.1°, MD 2.3°; transverse plane ROM 6.8° vs. 5.16°, MD 3.5°). Consequently, data from the metatarsus-midfoot articulation in the Istituto Ortopedico Rizzoli (IOR) foot model in adults aged over 50 years needs to be considered with respect to the findings of this study. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.
Pérez-Muñoz, Alfonso; Chacón, Fernando; Martínez Arias, Rosario
Poverty is a social problem, entailing not only an economical perspective but above all a human and social issue. Poverty is promoted, justified and maintained by unique individuals and groups by means of our own attitudes, interests and behavior, as well as with our social structures and social relationships. From this interactive, psychosocial and sociostructural perspective, and also considering poverty as a denial of basic human rights (UNDP, 1998), we carried out a study with the primary objective to design and verify an Explanatory Model of Poverty. This research may helps to increase the validity of diagnostics and the effectiveness of interventions. Most of the hypotheses were accepted during the analysis and verification of the Model (p poverty including its effects, processes and causes; (b) the need for everybody to accept the social responsibility in the prevention and solution to poverty; and (c) the need to conduct longitudinal interventions with scientific methodology and social participation.
Mancho, Ana M.; Hernández-García, Emilio; López, Cristóbal; Turiel, Antonio; Wiggins, Stephen; Pérez-Muñuzuri, Vicente
The third edition of the international workshop Nonlinear Processes in Oceanic and Atmospheric Flows was held at the Institute of Mathematical Sciences (ICMAT) in Madrid from 6 to 8 July 2016. The event gathered oceanographers, atmospheric scientists, physicists, and applied mathematicians sharing a common interest in the nonlinear dynamics of geophysical fluid flows. The philosophy of this meeting was to bring together researchers from a variety of backgrounds into an environment that favoured a vigorous discussion of concepts across different disciplines. The present Special Issue on Current perspectives in modelling, monitoring, and predicting geophysical fluid dynamics contains selected contributions, mainly from attendants of the workshop, providing an updated perspective on modelling aspects of geophysical flows as well as issues on prediction and assimilation of observational data and novel tools for describing transport and mixing processes in these contexts. More details on these aspects are discussed in this preface.
Laity, Peter R; Holland, Chris
Variability in silk's rheology is often regarded as an impediment to understanding or successfully copying the natural spinning process. We have previously reported such variability in unspun native silk extracted straight from the gland of the domesticated silkworm Bombyx mori and discounted classical explanations such as differences in molecular weight and concentration. We now report that variability in oscillatory measurements can be reduced onto a simple master-curve through normalizing with respect to the crossover. This remarkable result suggests that differences between silk feedstocks are rheologically simple and not as complex as originally thought. By comparison, solutions of poly(ethylene-oxide) and hydroxypropyl-methyl-cellulose showed similar normalization behavior; however, the resulting curves were broader than for silk, suggesting greater polydispersity in the (semi)synthetic materials. Thus, we conclude Nature may in fact produce polymer feedstocks that are more consistent than typical man-made counterparts as a model for future rheological investigations.
Full Text Available Born also as a reaction, with a pronounced contestatory character and as an alternative to the actual mondialization of the “total capitalism”, the altermondialism has succeeded to impose itself in the last decade as a social movement with transcontinental dimensions and as a theoretical position in full development. By denouncing the essential drawbacks of the international order of finance and commerce – the multiplication of the discrepancies between North and South, the amplification of the inequalities between rich and poor or the emphasis of the ecological insecurity, which demonstrates the incapacity of the occidental economic model in offering a sustainable future for the entire humanity – the altermondialist project proposes a global model of development, multidimensional, in which the factors: economy, society, ecology and culture are combining in a viable way. The neo-liberal dogma of absolute free change and of the pre-eminence of private is replaced with values, such as: solidarity, democracy and social justice. If the diversity of elements and its nature of “movement of movements” prove to be efficient as a front of contesting and denouncing of the existing mondialism, the lack of homogeneity impedes building a clear and coherent strategic program and, consequently, canalizing the efforts of the altermondialist militants towards a unique direction. Nevertheless, a common direction is affirming on general themes, such as: promoting a sustainable development, respecting fundamental rights, protecting the environment, peace and democracy. With an often idealist speech, marching towards a “contestant utopia”, the movement designated as its main ideological adversary, the neo-liberalism and wants to become a “theoretical engine” of social struggle. Until now, the performance of confrontations between the supporters of the two mondialisms – the one still in force and, respectively, the one in project phase, showed
Full Text Available Born also as a reaction, with a pronounced contestatory character and as an alternative to the actual mondialization of the “total capitalism”, the altermondialism has succeeded to impose itself in the last decade as a social movement with transcontinental dimensions and as a theoretical position in full development. By denouncing the essential drawbacks of the international order of finance and commerce – the multiplication of the discrepancies between North and South, the amplification of the inequalities between rich and poor or the emphasis of the ecological insecurity, which demonstrates the incapacity of the occidental economic model in offering a sustainable future for the entire humanity – the altermondialist project proposes a global model of development, multidimensional, in which the factors: economy, society, ecology and culture are combining in a viable way. The neo-liberal dogma of absolute free change and of the pre-eminence of private is replaced with values, such as: solidarity, democracy and social justice. If the diversity of elements and its nature of “movement of movements” prove to be efficient as a front of contesting and denouncing of the existing mondialism, the lack of homogeneity impedes building a clear and coherent strategic program and, consequently, canalizing the efforts of the altermondialist militants towards a unique direction. Nevertheless, a common direction is affirming on general themes, such as: promoting a sustainable development, respecting fundamental rights, protecting the environment, peace and democracy. With an often idealist speech, marching towards a “contestant utopia”, the movement designated as its main ideological adversary, the neo-liberalism and wants to become a “theoretical engine” of social struggle. Until now, the performance of confrontations between the supporters of the two mondialisms – the one still in force and, respectively, the one in project phase, showed
Bertollo, Maurizio; di Fronso, Selenia; Filho, Edson; Conforto, Silvia; Schmid, Maurizio; Bortoli, Laura; Comani, Silvia; Robazza, Claudio
Background. The main goal of the present study was to explore theta and alpha event-related desynchronization/synchronization (ERD/ERS) activity during shooting performance. We adopted the idiosyncratic framework of the multi-action plan (MAP) model to investigate different processing modes underpinning four types of performance. In particular, we were interested in examining the neural activity associated with optimal-automated (Type 1) and optimal-controlled (Type 2) performances. Methods. Ten elite shooters (6 male and 4 female) with extensive international experience participated in the study. ERD/ERS analysis was used to investigate cortical dynamics during performance. A 4 × 3 (performance types × time) repeated measures analysis of variance was performed to test the differences among the four types of performance during the three seconds preceding the shots for theta, low alpha, and high alpha frequency bands. The dependent variables were the ERD/ERS percentages in each frequency band (i.e., theta, low alpha, high alpha) for each electrode site across the scalp. This analysis was conducted on 120 shots for each participant in three different frequency bands and the individual data were then averaged. Results. We found ERS to be mainly associated with optimal-automatic performance, in agreement with the "neural efficiency hypothesis." We also observed more ERD as related to optimal-controlled performance in conditions of "neural adaptability" and proficient use of cortical resources. Discussion. These findings are congruent with the MAP conceptualization of four performance states, in which unique psychophysiological states underlie distinct performance-related experiences. From an applied point of view, our findings suggest that the MAP model can be used as a framework to develop performance enhancement strategies based on cognitive and neurofeedback techniques.
Full Text Available Background. The main goal of the present study was to explore theta and alpha event-related desynchronization/synchronization (ERD/ERS activity during shooting performance. We adopted the idiosyncratic framework of the multi-action plan (MAP model to investigate different processing modes underpinning four types of performance. In particular, we were interested in examining the neural activity associated with optimal-automated (Type 1 and optimal-controlled (Type 2 performances. Methods. Ten elite shooters (6 male and 4 female with extensive international experience participated in the study. ERD/ERS analysis was used to investigate cortical dynamics during performance. A 4 × 3 (performance types × time repeated measures analysis of variance was performed to test the differences among the four types of performance during the three seconds preceding the shots for theta, low alpha, and high alpha frequency bands. The dependent variables were the ERD/ERS percentages in each frequency band (i.e., theta, low alpha, high alpha for each electrode site across the scalp. This analysis was conducted on 120 shots for each participant in three different frequency bands and the individual data were then averaged. Results. We found ERS to be mainly associated with optimal-automatic performance, in agreement with the “neural efficiency hypothesis.” We also observed more ERD as related to optimal-controlled performance in conditions of “neural adaptability” and proficient use of cortical resources. Discussion. These findings are congruent with the MAP conceptualization of four performance states, in which unique psychophysiological states underlie distinct performance-related experiences. From an applied point of view, our findings suggest that the MAP model can be used as a framework to develop performance enhancement strategies based on cognitive and neurofeedback techniques.
Bokulich, Alisa Nicole
theoretical pluralism, are inadequate. The fruitful ways in which models have been used in quantum chaos research point to the need for a new framework for addressing intertheoretic relations that focuses on models rather than laws.
Orchestrating care through the fast-track perspective: Orthopaedic nurses’ perceptions and experiences of providing individualised nursing care in older patients’ standardised fast-track programmes after total hip or knee replacement
Bøttcher Berthelsen, Connie; Frederiksen, Kirsten
The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised...... fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim...... and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying...
Zhang, Hao; Cai, Zhijian; Xie, Yu
Take Chinese yew cooperative organization for exampleï¼Œdifferent game structures of forestry cooperation model were analyzedï¼Œthe elative merit and applicable occasion was discussed combined with empirical investigationï¼Œand some suggestions were given alsoï¼ŽThe results showed that depending entirely on normal forest farmers cooperate spontaneously is difficult. Policies should be designed from the perspective of promoted village cadres and influential family salons to cooperation. When m...
Bjøndal, Tore Stautland; Gedde, Mads
The Internet is an emerging distribution channel for television content that will deeply impact industry incumbents in the long term. This master thesis explores what challenges are brought forth in this industry by the possibility of Internet distribution of TV and how these issues should be addressed from the business model perspective of incumbent distributors in the Norwegian television market.There have been tremendous developments in Internet related infrastructure over the last decade....
Fukui, Sadaaki; Okada, Shinichi; Nishimoto, Yukio; Nelson-Becker, Holly B
Dementia care has been trapped in a "trial and error" type of practice due to difficulty understanding the needs of older adults with severe dementia. Behavioral and Psychological Signs and Symptoms of Dementia (BPSD) can be quite difficult for residential staff. However, some experienced care workers succeed in establishing effective relationships. The goal of this study was to: 1) develop a process to identify needs behind BPSD; 2) find solutions using a team approach; and 3) apply the results to educate new workers. The KJ method was employed to reach decision-making about best practices in residential dementia care. This qualitative method is used to organize group data collected in the field and is based on understanding complex situations. A group process of 12 Japanese care workers experienced in understanding and responding to the "repeated appeal to return home" of residents in nursing care facilities is highlighted along with an illustrative case example. The workgroup met over two years. The study revealed five steps in understanding the needs behind the appeal, which include: (1) Listen to the voice and go with the flow of the behavior; (2) Learn about the inner experience; (3) Learn about the contextual environment of "here and now" situations; (4) Reflect on the care environment; and (5) Find the keyword. This needs identification process has application to other cultural contexts. The implications of this study for practitioners who work with people with dementia in residential settings will be discussed.
Carmelo Manuella, Fabio; Scribano, Vittorio; Carbone, Serafina; Hovland, Martin; Johnsen, Hans-Konrad; Rueslåtten, Håkon
Mediterranean salt giants, occurring both in sub-seafloor and in onshore settings (the "Gessoso Solfifera Group"), are traditionally explained by repeated cycles of desiccation and replenishment of the entire basin. However, such hypotheses are strongly biased by mass balance calculations and geodynamic considerations. In addition, any hypothesis without full desiccation, still based on the evaporite model, should consider that seawater brines start to precipitate halite when 2/3 of the seawater has evaporated, and hence the level of the basin cannot be the same as the adjacent ocean. On the other hand, hydrothermal venting of hot saline brines onto the seafloor can precipitate salt in a deep marine basin if a layer of heavy brine exists along the seafloor. This process, likely related to sub-surface boiling or supercritical out-salting (Hovland et al., 2006), is consistent with geological evidence in the Red Sea "Deeps" (Hovland et al., 2015). Although supercritical out-salting and phase separation can sufficiently explain the formation of several marine salt deposits, even in deep marine settings, the Mediterranean salt giant formations can also be explained by the serpentinization model (Scribano et al., 2016). Serpentinization of abyssal peridotites does not involve seawater salts, and large quantities of saline brines accumulate in pores and fractures of the sub-seafloor serpentinites. If these rocks undergo thermal dehydration, for example, due to igneous intrusions, brines and salt slurries can migrate upwards as hydrothermal plumes, eventually venting at the seafloor, giving rise to giant salt deposits over time. These hydrothermal processes can take place in a temporal sequence, as it occurred in the "Caltanissetta Basin" (Sicily). There, salt accumulation associated with serpentinization started during Triassic times (and even earlier), and venting of heavy brines onto the seafloor eventually occurred in the Messinian via the hydrothermal plume mechanism
Tate, Charlotte Chuck
One long-standing project within lesbian studies has been to develop a satisfactory working definition of "lesbian." This article proposes two new models of a definition using principles of social psychology. Each model (a) utilizes the premise that gender lacks a categorical essence and (b) separates behavioral adherence to cultural stereotypes of femininity and masculinity from one's gender self-categorization. From these premises, I generate and critique two internally coherent models of lesbian identity that are inclusive (to different degrees) of various gender identities. For each model, the potential inclusion of trans men, trans women, genderqueers, and lesbian-identified cisgender men is evaluated. The explanatory power of these models is twofold. One, the models can serve as theoretical perspectives for scholars who study the intersection of gender and sexual identity. Two, the models can also characterize the everyday experience of people who have tacit working definitions of lesbian identity.
