Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

Science.gov (United States)

Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

2015-01-01

The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

Health related quality of life among elderly living in region of high vulnerability for health in Belo Horizonte, Minas Gerais, Brazil.

Science.gov (United States)

Camelo, Lidyane do Valle; Giatti, Luana; Barreto, Sandhi Maria

2016-01-01

To investigate whether social relations, sociodemographic characteristics, lifestyle, and health conditions are associated with health-related quality of life (HRQOL) among elderly persons living in regions classified as high vulnerable in terms of health. A cross-sectional study conducted with a population-based random sample of 366 elderly (≥ 60 years of age) persons registered at a primary health-care unit in Belo Horizonte, Minas Gerais, Brazil. HRQOL was measured using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and the scores obtained in the physical component score (PCS) and mental component score (MCS) were our response variables. Social relations, sociodemographic characteristics, lifestyle, and health conditions were considered our groups of explanatory variables. Multiple linear regression models were used for the analysis. In the final multivariate models, we found that elevated number of diagnosis of chronic diseases, and being bedridden for the last 15 days were variables associated with worse PCS and MCS. However, lack of education, dissatisfaction with personal relationships, lack of support and help when bedridden or to go to the doctor, and to prepare meals were associated with worse HRQOL only in MCS. Participants who reported black race/color, absence of work activity, lack of physical activity, no alcohol consumption, and hospitalization in the last 12 months had worse HRQOL only in PCS. In addition to the aspects related to social adversity, lifestyle, and health conditions, some functional aspects of social relations were important for understanding the HRQOL in elderly persons living in social vulnerability.

Evaluation of French version of the Vulnerability to abuse screen scale (VASS), a elder abuse screening tool.

Science.gov (United States)

Grenier, Florian; Capriz, Françoise; Lacroix-Hugues, Virginie; Paysant, François; Pradier, Christian; Franco, Alain

2016-06-01

The elder abuse is a major public health problem. In the world, almost 4 to 10% of people of more than 65 years would be abuse. The generalist practitioners report only 2% of the elder abuse. Furthermore, the evaluations of elder abuse screenings test found in the scientist literature were unsatisfactory. Evaluate the elder abuse screening capacities of the Vulnerability to abuse screen scale (VASS) in order to propose it to the doctors. VASS was translated in French. It's a quantitative and a forward-looking study whose the answers of people of more than 65 years old were analysed and compared in blind way to the answers of socials workers. 200 patients were included between March and May 2012 in the CHU of Cimiez, Nice. We found 104 patients in danger of abuse, 40 cases of abuse revealed by the socials workers, so 20% of abuses were reported by the gold standard. It means a sensibility of 90,9%, a specificity of 49,7% and a predictive value of 96,1% to a score of 1 to the test. The screening test VASS shown it useful to detect elder people in danger of abuse but a few discriminants and not adapted to patients who have cognitive pathologies. It's a screening tool usable by default, more sensitive than others tests in the scientist literature. However, these results ask the question of the useful of these tools of elder abuse screening in comparison with the education of doctors which made proofs of success in this subject.

Educational Support Group in Changing Caregivers' Psychological Elder Abuse Behavior toward Caring for Institutionalized Elders

Science.gov (United States)

Hsieh, Hsiu-Fang; Wang, Jing-Jy; Yen, Maiofen; Liu, Tzu-Ti

2009-01-01

Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver's…

Cognitive style and depressive symptoms in elderly people - extending the empirical evidence for the cognitive vulnerability-stress hypothesis.

Science.gov (United States)

Meyer, Thomas D; Gudgeon, Emma; Thomas, Alan J; Collerton, Daniel

2010-10-01

Depression is common in older people and its identification and treatment has been highlighted as one of the major challenges in an ageing world. Poor physical and cognitive health, bereavement, and prior depression are important risk factors for depression in elderly people. Attributional or cognitive style has been identified as a risk factor for depression in children, adolescents and younger adults but its relevance for depression and mood in elderly people has not been investigated in the context of other risk factors. Sixty-four older adults from an 'extra care' living scheme (aged 59-97) were recruited for a 6-week prospective study to examine the relationships between cognitive style and depressive symptoms. Regression analyses revealed that, when other risk factors were controlled for, cognitive style and its interaction with stress predicted changes in depressive symptoms, therefore partially replicating prior research. Cognitive-stress-vulnerability models also apply to elderly populations, but may be rather predictive of changes in depression when facing lower levels of stress. Copyright 2010 Elsevier Ltd. All rights reserved.