Lyons, K. J.; Salsbury, S. A.; Hondras, M. A.
Background: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs...... to talk openly and honestly about LBP, offer clear and consistent recommendations about treatment, and provide individualized care. Facilitators of MD-DC co-management included collegial relationships between providers, arrangements between doctors to support interdisciplinary referral, computer systems...... that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or imaging, scheduling...
After draining the northern flank of the Alps Mountains in Germany and Austria, the Danube River flows east as it enters this west-looking scene (upper right) and forms the border between Slovakia and Hungary. The river then leaves the border as it enters Hungary and transects the Transdanubian Mountains, which trend southwest to northeast. Upon exiting the mountains, the river turns southward, flowing past Budapest (purplish blue area) and along the western margin of the Great Hungarian Plain.South and west of the Danube, the Transdanubian Mountains have at most only about 400 meters (about 1300 feet) of relief but they exhibit varied landforms, which include volcanic, tectonic, fluvial (river), and eolian (wind) features. A thick deposit of loess (dust deposits likely blown from ancient glacial outwash) covers much of this area, and winds from the northwest, funneled between the Alps and the Carpathian Mountains, are apparently responsible for a radial pattern of erosional streaks across the entire region.This image was generated from a Landsat satellite image draped over an elevation model produced by the Shuttle Radar Topography Mission (SRTM). The view uses a 3-times vertical exaggeration to enhance topographic expression. The false colors of the scene result from displaying Landsat bands 1, 4, and 7 in blue, green, and red, respectively. Band 1 is visible blue light, but bands 4 and 7 are reflected infrared light. This band combination maximizes color contrasts between the major land cover types, namely vegetation (green), bare ground (red), and water (blue). Shading of the elevation model was used to further highlight the topographic features.Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space
Halvarsson, Alexandra; Ståhle, Agneta; Halén, Carolina; Roaldsen, Kirsti Skavberg
To explore how older women with osteoporosis perceive fall-related concerns and balance in daily life after having participated in balance training. Explorative study. Semi-structured interviews were conducted with 19 women (66-84 years), with osteoporosis recruited from an ongoing RCT; participants were asked about their perceived fall-related concerns and balance. Interviews were taped and transcribed verbatim. Data were analyzed using inductive qualitative content analysis. One underlying theme emerged: "Internalized risk perception related to experience of bodily fragility", and three manifest categories: empowerment, safety and menace. A dynamic process between the categories was found, in which contextual and personal factors influenced perceptions of fall-related concerns and balance, i.e. winter season may lead a person who is highly empowered and/or uses active strategies into a situation of perception of menace and avoidance of activity. To cope with the fragility caused by osteoporosis informants had an internalized risk perception that protected them against possible threats and harm. Informants perceived improved empowerment and self-efficacy after participation in balance training. They resumed activities and became more active and independent in daily life using safety precautions and fall-prevention strategies. Depending on contextual factors, some situations still invoked fear and led to avoidance. Implication for Rehabilitation Risk awareness protecting against possible threats and harms seems to be internalized in older women living with osteoporosis. When designing fall prevention programs, it is important to recognize that contextual and personal factors have a major influence on how older women with osteoporosis perceive fall-related concerns and balance. Perception of fragility and risk seems to be a significant problem for older women with osteoporosis and health-care providers should encourage their patients to participate in tailored
Vafaei, Afshin; Alvarado, Beatriz; Tomás, Concepcion; Muro, Carmen; Martinez, Beatriz; Zunzunegui, Maria Victoria
The Bem Sex Role Inventory (BSRI) is the most commonly used and validated gender role measurement tool across countries and age groups. However, it has been rarely validated in older adults and sporadically used in aging and health studies. Perceived gender role is a crucial part of a person's identity and an established determinant of health. Androgyny model suggests that those with high levels of both masculinity and femininity (androgynous) are more adaptive and hence have better health. Our objectives were to explore the validity of BSRI in an older Spanish population, to compare different standard methods of measuring gender roles, and to examine their impact on health indicators. The BSRI and health indicator questions were completed by 120 community-dwelling adults aged 65+ living in Aragon, Spain. Exploratory factor analysis was performed to examine psychometric properties of the BSRI. Androgyny was measured by three approaches: geometric mean, t-ratio, and traditional four-gender groups classification. Relationships between health indicators and gender roles were explored. Factor analysis resulted in two-factor solution consistent with the original masculine and feminine items with high loadings and good reliability. There were no associations between biological sex and gender roles. Different gender role measurement approaches classified participants differently into gender role groups. Overall, androgyny was associated with better mobility and physical and mental health. The traditional four groups approach showed higher compatibility with the androgyny model and was better able to disentangle the differential impact of gender roles on health. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Boulton-Lewis, Gillian M.; Buys, Laurie
This paper reports on the findings of qualitative, semistructured interviews conducted with 40 older Australian participants who either did or did not engage in organized learning. Phenomenology was used to guide the interviews and analysis to explore the lived learning experiences and perspectives of these older people. Their experiences of…
Taipale, Heidi; Tanskanen, Antti; Koponen, Marjaana; Tolppanen, Anna-Maija; Tiihonen, Jari; Hartikainen, Sirpa
Background PRE2DUP is a modeling method that generates drug use periods (ie, when drug use started and ended) from drug purchases recorded in dispensing-based register data. It is based on the evaluation of personal drug purchasing patterns and considers hospital stays, possible stockpiling of drugs, and package information. Objective The objective of this study was to investigate person-level agreement between self-reported drug use in the interview and drug use modeled from dispensing data with PRE2DUP method for various drug classes used by older persons. Methods Self-reported drug use was assessed from the GeMS Study including a random sample of persons aged ≥75 years from the city of Kuopio, Finland, in 2006. Drug purchases recorded in the Prescription register data of these persons were modeled to determine drug use periods with PRE2DUP modeling method. Agreement between self-reported drug use on the interview date and drug use calculated from register-based data was compared in order to find the frequently used drugs and drug classes, which was evaluated by Cohen’s kappa. Kappa values 0.61–0.80 were considered to represent good and 0.81–1.00 as very good agreement. Results Among 569 participants with mean age of 82 years, the agreement between interview and register data was very good for 75% and very good or good for 93% of the studied drugs or drug classes. Good or very good agreement was observed for drugs that are typically used on regular bases, whereas “as needed” drugs represented poorer results. Conclusion PRE2DUP modeling method validly describes regular drug use among older persons. For most of drug classes investigated, PRE2DUP-modeled register data described drug use as well as interview-based data which are more time-consuming to collect. Further studies should be conducted by comparing it with other methods and in different drug user populations. PMID:27785101
Full Text Available This paper presents the perspectives for application of computer models in forecasting the dynamics of forest development on example of Moczarne area, in Bieszczadzki National Park, based on authors’ computer models. First, the possibilities for forecasting the dynamics of forest development in a local scale, i.e. within single rectangular or circular study plot, are presented. For this purpose, a computer prognostic model FORKOM E has been applied, using both general mathematical relationships functioning within a forest ecosystem and empirical ones, characteristic for tree stands at analysed plots. Additionally, a layer of 3D visualisation of a tree stand, which is an integral part of the mentioned model, is also presented. Presented also are the possibilities for forecasting the dynamics of forest development at landscape scale, applying the theory of cellular automata. For this purpose, a prognostic computer model CELLAUT was used in which the whole analysed tree stand is understood as a set of single cells, where stages of landscape development dominating within those cells are considered as also the influence of particular cells upon their neighbours. The paper also describes the perspectives for application of self-learning neural networks in the process of supplementation and verification of some parameters of a tree stand, calculated by the above-mentioned models.
Haliko, Shannon; Downs, Julie; Mohan, Deepika; Arnold, Robert; Barnato, Amber E
Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the interviews. We then used Kruskal-Wallis tests to compare the weighted mental model themes of physicians who provided preference-concordant treatment with those who provided preference-discordant treatment. Sixty-six (90%) physicians provided preference-concordant treatment and 7 (10%) provided preference-discordant treatment (i.e., they intubated the patient). Physicians who intubated the patient were more likely to emphasize the reversible and emergent nature of the patient situation (z = -2.111, P = 0.035), their own comfort (z = -2.764, P = 0.006), and rarely focused on explicit patient preferences (z = 2.380, P = 0.017). Post-decisional interviewing with audio/video prompting may induce hindsight bias. The expert model has not yet been validated and may not be exhaustive. The small sample size limits generalizability and power. Hospital-based physicians providing preference-discordant used a different mental model for decision making for a critically and terminally ill simulated case. These differences may offer targets for future interventions to promote preference-concordant care for seriously ill patients.
Shimizu, Noritaka; Otsuka, Takaharu; Utsuno, Yutaka; Mizusaki, Takahiro; Honma, Michio; Abe, Takashi
We report a history of the developments of the Monte Carlo shell model (MCSM). The MCSM was proposed in order to perform large-scale shell-model calculations which direct diagonalization method cannot reach. Since 1999 PC clusters were introduced for parallel computation of the MCSM. Since 2011 we participated the High Performance Computing Infrastructure Strategic Program and developed a new MCSM code for current massively parallel computers such as K computer. We discuss future perspectives concerning a new framework and parallel computation of the MCSM by incorporating conjugate gradient method and energy-variance extrapolation
Collin F Payne
Full Text Available Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA; by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited.Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64% of their remaining 28 y of life (95% CI, 25.7-33.5 with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46% of their remaining 25.4 y (95% CI, 23.3-28.8 with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well
Payne, Collin F; Mkandawire, James; Kohler, Hans-Peter
Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited. Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge) microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64%) of their remaining 28 y of life (95% CI, 25.7-33.5) with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46%) of their remaining 25.4 y (95% CI, 23.3-28.8) with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well-being. Individuals in this
Julius Francis Gomes
Full Text Available Purpose: To facilitate futures business research by proposing a novel way to combine business models as a conceptual tool with futures research techniques. Design: A futures perspective is adopted to foresight business models of the Internet of Things (IoT enabled healthcare sector by using business models as a futures business research tool. In doing so, business models is coupled with one of the most prominent foresight methodologies, Causal Layered Analysis (CLA. Qualitative analysis provides deeper understanding of the phenomenon through the layers of CLA; litany, social causes, worldview and myth. Findings: It is di cult to predict the far future for a technology oriented sector like healthcare. This paper presents three scenarios for short-, medium- and long-term future. Based on these scenarios we also present a set of business model elements for different future time frames. This paper shows a way to combine business models with CLA, a foresight methodology; in order to apply business models in futures business research. Besides offering early results for futures business research, this study proposes a conceptual space to work with individual business models for managerial stakeholders. Originality / Value: Much research on business models has offered conceptualization of the phenomenon, innovation through business model and transformation of business models. However, existing literature does not o er much on using business model as a futures research tool. Enabled by futures thinking, we collected key business model elements and building blocks for the futures market and ana- lyzed them through the CLA framework.
Full Text Available Objectives: The aim of the present study is to examine the prediction of the reminiscence functions in older adults on the basis of the five personality factor model. Methods & Materials: 242 elderly adults older than 60 were recruited from retirement clubs of the city of Shiraz via available sampling method. The participants completed the Reminiscence Functions Scale and Goldberg's International Personality Item Pool. Forty participants were deleted from the sample because they did not complete the questionnaires fully. All the participants took part in the study with their conscious consent. To conduct the necessary descriptive and inferential statistical operations, SPSS (Version 16 was used. Mean, standard deviation and Pearson correlation coefficient were utilized to analyze the data in the descriptive statistics section, And in inferential statistics section, simultaneous multiple regression was used to predict reminiscence functions. Results: According to the results of the multiple regression analysis, Neuroticism predicted the reminiscence functions of Bitterness Revival (β=0.28, P≤0.001 and Intimacy Maintenance (β=0.25, P≤0.001 and Extraversion predicted the reminiscence functions of Teach/Inform (β=0.18, P<0.05. Conclusion: The results indicated that people with higher levels of psychological distress tend to rehash and ruminate on bitter memories and hold onto memories of intimate social relations who are no longer part of their lives. Moreover, extravert people tend to share memories to transmit a lesson of life and share personal ideologies and experiences. Clinicians should focus on more adaptive functions of reminiscence (e.g., identity, problem solving and teach/inform and teach such functions.
Khosravi, Yahya; Asilian-Mahabadi, Hassan; Hajizadeh, Ebrahim; Hassanzadeh-Rangi, Narmin; Bastani, Hamid; Khavanin, Ali; Mortazavi, Seyed Bagher
There can be little doubt that the construction is the most hazardous industry in the worldwide. This study was designed to modeling the factors affecting unsafe behavior from the perspective of safety supervisors. The qualitative research was conducted to extract a conceptual model. A structural model was then developed based on a questionnaire survey (n=266) by two stage Structural Equation Model (SEM) approach. An excellent confirmed 12-factors structure explained about 62% of variances unsafe behavior in the construction industry. A good fit structural model indicated that safety climate factors were positively correlated with safety individual factors (Pconstruction workers' engagement in safe or unsafe behavior. In order to improve construction safety performance, more focus on the workplace condition is required.
Roos, Paulien E; Dingwell, Jonathan B
Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of
Roos, Paulien E.; Dingwell, Jonathan B.
Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of
Payne, S; Doyal, L
Older women make up an increasingly important sector in the labour market. However, we know little about their health-the various influences on their health and the ways in which paid and unpaid work impact on both physical and mental well being. This paper reviews the available literature on older women's health in the workplace, focussing on work-specific and more general risks for older women, including stress, discrimination, physical hazards and the 'double burden' of paid work and caring responsibilities. Databases searched included Web of Science, CAS, CINAHL, Medline and ASSIA, together with UK and European statistical sources. We conclude with a three-point research agenda, calling for more empirical work on the risks faced by older women, studies that take a life-course perspective of women's occupational health and work that explores the interactions between unpaid and paid work in later life.
Rotmans, J.; Van Asselt, M.B.A.; De Bruin, A.J.; Den Elzen, M.G.J.; De greef, J.; Hilderink, H.; Hoekstra, A.Y.; Janssen, M.A.; Koester, H.W.; Martens, W.J.M.; Niessen, L.W.; De Vries, H.J.M.
The main objective of the title program is to develop an integrated modelling framework for analysing global change and sustainable development. The framework to be developed is referred to as TARGETS: Tool to Assess Regional and Global Environmental and health Targets for Sustainability. The research is based on a systems-based, integrated modelling approach and has a multi- and interdisciplinary character. A top-down approach is chosen: analysis starts at the global level and will be disaggregated to the level of major world regions. Alliance has been sought with the IMAGE project team in regard to data collection, regionalization and aggregation levels. The modelling framework is to be used by both researchers and policy analysts. In this report attention is paid to the requirements of an integrated systems approach (a multi-disciplinary systems analysis, quantification of uncertainties, and visualization of various system perspectives); the TARGETS model; the use of sustainability indicators to monitor the pressure on, the status of, and the impact on the global environment, which are linked to TARGETS; the scientific and cultural perspectives from which to describe and evaluate the global change phenomenon; the expected results; and finally the organizational embedment of the title programme. 19 figs., 3 tabs., 200 refs
Wann, Daniel L.; Rogers, Kelly; Dooley, Keith; Foley, Mary
According to the Team Identification-Social Psychological Health Model (Wann, 2006b), team identification and social psychological health should be positively correlated because identification leads to important social connections which, in turn, facilitate well-being. Although past research substantiates the hypothesized positive relationship…
Heerink, M.; Kröse, B.; Evers, V.; Wielinga, B.
This paper proposes a model of technology acceptance that is specifically developed to test the acceptance of assistive social agents by elderly users. The research in this paper develops and tests an adaptation and theoretical extension of the Unified Theory of Acceptance and Use of Technology
Full Text Available The Building Energy Management System (BEMS, a well-known system that has been implemented in some energy corporations, has become attractive to many companies seeking to better monitor their energy consumption efficiency. This study investigated the external factors that influence acceptance of the BEMS from managerial perspectives. An extended model based on the Technology Acceptance Model (TAM was created to evaluate the implementation of the BEMS in the manufacturing industries. A structural equation modeling (SEM approach was used to analyze the model by adopting compatibility, features, technology complexity, and perceived risk as the external variables, and integrating the five dimensions of perceived ease of use, perceived usefulness, attitude, user satisfaction, and behavioral intention. The analysis results indicated that the external factors positively influenced users’ behavioral intention to use the BEMS through expected satisfaction, perceived ease of use, and perceived usefulness. Suggestions for BEMS developers are provided as well.
This paper presents the Model of Strategic e-Learning to explain and evaluate student e-learning from metacognitive perspectives. An in-depth interview, pilot study and main study are employed to construct the model and develop an instrument--the Online Learning Strategies Scale (OLSS). The model framework is constructed and illustrated by four…
Understanding young and older male drivers' willingness to drive while intoxicated: the predictive utility of constructs specified by the theory of planned behaviour and the prototype willingness model.
Rivis, Amanda; Abraham, Charles; Snook, Sarah
The present study examined the predictive utility of constructs specified by the theory of planned behaviour (TPB) and prototype willingness model (PWM) for young and older male drivers' willingness to drive while intoxicated. A cross-sectional questionnaire was employed. Two hundred male drivers, recruited via a street survey, voluntarily completed measures of attitude, subjective norm, perceived behavioural control, prototype perceptions, and willingness. Findings showed that the TPB and PWM variables explained 65% of the variance in young male drivers' willingness and 47% of the variance in older male drivers' willingness, with the interaction between prototype favourability and similarity contributing 7% to the variance explained in older males' willingness to drive while intoxicated. The findings possess implications for theory, research, and anti-drink driving campaigns. ©2010 The British Psychological Society.
In this paper we will show how the OMG specification of BPMN (Business Process Modeling Notation) can be used to model the process- and event-oriented perspectives of an application subject area. We will illustrate how the fact-oriented conceptual models for the information-, process- and event perspectives can be used in a 'bottom-up' approach for creating a BPMN model in combination with other approaches, e.g. the use of a textual description. We will use the common doctor's office example as a running example in this article.
Lorefält, B; Wilhelmsson, S
The purpose of this study was with a multifaceted intervention model improve the nutritional status of elderly people living in residential homes to increase their energy intake and to maintain improvements over time. Three different municipal residential homes in the south-east of Sweden. The study population consisted of 67 elderly people. A within-subjects design was used which means that the participants were their own controls. A multifaceted intervention model was chosen, which included education on both theoretical and practical issues, training and support for staff, and individualized snacks to the residents. Nutritional status was measured by Mini Nutritional Assessment (MNA), the consumption of food was recorded by the staff using a food record method for 3 consecutive days. The length of night-time fasting has been calculated from the food records. Nutritional status improved after 3 months of intervention and was maintained after 9 months. Weight increased during the whole study period. Night-time fasting decreased but not to the recommended level. This study shows that it is possible by a multifaceted intervention model to increase energy intake including expanding snacks and thereby improve and maintain nutritional status over a longer period in the elderly living in residential homes. This result was possible to achieve because staff received education and training in nutritional issues and by provision of support during a period when new routines were introduced.
Melchiorre, Maria Gabriella; Di Rosa, Mirko; Lamura, Giovanni; Torres-Gonzales, Francisco; Lindert, Jutta; Stankunas, Mindaugas; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Macassa, Gloria; Soares, Joaquim J F
Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims. The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal. Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused. Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting traditional male characteristics of
Maria Gabriella Melchiorre
Full Text Available Several studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims.The cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden. We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal.Multivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain and greater social support seemed linked with a decreased probability of being abused.Male elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting traditional male
The environmental modeling community has historically been concerned with the proliferation of models and the effort associated with collective model development tasks (e.g., code generation, data provisioning and transformation, etc.). Environmental modeling frameworks (EMFs) have been developed to...
Williams, Allison; Sethi, Bharati; Duggleby, Wendy; Ploeg, Jenny; Markle-Reid, Maureen; Peacock, Shelley; Ghosh, Sunita
A little-studied issue in the provision of care at home by informal caregivers is the increase in older adult patients with chronic illness, and more specifically, multiple chronic conditions (MCC). We know little about the caregiving experience for this population, particularly as it is affected by social location, which refers to either a group's or individual's place/location in society at a given time, based on their intersecting demographics (age, gender, education, race, immigration status, geography, etc.). We have yet to fully comprehend the combined influence of these intersecting axes on caregivers' health and wellbeing, and attempt to do this by using an intersectionality approach in answering the following research question: How does social location influence the experience of family caregivers of older adults with MCC? The data presented herein is a thematic analysis of a qualitative sub-set of a large two-province study conducted using a repeated-measures embedded mixed method design. A survey sub-set of 20 survey participants per province (n = 40 total) were invited to participate in a semi-structured interview. In the first stage of data analysis, Charmaz's (2006) Constructivist Grounded Theory Method (CGTM) was used to develop initial codes, focused codes, categories and descriptive themes. In the second and the third stages of analysis, intersectionality was used to develop final analytical themes. The following four themes describe the overall study findings: (1) Caregiving Trajectory, where three caregiving phases were identified; (2) Work, Family, and Caregiving, where the impact of caregiving was discussed on other areas of caregivers' lives; (3) Personal and Structural Determinants of Caregiving, where caregiving sustainability and coping were deliberated, and; (4) Finding Meaning/Self in Caregiving, where meaning-making was highlighted. The intersectionality approach presented a number of axes of diversity as comparatively more important
Hydraulic servo system plays a significant role in industries, and usually acts as a core point in control and power transmission. Although linear theory-based control methods have been well established, advanced controller design methods for hydraulic servo system to achieve high performance is still an unending pursuit along with the development of modern industry. Essential nonlinearity is a unique feature and makes model-based nonlinear control more attractive, due to benefit from prior knowledge of the servo valve controlled hydraulic system. In this paper, a discussion for challenges in model-based nonlinear control, latest developments and brief perspectives of hydraulic servo systems are presented: Modelling uncertainty in hydraulic system is a major challenge, which includes parametric uncertainty and time-varying disturbance; some specific requirements also arise ad hoc difficulties such as nonlinear friction during low velocity tracking, severe disturbance, periodic disturbance, etc.; to handle various challenges, nonlinear solutions including parameter adaptation, nonlinear robust control, state and disturbance observation, backstepping design and so on, are proposed and integrated, theoretical analysis and lots of applications reveal their powerful capability to solve pertinent problems; and at the end, some perspectives and associated research topics (measurement noise, constraints, inner valve dynamics, input nonlinearity, etc.) in nonlinear hydraulic servo control are briefly explored and discussed.
Sevost'ianova, N N; Trofimov, A V; Lin'kova, N S; Poliakova, V O; Kvetnoĭ, I M
The influence of gamma-radiation on morphofunctional state of thymus is rather like as natural thymus aging. However gamma-radiation model of thymus aging widely used to investigate geroprotectors has many shortcomings and limitations. Gamma-radiation can induce irreversible changes in thymus very often. These changes are more intensive in comparison with changes, which can be observed at natural thymus aging. Low intensive laser radiation can not destroy structure of thymus and its effects are rather like as natural thymus aging in comparison with gamma-radiation effects. There are many parameters of low intensive laser radiation, which can be changed to improve morphofunctional thymus characteristics in aging model. Using low intensive laser radiation in thymus aging model can be very perspective for investigations of aging immune system.
Full Text Available Through the use of a historical perspective, the aim of this article is to discuss and clarify the concurrent and conflicting interests and norms that have characterized the establishment and development of important institutions in Norwegian working life. The article concentrates on collective bargaining systems, the arrangements for codetermination, and the working environment regulations in both the public and private sector, which are regarded as the main institutions in the Norwegian and Nordic models of working life relations. The article is structured by an analytical distinction between three different historical periods that have constituted three distinct versions of the Norwegian model. By presenting a historical synthesis of Norwegian experiences, the article is a contribution to the ongoing debate on the varieties in the Nordic model, as to further comparisons and broader transnational studies.
Full Text Available The present paper demonstrates that insights from the affordances perspective can contribute to developing a more comprehensive model of grammaticalization. The authors argue that the grammaticalization process is afforded differently depending on the values of three contributing parameters: the factor (schematized as a qualitative-quantitative map or a wave of a gram, environment (understood as the structure of the stream along which the gram travels, and actor (narrowed to certain cognitive-epistemological capacities of the users, in particular to the fact of being a native speaker. By relating grammaticalization to these three parameters and by connecting it to the theory of optimization, the proposed model offers a better approximation to realistic cases of grammaticalization: The actor and environment are overtly incorporated into the model and divergences from canonical grammaticalization paths are both tolerated and explicable.
Lammers, H B
From an Elaboration Likelihood Model perspective, it was hypothesized that postexposure awareness of deceptive packaging claims would have a greater negative effect on scores for purchase intention by consumers lowly involved rather than highly involved with a product (n = 40). Undergraduates who were classified as either highly or lowly (ns = 20 and 20) involved with M&Ms examined either a deceptive or non-deceptive package design for M&Ms candy and were subsequently informed of the deception employed in the packaging before finally rating their intention to purchase. As anticipated, highly deceived subjects who were low in involvement rated intention to purchase lower than their highly involved peers. Overall, the results attest to the robustness of the model and suggest that the model has implications beyond advertising effects and into packaging effects.
Capezuti, Elizabeth A; Bricoli, Barbara; Briccoli, Barbara; Boltz, Marie P
The Nurses Improving the Care of Healthsystem Elders (NICHE) program helps its more than 450 member sites to build the leadership capabilities to enact system-level change that targets the unique needs of older adults and embeds evidence-based geriatrics knowledge into practice. NICHE received expansion funding to establish a sustainable business model for operations while positioning the program to continue as a leader in innovative senior care programs. The expansion program focused on developing an internal business infrastructure, expanding NICHE-specific resources, creating a Web platform, increasing the number of participating NICHE hospitals, enhancing and expanding the NICHE benchmarking service, supporting research that generates evidence-based practices, fostering interorganizational collaboration, developing sufficient diversified revenue sources, and increasing the penetration and level of activity of current NICHE sites. These activities (improved services, Web-based tools, better benchmarking) added value and made it feasible to charge hospitals an annual fee for access and participation. NICHE does not stipulate how institutions should modify geriatric care; rather, NICHE principles and tools are meant to be adapted to each site's unique institutional culture. This article describes the historical context, the rationale, and the business plan that has resulted in successful organizational outcomes, including financial sustainability of the business operations of NICHE. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.
Banerjee, Ananya Tina; Kin, R; Strachan, Patricia H; Boyle, Michael H; Anand, Sonia S; Oremus, Mark
To describe the factors facilitating the implementation of heart health promotion programs for older adults in Anglican, United, and Catholic churches. The study used qualitative methods comprising semistructured interviews and focus groups. The interviews and focus groups were conducted in Anglican, Catholic, and United churches located in the Canadian cities of Toronto and Hamilton, Ontario. Twelve ordained pastors and 21 older parishioners who attended church regularly and who had no health conditions were recruited to best explain how churches could be suitable locations for health promotion activities targeting older adults. Twelve semistructured interviews with the pastors and three focus groups with the 21 parishioners were undertaken. A component of the Precede-Proceed model (a model for planning health education and health promotion programs and policies) was applied to the findings after direct content analysis of the data. Participants identified pastor leadership, funding for a parish nurse, community-focused interventions, secured infrastructure, and social support from congregation members as pertinent factors required for implementing health promotion programs in Anglican, United, and Catholic churches. The findings have particular relevance for health promotion and public health because they suggest factors that would be necessary to design church-based heart health promotion programs for older adults at risk of chronic diseases.
Wang, Dai; Schultz, Tim; Novak, Gerald P; Baker, Susan; Bennett, David A; Narayan, Vaibhav A
Therapeutic research on Alzheimer's disease (AD) has moved to intercepting the disease at the preclinical phase. Most drugs in late development have focused on the amyloid hypothesis. To understand the magnitude of amyloid-related functional decline and to identify the functional domains sensitive to decline in a preclinical AD population. Data were from the Religious Orders Study and the Rush Memory and Aging Project. Cognitive decline was measured by a modified version of the Alzheimer's Disease Cooperative Study Preclinical Alzheimer Cognitive Composite. The trajectories of functional decline, as measured by the instrumental and basic activities of daily living, were longitudinally modeled in 484 participants without cognitive impairment at baseline and having both a final clinical and a postmortem neuropathology assessment of AD. Individuals with different final clinical diagnoses had different trajectories of cognitive and functional decline. Individuals with AD dementia, minor cognitive impairment, and no cognitive impairment had the most, intermediate, and least declines. While individuals with pathologic AD had significantly more cognitive decline over time than those without, the magnitude of difference in functional decline between these two groups was small. Functional domains such as handling finance and handling medications were more sensitive to decline. Demonstrating the functional benefit of an amyloid-targeting drug represents a significant challenge as elderly people experience functional decline due to a wide range of reasons with limited manifestation attributable to AD neuropathology. More sensitive functional scales focusing on the functional domains sensitive to decline in preclinical AD are needed.
Knipscheer, C.P.M.; Broese Van Groenou, M.I.; Leene, G.J.F.; Beekman, A.; Deeg, D.J.H.
This study examines the environmental and psychosocial determinants of depression in older adults. Based on Lawton's environmental docility thesis, the question is posed: is the strong association between functional limitations and depressive symptomatology affected when environmental conditions,
Full Text Available With rapid advancement of Cloud computing and networking technologies, a wide spectrum of Cloud services have been developed by various providers and utilized by numerous organizations as indispensable ingredients of their information systems. Cloud service performance has a significant impact on performance of the future information infrastructure. Thorough evaluation on Cloud service performance is crucial and beneficial to both service providers and consumers; thus forming an active research area. Some key technologies for Cloud computing, such as virtualization and the Service-Oriented Architecture (SOA, bring in special challenges to service performance evaluation. A tremendous amount of effort has been put by the research community to address these challenges and exciting progress has been made. Among the work on Cloud performance analysis, evaluation approaches developed with a system modeling perspective play an important role. However, related works have been reported in different sections of the literature; thus lacking a big picture that shows the latest status of this area. The objectives of this article is to present a survey that reflects the state of the art of Cloud service performance evaluation from the system modeling perspective. This articles also examines open issues and challenges to the surveyed evaluation approaches and identifies possible opportunities for future research in this important field.
Ybema,J.F.; Giesen, F.
Due to an ageing population and global economic competition, there is a societal need for people to extend their working lives while maintaining high work productivity. This article presents an overview of the labour participation, job performance, and job characteristics of older workers in the
Pasupuleti, Mohan Kumar; Molahally, Subramanya Shetty; Salwaji, Supraja
Laboratory animal models serve as a facilitator to investigate the etiopathogenesis of periodontal disease, are used to know the efficacy of reconstructive and regenerative procedures, and are also helpful in evaluation of newer therapeutic techniques including laser and implant therapies prior to application in the human beings. The aim of this review is to know the different animal models used in various specialties of dental research and to know the ethical guidelines prior to the usage of experimental models with main emphasis on how to refine, replace, and reduce the number of animal models usage in the laboratory. An online search for experimental animal models used in dental research was performed using MEDLINE/PubMed database. Publications from 2009 to May 2013 in the specialty of periodontics were included in writing this review. A total of 652 references were published in PubMed/MEDLINE databases based on the search terms used. Out of 245 studies, 241 were related to the periodontal research published in English from 2009 to 2013. Relevant papers were chosen according to the inclusion and exclusion criteria. After extensive electronic and hand search on animal models, it has been observed that various animal models were used in dental research. Search on animal models used for dental research purpose revealed that various animals such as rats, mice, guinea pigs, rabbit, beagle dogs, goats, and nonhuman primates were extensively used. However, with the new advancement of ex vivo animal models, it has become easy to investigate disease pathogenesis and to test the efficacy of newer therapeutic modalities with the reduced usage of animal models. This review summarized the large amount of literature on animal models used in periodontal research with main emphasis on ethical guidelines and on reducing the animal model usage in future perspective.
Mohan Kumar Pasupuleti
Full Text Available Laboratory animal models serve as a facilitator to investigate the etiopathogenesis of periodontal disease, are used to know the efficacy of reconstructive and regenerative procedures, and are also helpful in evaluation of newer therapeutic techniques including laser and implant therapies prior to application in the human beings. The aim of this review is to know the different animal models used in various specialties of dental research and to know the ethical guidelines prior to the usage of experimental models with main emphasis on how to refine, replace, and reduce the number of animal models usage in the laboratory. An online search for experimental animal models used in dental research was performed using MEDLINE/PubMed database. Publications from 2009 to May 2013 in the specialty of periodontics were included in writing this review. A total of 652 references were published in PubMed/MEDLINE databases based on the search terms used. Out of 245 studies, 241 were related to the periodontal research published in English from 2009 to 2013. Relevant papers were chosen according to the inclusion and exclusion criteria. After extensive electronic and hand search on animal models, it has been observed that various animal models were used in dental research. Search on animal models used for dental research purpose revealed that various animals such as rats, mice, guinea pigs, rabbit, beagle dogs, goats, and nonhuman primates were extensively used. However, with the new advancement of ex vivo animal models, it has become easy to investigate disease pathogenesis and to test the efficacy of newer therapeutic modalities with the reduced usage of animal models. This review summarized the large amount of literature on animal models used in periodontal research with main emphasis on ethical guidelines and on reducing the animal model usage in future perspective.
Frank, T D
Using a nonlinear Fokker-Planck perspective we re-formulate the linear discrepancy model proposed by Boster and colleagues that describes the emergence of risky shifts during group decision making. Analytical expressions for the stationary case are derived and risky shifts are obtained by Monte Carlo simulations. Striking similarities with the Kuramoto model for group synchronization are pointed out
Hu, Ming-Hsia; Yeh, Chih-Jun; Chen, Tou-Rong; Wang, Ching-Yi
A valid, time-efficient and easy-to-use instrument is important for busy clinical settings, large scale surveys, or community screening use. The purpose of this study was to validate the mobility hierarchical disability categorization model (an abbreviated model) by investigating its concurrent validity with the multidimensional hierarchical disability categorization model (a comprehensive model) and triangulating both models with physical performance measures in older adults. 604 community-dwelling older adults of at least 60 years in age volunteered to participate. Self-reported function on mobility, instrumental activities of daily living (IADL) and activities of daily living (ADL) domains were recorded and then the disability status determined based on both the multidimensional hierarchical categorization model and the mobility hierarchical categorization model. The physical performance measures, consisting of grip strength and usual and fastest gait speeds (UGS, FGS), were collected on the same day. Both categorization models showed high correlation (γs = 0.92, p categorization models. The results of multiple regression analysis indicated that both models individually explain similar amount of variance on all physical performances, with adjustments for age, sex, and number of comorbidities. Our results found that the mobility hierarchical disability categorization model is a valid and time efficient tool for large survey or screening use.
Venkata Mohan, S; Nikhil, G N; Chiranjeevi, P; Nagendranatha Reddy, C; Rohit, M V; Kumar, A Naresh; Sarkar, Omprakash
Increased urbanization worldwide has resulted in a substantial increase in energy and material consumption as well as anthropogenic waste generation. The main source for our current needs is petroleum refinery, which have grave impact over energy-environment nexus. Therefore, production of bioenergy and biomaterials have significant potential to contribute and need to meet the ever increasing demand. In this perspective, a biorefinery concept visualizes negative-valued waste as a potential renewable feedstock. This review illustrates different bioprocess based technological models that will pave sustainable avenues for the development of biobased society. The proposed models hypothesize closed loop approach wherein waste is valorised through a cascade of various biotechnological processes addressing circular economy. Biorefinery offers a sustainable green option to utilize waste and to produce a gamut of marketable bioproducts and bioenergy on par to petro-chemical refinery. Copyright © 2016 Elsevier Ltd. All rights reserved.
Our model of psychotherapy for patients with brain lesions is based on an integrative approach of psychobehavioral symptoms, especially from the neuropsychological and psychodynamic perspectives. Adjustment of technical modalities and aims of psychoanalytical therapy is required for these patients. The analysis of the influence of cognitive disorders on transference and contre-transference plays a major role, including the role of procedural processes in changes in the intersubjective relationship between the patient and the therapist. Two vignettes are presented to illustrate our model, which respects the integrity of the cognitive and psychodynamic approaches and can be implemented by only one therapist, using alternatively each lecture, or by a working team bringing to light the different aspects of the same symptom.
Ebrecht, L.; Schmerwitz, S.
Synthetic vision systems (SVS) appear as spreading technology in the avionic domain. Several studies prove enhanced situational awareness when using synthetic vision. Since the introduction of synthetic vision a steady change and evolution started concerning the primary flight display (PFD) and the navigation display (ND). The main improvements of the ND comprise the representation of colored ground proximity warning systems (EGPWS), weather radar, and TCAS information. Synthetic vision seems to offer high potential to further enhance cockpit display systems. Especially, concerning the current trend having a 3D perspective view in a SVS-PFD while leaving the navigational content as well as methods of interaction unchanged the question arouses if and how the gap between both displays might evolve to a serious problem. This issue becomes important in relation to the transition and combination of strategic and tactical flight guidance. Hence, pros and cons of 2D and 3D views generally as well as the gap between the egocentric perspective 3D view of the PFD and the exocentric 2D top and side view of the ND will be discussed. Further a concept for the integration of a 3D perspective view, i.e., bird's eye view, in synthetic vision ND will be presented. The combination of 2D and 3D views in the ND enables a better correlation of the ND and the PFD. Additionally, this supports the building of pilot's mental model. The authors believe it will improve the situational and spatial awareness. It might prove to further raise the safety margin when operating in mountainous areas.
Older people can be regarded as a marginalised group within society from a number of perspectives including that of health. When it comes to the use of medication older people have suffered from a double whammy. Not only are they more at risk from the adverse effects of drugs but also their involvement in clinical trials has been limited so that rational prescribing both to maximise benefit and to reduce risk has been problematic. Their special problems have been recognised formerly by the Department of Health in its NSF for Older People [National Service Framework for Older People. Department of Health, London (2001a)], [Medicines and Older People. Implementing medicines-related aspects of the NSF for Older People. Department of Health (2001b)]. Early studies focussed on compliance, the avoidance of poly-pharmacy and the high prevalence of adverse effects of drugs and the reasons for this. Studies in long-stay patients showed dramatic differences in pharmacokinetics between such older people and young healthy volunteers. Initially such differences were ascribed to age alone and the overall message became "start low and go slow". Studies in healthy older people then revealed that age differences in drug metabolism were, as a rule, not so marked although clearance of renally excreted drugs was reduced in line with the age associated decline in renal function. Including older people in clinical trials poses challenges. Many traditional trialists do not have ready access to older people, co-morbidity and poly-pharmacy are common and most people feel reluctant to ask older people to take part in complex and potentially hazardous trials. Concern about compliance is unwarranted. Adverse events may be more serious. Thus in a younger patient postural hypotension may make a subject unsteady but in an older subject the unsteadiness may lead to a fall, the fall to a fracture, and the fracture to poor recovery. The choice of end-points is crucial. Although reduction of
Pham-The, Hai; Nam, Nguyen-Hai; Nga, Doan-Viet; Hai, Dang Thanh; Dieguez-Santana, Karel; Marrero-Poncee, Yovani; Castillo-Garit, Juan A; Casanola-Martin, Gerardo M; Le-Thi-Thu, Huong
Quantitative Structure - Activity Relationship (QSAR) modeling has been widely used in medicinal chemistry and computational toxicology for many years. Today, as the amount of chemicals is increasing dramatically, QSAR methods have become pivotal for the purpose of handling the data, identifying a decision, and gathering useful information from data processing. The advances in this field have paved a way for numerous alternative approaches that require deep mathematics in order to enhance the learning capability of QSAR models. One of these directions is the use of Multiple Classifier Systems (MCSs) that potentially provide a means to exploit the advantages of manifold learning through decomposition frameworks, while improving generalization and predictive performance. In this paper, we presented MCS as a next generation of QSAR modeling techniques and discuss the chance to mining the vast number of models already published in the literature. We systematically revisited the theoretical frameworks of MCS as well as current advances in MCS application for QSAR practice. Furthermore, we illustrated our idea by describing ensemble approaches on modeling histone deacetylase (HDACs) inhibitors. We expect that our analysis would contribute to a better understanding about MCS application and its future perspectives for improving the decision making of QSAR models. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Ozbek, M. M.
Fuzzy rule-based systems provide an efficient environment for the modeling of expert information in the context of risk management for groundwater contamination problems. In general, their use in the form of conditional pieces of knowledge, has been either as a tool for synthesizing control laws from data (i.e., conjunction-based models), or in a knowledge representation and reasoning perspective in Artificial Intelligence (i.e., implication-based models), where only the latter may lead to coherence problems (e.g., input data that leads to logical inconsistency when added to the knowledge base). We implement a two-fold extension to an implication-based groundwater risk model (Ozbek and Pinder, 2002) including: 1) the implementation of sufficient conditions for a coherent knowledge base, and 2) the interpolation of expert statements to supplement gaps in knowledge. The original model assumes statements of public health professionals for the characterization of the exposed individual and the relation of dose and pattern of exposure to its carcinogenic effects. We demonstrate the utility of the extended model in that it: 1)identifies inconsistent statements and establishes coherence in the knowledge base, and 2) minimizes the burden of knowledge elicitation from the experts for utilizing existing knowledge in an optimal fashion.ÿÿ
The first goal of this study is to see if social relationships in the church influence feelings of gratitude toward God. The second goal is to assess the impact of race and ethnicity on this relationship. The data support the following hypotheses: (1) older people who go to church more often tend to receive more spiritual support from fellow church members; (2) older adults who receive more spiritual support at church will derive a deeper understanding of themselves and others; (3) older people who develop greater insight into themselves and others will derive a greater sense of religious meaning in life; and (4) older adults who develop a deeper sense of religious meaning in life will feel more grateful to God. The results also indicate that the study model explains how feelings of gratitude toward God arise among older blacks and whites, but not older Mexican Americans.
The first goal of this study is to see if social relationships in the church influence feelings of gratitude toward God. The second goal is to assess the impact of race and ethnicity on this relationship. The data support the following hypotheses: (1) older people who go to church more often tend to receive more spiritual support from fellow church members; (2) older adults who receive more spiritual support at church will derive a deeper understanding of themselves and others; (3) older people who develop greater insight into themselves and others will derive a greater sense of religious meaning in life; and (4) older adults who develop a deeper sense of religious meaning in life will feel more grateful to God. The results also indicate that the study model explains how feelings of gratitude toward God arise among older blacks and whites, but not older Mexican Americans. PMID:23543840
Erdemir, Ahmet; Hunter, Peter J; Holzapfel, Gerhard A; Loew, Leslie M; Middleton, John; Jacobs, Christopher R; Nithiarasu, Perumal; Löhner, Rainlad; Wei, Guowei; Winkelstein, Beth A; Barocas, Victor H; Guilak, Farshid; Ku, Joy P; Hicks, Jennifer L; Delp, Scott L; Sacks, Michael; Weiss, Jeffrey A; Ateshian, Gerard A; Maas, Steve A; McCulloch, Andrew D; Peng, Grace C Y
The role of computational modeling for biomechanics research and related clinical care will be increasingly prominent. The biomechanics community has been developing computational models routinely for exploration of the mechanics and mechanobiology of diverse biological structures. As a result, a large array of models, data, and discipline-specific simulation software has emerged to support endeavors in computational biomechanics. Sharing computational models and related data and simulation software has first become a utilitarian interest, and now, it is a necessity. Exchange of models, in support of knowledge exchange provided by scholarly publishing, has important implications. Specifically, model sharing can facilitate assessment of reproducibility in computational biomechanics and can provide an opportunity for repurposing and reuse, and a venue for medical training. The community's desire to investigate biological and biomechanical phenomena crossing multiple systems, scales, and physical domains, also motivates sharing of modeling resources as blending of models developed by domain experts will be a required step for comprehensive simulation studies as well as the enhancement of their rigor and reproducibility. The goal of this paper is to understand current perspectives in the biomechanics community for the sharing of computational models and related resources. Opinions on opportunities, challenges, and pathways to model sharing, particularly as part of the scholarly publishing workflow, were sought. A group of journal editors and a handful of investigators active in computational biomechanics were approached to collect short opinion pieces as a part of a larger effort of the IEEE EMBS Computational Biology and the Physiome Technical Committee to address model reproducibility through publications. A synthesis of these opinion pieces indicates that the community recognizes the necessity and usefulness of model sharing. There is a strong will to facilitate
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (-0.88) and responsiveness (-0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. There were gaps between the patients' perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time.
Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid
Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218
This text is a short summary of the work on pedagogical analysis carried out when EML (Educational Modelling Language) was being developed. Because we address pedagogical meta-models the consequence is that I must justify the underlying pedagogical models it describes. I have included a (far from
Galambos, Colleen; Rantz, Marilyn; Back, Jessie; Jun, Jung Sim; Skubic, Marjorie; Miller, Steven J
Aging in place is a preferred and cost-effective living option for older adults. Research indicates that technology can assist with this goal. Information on consumer preferences will help in technology development to assist older adults to age in place. The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study examined the perceptions, attitudes, and preferences of 13 older adults and five family members about their experience living with the fall risk assessment system during five points in time. Themes emerged in relation to preferences and expectations about the technology and how it fits into daily routines. We were able to capture changes that occurred over time for older adult participants. Results indicated that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation. Identified themes, stages of acceptance, and design and development considerations are discussed.
Credible scenarios for releases from high level nuclear waste repositories require radionuclides to be mobilized and transported by ground water. The capability to predict ground water flow velocities and directions as well as radionuclide concentrations in the flow system as a function of time are essential for assessing the performance of disposal systems. The first of these parameters can be estimated by hydrologic modeling while the concentrations can be predicted by geochemical modeling. The complementary use of empirical and phenomenological approaches to the geochemical modeling, when effectively coupled with hydrologic models can provide the tools needed for realistic performance assessment. An overview of the activities of the NEA in this area, with emphasis on the geochemical data bases (ISIRS for Ksub(d) data and the thermochemical data base critical review), rock/water interaction modeling (code development and short-courses), and hydrologic-geochemical code coupling (workshop and in-house activities) is presented in this paper from the perspective of probabilistic risk assessment needs. (author)
Full Text Available Land use patterns and transport system are considered to be the two basic components of the urban development process, and as such they have been in the core of spatial planning policies for the last 4 decades. Land use transport interaction models are computer tools that could help us understand land use changes and organization of human activities in relation to existing or planned transport infrastructure. In this context this paper examines the perspectives of applying a land use transport interaction model for the city of Thessaloniki. Obtaining, preparing and validating socioeconomic data is a crucial part of the modeling process, therefore an extensive search of the required data was performed. The quest for appropriate and suitable data concluded with a detailed recording of emerged problems. In response to the inability of finding suitable data to perform the first step of the modeling process i.e. calibration, the paper concludes with some thoughts related to data availability, organization and standardization issues. Last but not least, the paper stresses out the significance of data availability for utilization of land use transport models, so as not to remain purely academic products but tools with practical value in planning.
Bertsimas, Dimitris; Gupta, Vishal; Paschalidis, Ioannis Ch.
The Black-Litterman (BL) model is a widely used asset allocation model in the financial industry. In this paper, we provide a new perspective. The key insight is to replace the statistical framework in the original approach with ideas from inverse optimization. This insight allows us to significantly expand the scope and applicability of the BL model. We provide a richer formulation that, unlike the original model, is flexible enough to incorporate investor information on volatility and market dynamics. Equally importantly, our approach allows us to move beyond the traditional mean-variance paradigm of the original model and construct “BL”-type estimators for more general notions of risk such as coherent risk measures. Computationally, we introduce and study two new “BL”-type estimators and their corresponding portfolios: a Mean Variance Inverse Optimization (MV-IO) portfolio and a Robust Mean Variance Inverse Optimization (RMV-IO) portfolio. These two approaches are motivated by ideas from arbitrage pricing theory and volatility uncertainty. Using numerical simulation and historical backtesting, we show that both methods often demonstrate a better risk-reward tradeoff than their BL counterparts and are more robust to incorrect investor views. PMID:25382873
Bertsimas, Dimitris; Gupta, Vishal; Paschalidis, Ioannis Ch
The Black-Litterman (BL) model is a widely used asset allocation model in the financial industry. In this paper, we provide a new perspective. The key insight is to replace the statistical framework in the original approach with ideas from inverse optimization. This insight allows us to significantly expand the scope and applicability of the BL model. We provide a richer formulation that, unlike the original model, is flexible enough to incorporate investor information on volatility and market dynamics. Equally importantly, our approach allows us to move beyond the traditional mean-variance paradigm of the original model and construct "BL"-type estimators for more general notions of risk such as coherent risk measures. Computationally, we introduce and study two new "BL"-type estimators and their corresponding portfolios: a Mean Variance Inverse Optimization (MV-IO) portfolio and a Robust Mean Variance Inverse Optimization (RMV-IO) portfolio. These two approaches are motivated by ideas from arbitrage pricing theory and volatility uncertainty. Using numerical simulation and historical backtesting, we show that both methods often demonstrate a better risk-reward tradeoff than their BL counterparts and are more robust to incorrect investor views.
Monier, Erwan; Kicklighter, David W.; Sokolov, Andrei P.; Zhuang, Qianlai; Sokolik, Irina N.; Lawford, Richard; Kappas, Martin; Paltsev, Sergey V.; Groisman, Pavel Ya
Northern Eurasia is made up of a complex and diverse set of physical, ecological, climatic and human systems, which provide important ecosystem services including the storage of substantial stocks of carbon in its terrestrial ecosystems. At the same time, the region has experienced dramatic climate change, natural disturbances and changes in land management practices over the past century. For these reasons, Northern Eurasia is both a critical region to understand and a complex system with substantial challenges for the modeling community. This review is designed to highlight the state of past and ongoing efforts of the research community to understand and model these environmental, socioeconomic, and climatic changes. We further aim to provide perspectives on the future direction of global change modeling to improve our understanding of the role of Northern Eurasia in the coupled human-Earth system. Modeling efforts have shown that environmental and socioeconomic changes in Northern Eurasia can have major impacts on biodiversity, ecosystems services, environmental sustainability, and the carbon cycle of the region, and beyond. These impacts have the potential to feedback onto and alter the global Earth system. We find that past and ongoing studies have largely focused on specific components of Earth system dynamics and have not systematically examined their feedbacks to the global Earth system and to society. We identify the crucial role of Earth system models in advancing our understanding of feedbacks within the region and with the global system. We further argue for the need for integrated assessment models (IAMs), a suite of models that couple human activity models to Earth system models, which are key to address many emerging issues that require a representation of the coupled human-Earth system.
Jeffrey E. Schneiderman; Hong S. He; Frank R. Thompson; William D. Dijak; Jacob S. Fraser
Tree species distribution and abundance are affected by forces operating across a hierarchy of ecological scales. Process and species distribution models have been developed emphasizing forces at different scales. Understanding model agreement across hierarchical scales provides perspective on prediction uncertainty and ultimately enables policy makers and managers to...
P Le Roux
Full Text Available Even though econometric models and yield curve analysis are useful in assessing the impact of interest rate changes on the economic structure, their power to predict the magnitude and direction of swings in the business cycle is often restricted to the use of short-term interest rates. From an Austrian school perspective on interest rates, empirical evidence suggests that the profitability of heavy industries further downstream outperforms that of light industries in the initial stages of monetary easing, due to a rising demand for investment goods and a rise in capacity utilisation levels. This paper assesses the impact of interest rates changes on the productive structure of the economy by taking into account the effect thereof on sector earnings and ultimately share prices.
Samson, Sundeep; Reneke, James A.; Wiecek, Margaret M.
The literature in economics, finance, operations research, engineering and in general mathematics is first reviewed on the subject of defining uncertainty and risk. The review goes back to 1901. Different perspectives on uncertainty and risk are examined and a new paradigm to model uncertainty and risk is proposed using relevant ideas from this study. This new paradigm is used to represent, aggregate and propagate uncertainty and interpret the resulting variability in a challenge problem developed by Oberkampf et al. [2004, Challenge problems: uncertainty in system response given uncertain parameters. Reliab Eng Syst Safety 2004; 85(1): 11-9]. The challenge problem is further extended into a decision problem that is treated within a multicriteria decision making framework to illustrate how the new paradigm yields optimal decisions under uncertainty. The accompanying risk is defined as the probability of an unsatisfactory system response quantified by a random function of the uncertainty
Ayhan, Yavuz; McFarland, Ross; Pletnikov, Mikhail V
Schizophrenia has long been considered as a disorder with multifactorial origins. Recent discoveries have advanced our understanding of the genetic architecture of the disease. However, even with the increase of identified risk variants, heritability estimates suggest an important contribution of non-genetic factors. Various environmental risk factors have been proposed to play a role in the etiopathogenesis of schizophrenia. These include season of birth, maternal infections, obstetric complications, adverse events at early childhood, and drug abuse. Despite the progress in identification of genetic and environmental risk factors, we still have a limited understanding of the mechanisms whereby gene-environment interactions (G × E) operate in schizophrenia and psychoses at large. In this review we provide a critical analysis of current animal models of G × E relevant to psychotic disorders and propose that dimensional perspective will advance our understanding of the complex mechanisms of these disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ayhan, Yavuz; McFarland, Ross; Pletnikov, Mikhail V.
Schizophrenia has long been considered as a disorder with multifactorial origins. Recent discoveries have advanced our understanding of the genetic architecture of the disease. However, even with the increase of identified risk variants, heritability estimates suggest an important contribution of non-genetic factors. Various environmental risk factors have been proposed to play a role in the etiopathogenesis of schizophrenia. These include season of birth, maternal infections, obstetric complications, adverse events at early childhood, and drug abuse. Despite the progress in identification of genetic and environmental risk factors, we still have a limited understanding of the mechanisms whereby gene-environment interactions (GxE) operate in schizophrenia and psychoses at large. In this review we provide a critical analysis of current animal models of GxE relevant to psychotic disorders and propose that dimensional perspective will advance our understanding of the complex mechanisms of these disorders. PMID:26510407
Full Text Available The study of corporate governance requires not only the knowledge of economic, financial, managerial and sociological mechanisms and norms, but it must also incorporate an ethical dimension, while remaining aware of the demands of various stakeholders. The interest towards good governance practice is very present in the company laws of many countries. National differences may lead to specific attributes derived from the meaning that is given to the role of competition and market dispersion of capital. Based on a research consisting of a critical and comparative perspective, the present contribution is dominated by qualitative and mixed methods. In conclusion, it can be said that a market-oriented corporate governance model, though not part of the European Union’s convergence process, may very well respond to the increasing importance of investors’ rights and to the gradual evolution of corporate responsibilities, beyond the national context, with the aim of ensuring market liberalization.
Cole, Wesley J. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Frew, Bethany A. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mai, Trieu T. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sun, Yinong [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bistline, John [Electric Power Research Inst., Palo Alto, CA (United States); Blanford, Geoffrey [Electric Power Research Inst., Palo Alto, CA (United States); Young, David [Electric Power Research Inst., Palo Alto, CA (United States); Marcy, Cara [Energy Information Administration, Washington, DC (United States); Namovicz, Chris [Energy Information Administration, Washington, DC (United States); Edelman, Risa [Environmental Protection Agency, Washington, DC (United States); Meroney, Bill [Environmental Protection Agency; Sims, Ryan [Environmental Protection Agency; Stenhouse, Jeb [Environmental Protection Agency; Donohoo-Vallett, Paul [U.S. Department of Energy
Long-term capacity expansion models of the U.S. electricity sector have long been used to inform electric sector stakeholders and decision makers. With the recent surge in variable renewable energy (VRE) generators - primarily wind and solar photovoltaics - the need to appropriately represent VRE generators in these long-term models has increased. VRE generators are especially difficult to represent for a variety of reasons, including their variability, uncertainty, and spatial diversity. To assess current best practices, share methods and data, and identify future research needs for VRE representation in capacity expansion models, four capacity expansion modeling teams from the Electric Power Research Institute, the U.S. Energy Information Administration, the U.S. Environmental Protection Agency, and the National Renewable Energy Laboratory conducted two workshops of VRE modeling for national-scale capacity expansion models. The workshops covered a wide range of VRE topics, including transmission and VRE resource data, VRE capacity value, dispatch and operational modeling, distributed generation, and temporal and spatial resolution. The objectives of the workshops were both to better understand these topics and to improve the representation of VRE across the suite of models. Given these goals, each team incorporated model updates and performed additional analyses between the first and second workshops. This report summarizes the analyses and model 'experiments' that were conducted as part of these workshops as well as the various methods for treating VRE among the four modeling teams. The report also reviews the findings and learnings from the two workshops. We emphasize the areas where there is still need for additional research and development on analysis tools to incorporate VRE into long-term planning and decision-making.
Naik, Pooja; Cucullo, Luca
Even in the 21st century, studies aimed at characterizing the pathological paradigms associated with the development and progression of central nervous system diseases are primarily performed in laboratory animals. However, limited translational significance, high cost, and labor to develop the appropriate model (e.g., transgenic or inbred strains) have favored parallel in vitro approaches. In vitro models are of particular interest for cerebrovascular studies of the blood-brain barrier (BBB), which plays a critical role in maintaining the brain homeostasis and neuronal functions. Because the BBB dynamically responds to many events associated with rheological and systemic impairments (e.g., hypoperfusion), including the exposure of potentially harmful xenobiotics, the development of more sophisticated artificial systems capable of replicating the vascular properties of the brain microcapillaries are becoming a major focus in basic, translational, and pharmaceutical research. In vitro BBB models are valuable and easy to use supporting tools that can precede and complement animal and human studies. In this article, we provide a detailed review and analysis of currently available in vitro BBB models ranging from static culture systems to the most advanced flow-based and three-dimensional coculture apparatus. We also discuss recent and perspective developments in this ever expanding research field. Copyright © 2011 Wiley Periodicals, Inc.
Cole, Wesley [National Renewable Energy Lab. (NREL), Golden, CO (United States); Frew, Bethany [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sun, Yinong [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bistline, John [Electric Power Research Inst. (EPRI), Knoxville, TN (United States); Blanford, Geoffrey [Electric Power Research Inst. (EPRI), Knoxville, TN (United States); Young, David [Electric Power Research Inst. (EPRI), Knoxville, TN (United States); Marcy, Cara [U.S. Energy Information Administration, Washington, DC (United States); Namovicz, Chris [U.S. Energy Information Administration, Washington, DC (United States); Edelman, Risa [US Environmental Protection Agency (EPA), Washington, DC (United States); Meroney, Bill [US Environmental Protection Agency (EPA), Washington, DC (United States); Sims, Ryan [US Environmental Protection Agency (EPA), Washington, DC (United States); Stenhouse, Jeb [US Environmental Protection Agency (EPA), Washington, DC (United States); Donohoo-Vallett, Paul [Dept. of Energy (DOE), Washington DC (United States)
Long-term capacity expansion models of the U.S. electricity sector have long been used to inform electric sector stakeholders and decision-makers. With the recent surge in variable renewable energy (VRE) generators — primarily wind and solar photovoltaics — the need to appropriately represent VRE generators in these long-term models has increased. VRE generators are especially difficult to represent for a variety of reasons, including their variability, uncertainty, and spatial diversity. This report summarizes the analyses and model experiments that were conducted as part of two workshops on modeling VRE for national-scale capacity expansion models. It discusses the various methods for treating VRE among four modeling teams from the Electric Power Research Institute (EPRI), the U.S. Energy Information Administration (EIA), the U.S. Environmental Protection Agency (EPA), and the National Renewable Energy Laboratory (NREL). The report reviews the findings from the two workshops and emphasizes the areas where there is still need for additional research and development on analysis tools to incorporate VRE into long-term planning and decision-making. This research is intended to inform the energy modeling community on the modeling of variable renewable resources, and is not intended to advocate for or against any particular energy technologies, resources, or policies.
Haueis, Philipp; Slaby, Jan
The term "connectome" is commonly taken to describe a complete map of neural connections in a nervous system of a given species. This chapter provides a critical perspective on the role of connectomes in neuroscientific practice and asks how the connectomic approach fits into a larger context in which network thinking permeates technology, infrastructure, social life, and the economy. In the first part of this chapter, we argue that, seen from the perspective of ongoing research, the notion of connectomes as "complete descriptions" is misguided. Our argument combines Rachel Ankeny's analysis of neuroanatomical wiring diagrams as "descriptive models" with Hans-Jörg Rheinberger's notion of "epistemic objects," i.e., targets of research that are still partially unknown. Combining these aspects we conclude that connectomes are constitutively epistemic objects: there just is no way to turn them into permanent and complete technical standards because the possibilities to map connection properties under different modeling assumptions are potentially inexhaustible. In the second part of the chapter, we use this understanding of connectomes as constitutively epistemic objects in order to critically assess the historical and political dimensions of current neuroscientific research. We argue that connectomics shows how the notion of the "brain as a network" has become the dominant metaphor of contemporary brain research. We further point out that this metaphor shares (potentially problematic) affinities to the form of contemporary "network societies." We close by pointing out how the relation between connectomes and networks in society could be used in a more fruitful manner. © 2017 Elsevier B.V. All rights reserved.
Ludwig, R.; Escher-Vetter, H.; Hennicker, R.; Mauser, W.; Niemeyer, S.; Reichstein, M.; Tenhunen, J.
Within the GLOWA initiative of the German Ministry for Research and Educa- tion (BMBF), the project GLOWA-Danube is funded to establish a transdisciplinary network-based decision support tool for water related issues in the Upper Danube wa- tershed. It aims to develop and validate integration techniques, integrated models and integrated monitoring procedures and to implement them in the network-based De- cision Support System DANUBIA. An accurate description of processes involved in energy, water and matter fluxes and turnovers requires an intense collaboration and exchange of water related expertise of different scientific disciplines. DANUBIA is conceived as a distributed expert network and is developed on the basis of re-useable, refineable, and documented sub-models. In order to synthesize a common understand- ing between the project partners, a standardized notation of parameters and functions and a platform-independent structure of computational methods and interfaces has been established using the Unified Modeling Language UML. DANUBIA is object- oriented, spatially distributed and raster-based at its core. It applies the concept of "proxels" (Process Pixel) as its basic object, which has different dimensions depend- ing on the viewing scale and connects to its environment through fluxes. The presented study excerpts the hydrological view point of GLOWA-Danube, its approach of model coupling and network based communication (using the Remote Method Invocation RMI), the object-oriented technology to simulate physical processes and interactions at the land surface and the methodology to treat the issue of spatial and temporal scal- ing in large, heterogeneous catchments. The mechanisms applied to communicate data and model parameters across the typical discipline borders will be demonstrated from the perspective of a land-surface object, which comprises the capabilities of interde- pendent expert models for snowmelt, soil water movement, runoff formation, plant
Fischer, Andreas; Keller, Denise; Liniger, Mark; Rajczak, Jan; Schär, Christoph; Appenzeller, Christof
Fundamental changes in the hydrological cycle are expected in a future warmer climate. This is of particular relevance for the Alpine region, as a source and reservoir of several major rivers in Europe and being prone to extreme events such as floodings. For this region, climate change assessments based on the ENSEMBLES regional climate models (RCMs) project a significant decrease in summer mean precipitation under the A1B emission scenario by the mid-to-end of this century, while winter mean precipitation is expected to slightly rise. From an impact perspective, projected changes in seasonal means, however, are often insufficient to adequately address the multifaceted challenges of climate change adaptation. In this study, we revisit the full matrix of the ENSEMBLES RCM projections regarding changes in frequency and intensity, precipitation-type (convective versus stratiform) and temporal structure (wet/dry spells and transition probabilities) over Switzerland and surroundings. As proxies for raintype changes, we rely on the model parameterized convective and large-scale precipitation components. Part of the analysis involves a Bayesian multi-model combination algorithm to infer changes from the multi-model ensemble. The analysis suggests a summer drying that evolves altitude-specific: over low-land regions it is associated with wet-day frequency decreases of convective and large-scale precipitation, while over elevated regions it is primarily associated with a decline in large-scale precipitation only. As a consequence, almost all the models project an increase in the convective fraction at elevated Alpine altitudes. The decrease in the number of wet days during summer is accompanied by decreases (increases) in multi-day wet (dry) spells. This shift in multi-day episodes also lowers the likelihood of short dry spell occurrence in all of the models. For spring and autumn the combined multi-model projections indicate higher mean precipitation intensity north of the
leading to the risk of overfitting. The final aim of the work is to facilitate the use of the model also by scientists that do not necessarily have a solid background on modelling or physics. However, this work should not be considered simply as a collection of best practices, but also as the attempt to foster the communication and interaction among colleagues of a branch of science, limnology, that suffer of significant fragmentation. This is summarized in the future perspectives and challenges concerning potential improvements of the air2water, with a particular emphasis on possible cross-sectoral applications.
This paper uses the social cognitive theory model to review the literature on older adult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by older adults, followed by casino games. Older adults take trips to casinos to socialize, find excitement, and win…
Greenly, G.D.; Dickerson, M.H.
Numerical models on several levels of complexity should be available to the emergency response planner. They are a basic tool but must be used in conjunction with both measurements and experience. When these tools are used in a complimentary fashion they greatly enhance the capability of the consequence manager to respond in an emergency situation. Because each accident or incident develops it's own characteristics and requirements the system must be capable of a flexible response. Interaction and feedback between model results from a suite of models and measurements (including airborne measurements) serve the emergency response planner's spectrum of needs, ranging from planning exercises and emergency precalculations to a real-time emergency response
Humes, Larry E; Rogers, Sara E; Quigley, Tera M; Main, Anna K; Kinney, Dana L; Herring, Christine
The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p purchase hearing aids after the trial. Hearing aids are efficacious in
Pijnappels, M.A.G.M.; Delbaere, K.; Sturnieks, D.L.; Lord, S.R.
Background: choice stepping reaction time (CSRT) is a functional measure that has been shown to significantly discriminate older fallers from non-fallers. Objective: to investigate how physiological and cognitive factors mediate the association between CSRT performance and multiple falls by use of
Van Zomeren, M.; Postmes, T.; Spears, R.
An integrative social identity model of collective action (SIMCA) is developed that incorporates 3 socio-psychological perspectives on collective action. Three meta-analyses synthesized a total of 182 effects of perceived injustice, efficacy, and identity on collective action (corresponding to these
van Zomeren, M.; Postmes, T.; Spears, R.
An integrative social identity model of collective action (SIMCA) is developed that incorporates 3 socio-psychological perspectives on collective action. Three meta-analyses synthesized a total of 182 effects of perceived injustice, efficacy, and identity on collective action (corresponding to these
Gao, Zan; Lee, Amelia M.; Harrison, Louis, Jr.
In this article, the roles of individuals' expectancy beliefs and incentives (i.e., task value, outcome expectancy) in sport and physical education are examined from expectancy-value model and self-efficacy theory perspectives. Overviews of the two theoretical frameworks and the conceptual and measurement issues are provided, followed by a review…
Durbin, J.; Koopman, S.J.M.
The analysis of non-Gaussian time series using state space models is considered from both classical and Bayesian perspectives. The treatment in both cases is based on simulation using importance sampling and antithetic variables; Monte Carlo Markov chain methods are not employed. Non-Gaussian
Melanie D Logue
Full Text Available Background Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chronically ill older adult has unique circumstances that impact their decision to participate in self-directed care, a theoretical framework to help understand factors that influence the adoption of PHRs is important. Here we describe the results of an exploratory study that provided an initial test of such a framework.Methods The study used a descriptive survey methodology with 38 older adults. The survey questionnaire asked about the personal barriers and facilitators associated with personal health record adoption and included items measuring each of the PHRAM’s four interacting factors (environmental factors, personal factors, technology factors, and self-management, and the resulting behavioural outcome.Results Younger seniors had a more positive attitude toward computers, knew what health resources were available on the internet, agreed that they had the resources in place to use PHRs, and would be more influenced by a family member than a healthcare provider to use them. Conversely, older seniors reported less confidence in their ability to use Internet-based PHRs and did not perceive that they had the resources in place to use them.Conclusions The results of this study indicated that personal, environmental, technology, chronic illness, and behavioral factors operated concurrently as personal barriers and/or facilitators to the adoption of PHRs among the older adult with chronic illness. These factors cannot be isolated because the person commonly
Hoogendijk, Emiel O; van der Horst, Henriëtte E; van de Ven, Peter M; Twisk, Jos W R; Deeg, Dorly J H; Frijters, Dinnus H M; van Leeuwen, Karen M; van Campen, Jos P C M; Nijpels, Giel; Jansen, Aaltje P D; van Hout, Hein P J
Primary care-based comprehensive care programs have the potential to improve outcomes in frail older adults. We evaluated the impact of the Geriatric Care Model (GCM) on the quality of life of community-dwelling frail older adults. A 24-month stepped wedge cluster randomized controlled trial was conducted between May 2010 and March 2013 in 35 primary care practices in the Netherlands, and included 1147 frail older adults. The intervention consisted of a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Reassessment occurred every six months. Nurses worked together with primary care physicians and were supervised and trained by geriatric expert teams. Complex patients were reviewed in multidisciplinary consultations. The primary outcome was quality of life (SF-12). Secondary outcomes were health-related quality of life, functional limitations, self-rated health, psychological wellbeing, social functioning and hospitalizations. Intention-to-treat analyses based on multilevel modeling showed no significant differences between the intervention group and usual care regarding SF-12 and most secondary outcomes. Only for IADL limitations we found a small intervention effect in patients who received the intervention for 18months (B=-0.25, 95%CI=-0.43 to -0.06, p=0.007), but this effect was not statistically significant after correction for multiple comparisons. The GCM did not show beneficial effects on quality of life in frail older adults in primary care, compared to usual care. This study strengthens the idea that comprehensive care programs add very little to usual primary care for this population. The Netherlands National Trial Register NTR2160. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Akimov, Alexey V.; Wang, Linjun; Prezhdo, Oleg V.; Trivedi, Dhara
We analyze the applicability of the seminal fewest switches surface hopping (FSSH) method of Tully to modeling quantum transitions between electronic states that are not coupled directly, in the processes such as Auger recombination. We address the known deficiency of the method to describe such transitions by introducing an alternative definition for the surface hopping probabilities, as derived from the Markov state model perspective. We show that the resulting transition probabilities simplify to the quantum state populations derived from the time-dependent Schrödinger equation, reducing to the rapidly switching surface hopping approach of Tully and Preston. The resulting surface hopping scheme is simple and appeals to the fundamentals of quantum mechanics. The computational approach is similar to the FSSH method of Tully, yet it leads to a notably different performance. We demonstrate that the method is particularly accurate when applied to superexchange modeling. We further show improved accuracy of the method, when applied to one of the standard test problems. Finally, we adapt the derived scheme to atomistic simulation, combine it with the time-domain density functional theory, and show that it provides the Auger energy transfer timescales which are in good agreement with experiment, significantly improving upon other considered techniques. (author)
Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg
Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning. © 2018 Australian College of Mental Health Nurses Inc.
Dois, Angelina; Bravo, Paulina; Soto, Gabriela
The Family and Community Health Model is based on three essential principles: user-centered care, comprehensive care and continuity of care. To describe the attributes and characteristics of the guiding principles of the Family and Community Health Model (FHM) from the perspective of primary care experts. This was a qualitative study. An electronic Delphi was conducted with 29 national experts on primary care. The experts agree that user centered care must be based on a psycho-social model integrating the multiple factors that influence health problems. It also must integrate patients' individual features, family and environmental issues. The proposed actions promote shared decision making. To promote integral care, anticipatory guidelines should be expanded and health care of patients with chronic conditions should be improved. Continuity of care should be promoted increasing working hours of medical centers and easing access to integrated electronic medical records, thereby generating efficient links between the different care levels. The results of the study can guide the clinical and administrative management of health teams, allowing the strengthening of primary health care according to the local realities.
Full Text Available Time out-of-home has been linked with numerous health outcomes, including cognitive decline, poor physical ability and low emotional state. Comprehensive characterization of this important health metric would potentially enable objective monitoring of key health outcomes. The objective of this study is to determine the relationship between time out-of-home and cognitive status, physical ability and emotional state.Participants included 85 independent older adults, age 65-96 years (M = 86.36; SD = 6.79 who lived alone, from the Intelligent Systems for Assessing Aging Changes (ISAAC and the ORCATECH Life Laboratory cohorts. Factors hypothesized to affect time out-of-home were assessed on three different temporal levels: yearly (cognitive status, loneliness, clinical walking speed, weekly (pain and mood or daily (time out-of-home, in-home walking speed, weather, and season. Subject characteristics including age, race, and gender were assessed at baseline. Total daily time out-of-home in hours was assessed objectively and unobtrusively for up to one year using an in-home activity sensor platform. A longitudinal tobit mixed effects regression model was used to relate daily time out-of-home to cognitive status, physical ability and emotional state. More hours spend outside the home was associated with better cognitive function as assessed using the Clinical Dementia Rating (CDR Scale, where higher scores indicate lower cognitive function (βCDR = -1.69, p<0.001. More hours outside the home was also associated with superior physical ability (βPain = -0.123, p<0.001 and improved emotional state (βLonely = -0.046, p<0.001; βLow mood = -0.520, p<0.001. Weather, season, and weekday also affected the daily time out-of-home.These results suggest that objective longitudinal monitoring of time out-of-home may enable unobtrusive assessment of cognitive, physical and emotional state. In addition, these results indicate that the factors affecting out
Dolfin, M; Leonida, L; Outada, N
We take advantage of the challenging comments to the modeling approach we proposed in  to look ahead at a number of applications of the methods to the alternative questions these comments raise. In turn, our effort results in a number of interesting and valuable research perspectives. The presentation goes along three main lines. In the first line, we summarize briefly the aims and results in . In the second section we give a technical the issues raised and, finally, the focus moves to the above mentioned research perspectives. Copyright © 2017 Elsevier B.V. All rights reserved.
The current study introduced a general modeling framework, multilevel mixture IRT (MMIRT) which detects and describes characteristics of population heterogeneity, while accommodating the hierarchical data structure. In addition to introducing both continuous and discrete approaches to MMIRT, the main focus of the current study was to distinguish…
Markle-Reid, Maureen; Browne, Gina
The aim of this article is to discuss the concept of frailty and its adequacy in identifying and describing older adults as frail. Despite the dramatic increase in use of the term 'frailty' over the past two decades, there is a lack of consensus in the literature about its meaning and use, and no clear conceptual guidelines for identifying and describing older adults as frail. Differences in theoretical perspectives will influence policy decisions regarding eligibility for, and allocation of, scarce health care resources among older adults. The article presents a literature review and synthesis of definitions and conceptual models of frailty in relation to older adults. The first part of the paper is a summary of the synonyms, antonyms and definitions of the term frailty. The second part is a critical evaluation of conceptual models of frailty. Six conceptual models are analysed on the basis of four main categories of assumptions about: (1) the nature of scientific knowledge; (2) the level of analysis; (3) the ageing process; (4) the stability of frailty. The implications of these are discussed in relation to clinical practice, policy and research. The review gives guidelines for a new theoretical approach to the concept of frailty in older adults: (1) it must be a multidimensional concept that considers the complex interplay of physical, psychological, social and environmental factors; (2) the concept must not be age-related, suggesting a negative and stereotypical view of ageing; (3) the concept must take into account an individual's context and incorporate subjective perceptions; (4) the concept must take into account the contribution of both individual and environmental factors.
Beglaryan, Mher; Petrosyan, Varduhi; Bunker, Edward
In health care, information technologies (IT) hold a promise to harness an ever-increasing flow of health related information and bring significant benefits including improved quality of care, efficiency, and cost containment. One of the main tools for collecting and utilizing health data is the Electronic Health Record (EHR). EHRs implementation can face numerous barriers to acceptance including attitudes and perceptions of potential users, required effort attributed to their implementation and usage, and resistance to change. Various theories explicate different aspects of technology deployment, implementation, and acceptance. One of the common theories is the Technology Acceptance Model (TAM), which helps to study the implementation of different healthcare IT applications. The objectives of this study are: to understand the barriers of EHR implementation from the perspective of physicians; to identify major determinants of physicians' acceptance of technology; and develop a model that explains better how EHRs (and technologies in general) are accepted by physicians. The proposed model derives from a cross-sectional survey of physicians selected through multi-stage cluster sampling from the hospitals of Yerevan, Armenia. The study team designed the survey instrument based on a literature review on barriers of EHR implementation. The analysis employed exploratory structural equation modeling (ESEM) with a robust weighted least squares (WLSMV) estimator for categorical indicators. The analysis progressed in two steps: appraisal of the measurement model and testing of the structural model. The derived model identifies the following factors as direct determinants of behavioral intention to use a novel technology: projected collective usefulness; personal innovativeness; patient influence; and resistance to change. Other factors (e.g., organizational change, professional relationships, administrative monitoring, organizational support and computer anxiety) exert their
Full Text Available Although elder abuse and neglect are not unfamiliar situations in research and intervention programmes, current perspectives indicate that when highlighting age as a factor for this kind of violence, the gender perspective in the understanding of violence towards the elderly has been overlooked. This review attempts to shed light on this gender perspective when we look at what kind of abuse older people, and especially older women, are suffering. Three issues concerning the mistreatment of older women will be reviewed: the characteristics of intimate partner violence against older women, the health and quality of life consequences of this kind of abuse, and intervention programmes that can be implemented for this group. The aim of this paper is to provide a framework for starting up national studies and interventions regarding intimate partner violence against older women, an issue barely studied in our country so far.
Roberts, Sa; McGowan, L; Hirst, Wm; Brison, Dr; Vail, A; Lieberman, Ba
In vitro fertilisation (IVF) treatments involve an egg retrieval process, fertilisation and culture of the resultant embryos in the laboratory, and the transfer of embryos back to the mother over one or more transfer cycles. The first transfer is usually of fresh embryos and the remainder may be cryopreserved for future frozen cycles. Most commonly in UK practice two embryos are transferred (double embryo transfer, DET). IVF techniques have led to an increase in the number of multiple births, carrying an increased risk of maternal and infant morbidity. The UK Human Fertilisation and Embryology Authority (HFEA) has adopted a multiple birth minimisation strategy. One way of achieving this would be by increased use of single embryo transfer (SET). To collate cohort data from treatment centres and the HFEA; to develop predictive models for live birth and twinning probabilities from fresh and frozen embryo transfers and predict outcomes from treatment scenarios; to understand patients' perspectives and use the modelling results to investigate the acceptability of twin reduction policies. A multidisciplinary approach was adopted, combining statistical modelling with qualitative exploration of patients' perspectives: interviews were conducted with 27 couples at various stages of IVF treatment at both UK NHS and private clinics; datasets were collated of over 90,000 patients from the HFEA registry and nearly 9000 patients from five clinics, both over the period 2000-5; models were developed to determine live birth and twin outcomes and predict the outcomes of policies for selecting patients for SET or DET in the fresh cycle following egg retrieval and fertilisation, and the predictions were used in simulations of treatments; two focus groups were convened, one NHS and one web based on a patient organisation's website, to present the results of the statistical analyses and explore potential treatment policies. The statistical analysis revealed no characteristics that
Maria Aparecida Salci
Full Text Available ABSTRACT Objective: to assess the health care Primary Health Care professionals provide to diabetes mellitus patients from the perspective of the Modelo de Atenção às Condições Crônicas. Method: qualitative study, using the theoretical framework of Complex Thinking and the Modelo de Atenção às Condições Crônicas and the methodological framework of assessment research. To collect the data, 38 interviews were held with health professionals and managers; observation of the activities by the health teams; and analysis of 25 files of people who received this care. The data analysis was supported by the software ATLAS.ti, using the directed content analysis technique. Results: at the micro level, care was distant from the integrality of the actions needed to assist people with chronic conditions and was centered on the biomedical model. At the meso level, there was disarticulation among the professionals of the Family Health Strategy, between them and the users, family and community. At the macro level, there was a lack of guiding strategies to implement public policies for diabetes in care practice. Conclusion: the implementation of the Modelo de Atenção às Condições Crônicas represents a great challenge, mainly needing professionals and managers who are prepared to work with chronic conditions are who are open to break with the traditional model.
M. Sabri Haron
Full Text Available Objective of this article is to assess how far the principles of inclusiveness in the Economic New Model in Malaysia can fulfil the needs of maqasid syar’iyyah. The assessment is conducted through the key concepts and strategic measures of the principles of inclusiveness. This study is a qualitative which descriptive and analytical approach is used for assessing the principles of inclusiveness in the Economic New Model based on maqasid syar’iyyah perspective. The method of this study is using the literature review with references from secondary data. This study is expected to provide recommendations about the important role of maqasid syar’iyyah for maintaining the welfare of society and developing of a country, in this context for developing the Malaysian economy, in line with the vision 2020, Malaysia on par with developed countries.DOI:10.15408/aiq.v7i1.1362
Lin, XuXun; Yuan, PengCheng
In this research we consider commuters' dynamic learning effect by modeling the trip mode choice behavior from a new perspective of dynamic evolutionary game theory. We explore the behavior pattern of different types of commuters and study the evolution path and equilibrium properties under different traffic conditions. We further establish a dynamic parking charge optimal control (referred to as DPCOC) model to alter commuters' trip mode choice while minimizing the total social cost. Numerical tests show. (1) Under fixed parking fee policy, the evolutionary results are completely decided by the travel time and the only method for public transit induction is to increase the parking charge price. (2) Compared with fixed parking fee policy, DPCOC policy proposed in this research has several advantages. Firstly, it can effectively turn the evolutionary path and evolutionary stable strategy to a better situation while minimizing the total social cost. Secondly, it can reduce the sensitivity of trip mode choice behavior to traffic congestion and improve the ability to resist interferences and emergencies. Thirdly, it is able to control the private car proportion to a stable state and make the trip behavior more predictable for the transportation management department. The research results can provide theoretical basis and decision-making references for commuters' mode choice prediction, dynamic setting of urban parking charge prices and public transit induction.
Tohidi, Hamid; Namdari, Alireza; Keyser, Thomas K.; Drzymalski, Julie
Teamwork contributes to a considerable improvement in quality and quantity of the ultimate outcome. Collaboration and alliance between team members bring a substantial progress for any business. However, it is imperative to acquire an appropriate team since many factors must be considered in this regard. Team size may represent the effectiveness of a team and it is of paramount importance to determine what the ideal team size exactly should be. In addition, information technology increasingly plays a differentiating role in productivity and adopting appropriate information sharing systems may contribute to improvement in efficiency especially in competitive markets when there are numerous producers that compete with each other. The significance of transmitting information to individuals is inevitable to assure an improvement in team performance. In this paper, a model of teamwork and its organizational structure are presented. Furthermore, a mathematical model is proposed in order to characterize a group of sub-teams according to two criteria: team size and information technology. The effect of information technology on performance of team and sub-teams as well as optimum size of those team and sub-teams from a productivity perspective are studied. Moreover, a quantitative sensitivity analysis is presented in order to analyze the interaction between these two factors through a sharing system.
Piccoli, Beatrice; De Witte, Hans; Reisel, William D
This study examines the relationship between job insecurity and discretionary behaviors, that is, organizational citizenship behaviors (OCB) and counterproductive work behaviors (CWB), with the purpose to extend knowledge on the theoretical explanations for these outcomes. Considering the employment relationship with the organization, two different perspectives are suggested and compared in a multiple mediator model, in order to understand the reasons for discretionary behaviors. We draw upon social exchange theory as the basis of psychological contract perceptions and we rely on the group value model to explain organizational justice evaluations. A total of 570 blue-collar workers in Italy participated in our survey. The results show that job insecurity is indirectly related to OCB and CWB through psychological contract breach and organizational injustice. Both mediational mechanisms have equivalent strength in explaining the relationships, namely, they are complementary processes in accounting for both behaviors. These findings suggest that employees' behaviors in job insecure contexts are driven not only by concerns related to the exchange of resources with the organization, but also by evaluations about their value as important members of the group. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Hanlin, Erin R; Delgado-Rendón, Angélica; Lerner, E Brooke; Hargarten, Stephen; Farías, René
The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.
Lipman, Peter W.; Calvert, Andrew T.
Recent ocean-bottom geophysical surveys, dredging, and dives, which complement surface data and scientific drilling at the Island of Hawaii, document that evolutionary stages during volcano growth are more diverse than previously described. Based on combining available composition, isotopic age, and geologically constrained volume data for each of the component volcanoes, this overview provides the first integrated models for overall growth of any Hawaiian island. In contrast to prior morphologic models for volcano evolution (preshield, shield, postshield), growth increasingly can be tracked by age and volume (magma supply), defining waxing alkalic, sustained tholeiitic, and waning alkalic stages. Data and estimates for individual volcanoes are used to model changing magma supply during successive compositional stages, to place limits on volcano life spans, and to interpret composite assembly of the island. Volcano volumes vary by an order of magnitude; peak magma supply also varies sizably among edifices but is challenging to quantify because of uncertainty about volcano life spans. Three alternative models are compared: (1) near-constant volcano propagation, (2) near-equal volcano durations, (3) high peak-tholeiite magma supply. These models define inconsistencies with prior geodynamic models, indicate that composite growth at Hawaii peaked ca. 800–400 ka, and demonstrate a lower current rate. Recent age determinations for Kilauea and Kohala define a volcano propagation rate of 8.6 cm/yr that yields plausible inception ages for other volcanoes of the Kea trend. In contrast, a similar propagation rate for the less-constrained Loa trend would require inception of Loihi Seamount in the future and ages that become implausibly large for the older volcanoes. An alternative rate of 10.6 cm/yr for Loa-trend volcanoes is reasonably consistent with ages and volcano spacing, but younger Loa volcanoes are offset from the Kea trend in age-distance plots. Variable magma flux
Wilson, Christine Brown; Clissett, Philip
Aim The purpose of this paper is to identify practical suggestions that could enable other researchers to consider how quality may be evidenced using constructivist principles including the perspectives of older people and their caregivers. Background Constructivism suggests that reality is part of a social construction, which holds different meanings for each person, in which people are active agents, making autonomous decisions. This approach to research has been identified as suitable for health and social care professionals because these underpinning principles reflect the values of these professions, facilitating the involvement of users and carers. The authenticity criteria have been developed to reflect these philosophical principles but have been criticized for their inaccessible language. To incorporate user and carer perspectives, the criteria have been revised into a more accessible model matrix known as the AldreVast Sjuharad criteria. Discussion This paper reports on two constructivist studies that explored relationships between older people, families and staff in different settings – the community and care homes. Examples from both settings demonstrate how the perspectives of users and carers were incorporated throughout the research process. Following the AldreVast Sjuharad model matrix, practical guidance is provided on how the quality of constructivist research may be implemented in nursing research. Conclusions The different settings in this paper influenced how the AldreVast Sjuharad model matrix was applied. Further work is needed in exploring how the perspective of users and carers may be incorporated into the quality process of constructivist research. PMID:21073505
Understanding the Attributes of Implementation Frameworks to Guide the Implementation of a Model of Community-based Integrated Health Care for Older Adults with Complex Chronic Conditions: A Metanarrative Review
Full Text Available Introduction: Many studies have investigated the process of healthcare implementation to understand better how to bridge gaps between recommended practice, the needs and demands of healthcare consumers, and what they actually receive. However, in the implementation of integrated community-based and integrated health care, it is still not well known which approaches work best. Methods: We conducted a systematic review and metanarrative synthesis of literature on implementation frameworks, theories and models in support of a research programme investigating CBPHC for older adults with chronic health problems. Results: Thirty-five reviews met our inclusion criteria and were appraised, summarised, and synthesised. Five metanarratives emerged 1 theoretical constructs; 2 multiple influencing factors; 3 development of new frameworks; 4 application of existing frameworks; and 5 effectiveness of interventions within frameworks/models. Four themes were generated that exposed the contradictions and synergies among the metanarratives. Person-centred care is fundamental to integrated CBPHC at all levels in the health care delivery system, yet many implementation theories and frameworks neglect this cornerstone. Discussion: The research identified perspectives central to integrated CBPHC that were missing in the literature. Context played a key role in determining success and in how consumers and their families, providers, organisations and policy-makers stay connected to implementing the best care possible. Conclusions: All phases of implementation of a new model of CBPHC call for collaborative partnerships with all stakeholders, the most important being the person receiving care in terms of what matters most to them.
Lynchard, Nicholas A; Radvansky, Gabriel A
Emotion is processed differently in younger and older adults. Older adults show a positivity effect, whereas younger adults show a negativity effect. Socioemotional selectivity theory suggests that these effects can be elicited in any age group when age-related perspectives are manipulated. To examine this, younger and older adults were oriented to actual and age-contrasting possible selves. Emotion activations were assessed using lexical decision. In line with socioemotional selectivity theory, shifts in emotion orientation varied according to perspective, with both younger and older adults showing a negativity effect when a younger adult perspective was taken and a positivity effect when an older adult perspective was taken. 2013 APA, all rights reserved
Alyamani, Talal M.
Environmental issues and reliance on fossil fuel sources, including coal, oil, and natural gas, are the two most common energy issues that are currently faced by the United States (U.S.). Incorporation of renewable energy sources, a non-economical option in electricity generation compared to conventional sources that burn fossil fuels, single handedly promises a viable solution for both of these issues. Several energy policies have concordantly been suggested to reduce the financial burden of adopting renewable energy technologies and make such technologies competitive with conventional sources throughout the U.S. This study presents a modeling and analysis approach for comprehensive evaluation of renewable energy policies with respect to their benefits to various related stakeholders--customers, utilities, governmental and environmental agencies--where the debilitating impacts, advantages, and disadvantages of such policies can be assessed and quantified at the state level. In this work, a novel simulation framework is presented to help policymakers promptly assess and evaluate policies from different perspectives of its stakeholders. The proposed framework is composed of four modules: 1) a database that collates the economic, operational, and environmental data; 2) elucidation of policy, which devises the policy for the simulation model; 3) a preliminary analysis, which makes predictions for consumption, supply, and prices; and 4) a simulation model. After the validity of the proposed framework is demonstrated, a series of planned Florida and Texas renewable energy policies are implemented into the presented framework as case studies. Two solar and one energy efficiency programs are selected as part of the Florida case study. A utility rebate and federal tax credit programs are selected as part of the Texas case study. The results obtained from the simulation and conclusions drawn on the assessment of current energy policies are presented with respect to the
Dossa, P A
The literature refers to older people with developmental disabilities as the "new service population." How and why this population emerged as a special category is discussed conceptually with