Anaphylaxis vulnerable groups

African Journals Online (AJOL)

Ehab

Age groups vulnerable to serious attacks of anaphylaxis include infants, teenagers, pregnant women, and the elderly. Concomitant diseases, such as severe or uncontrolled asthma, cardiovascular disease, mastocytosis or clonal mast cell disorders and the concurrent use of some medications such as beta adrenergic ...

An holistic view on aquifer vulnerability based on a distinction of different types of vulnerability

Science.gov (United States)

De Luca, Domenico Antonio; Lasagna, Manuela; Franchino, Elisa

2016-04-01

AN HOLISTIC VIEW ON AQUIFER VULNERABILITY BASED ON A DISTINCTION OF DIFFERENT TYPES OF VULNERABILITY D.A. De Luca1 , M. Lasagna1, E. Franchino1 1Department of Earth Sciences, University of Turin The concept of vulnerability is certainly useful in the field of groundwater protection. Nevertheless, within the scientific community, the definition of groundwater vulnerability is still debatable and not clear and conclusive. This is probably due to the fact that researchers often have very different experiences and education. A positive effect of it is a constant exchange of ideas, but there are also negative consequences and difficulties in deepening the issue. The different approaches are very important but they are usable only if the concept of vulnerability is standardized: thus, for the sake of clarity, a number of definitions should be laid down, based on the different types of vulnerability. These definitions can then provide the necessary holistic view for the aquifer vulnerability assessment. Nowadays vulnerability methods focus on the degree of vulnerability and the parameters needed for its evaluation, often neglecting to clarify what is the type of vulnerability the proposed methods are referred. The type of vulnerability, indeed, is both logically and hierarchically superior to the degree of vulnerability. More specifically the type of vulnerability represents the evaluation of the hydrogeological conditions considered in the vulnerability assessment and able to influence the way in which the contamination can take place. Currently the only distinction, based on of the type of vulnerability, is referred to intrinsic and specific vulnerability. Intrinsic vulnerability assesses the susceptibility of the receptor based on the natural properties of the land and subsurface; specific vulnerability also includes properties of the analyzed contaminant. This distinction is useful but not exhaustive. In addition to this, e.g., a distinction of vertical vulnerability

Vulnerability of Elderly Women: Victim of Gender Discrimination

OpenAIRE

Subir Kumar Roy

2017-01-01

The life cycle of human being completes with the process of aging but we fail to realize this simple arithmetic of life and often consider our elders as a burden for us. They are compelled to compromise with their dignity and integrity and forced to live at the mercy of their own nearest and dearest. When we talk about elderly women their position is more appalling than their male counterpart due to this male chauvinism which tries to regulate every affair of the life of the people. Under the...

Vulnerability curves vs. vulnerability indicators: application of an indicator-based methodology for debris-flow hazards

Science.gov (United States)

Papathoma-Köhle, Maria

2016-08-01

The assessment of the physical vulnerability of elements at risk as part of the risk analysis is an essential aspect for the development of strategies and structural measures for risk reduction. Understanding, analysing and, if possible, quantifying physical vulnerability is a prerequisite for designing strategies and adopting tools for its reduction. The most common methods for assessing physical vulnerability are vulnerability matrices, vulnerability curves and vulnerability indicators; however, in most of the cases, these methods are used in a conflicting way rather than in combination. The article focuses on two of these methods: vulnerability curves and vulnerability indicators. Vulnerability curves express physical vulnerability as a function of the intensity of the process and the degree of loss, considering, in individual cases only, some structural characteristics of the affected buildings. However, a considerable amount of studies argue that vulnerability assessment should focus on the identification of these variables that influence the vulnerability of an element at risk (vulnerability indicators). In this study, an indicator-based methodology (IBM) for mountain hazards including debris flow (Kappes et al., 2012) is applied to a case study for debris flows in South Tyrol, where in the past a vulnerability curve has been developed. The relatively "new" indicator-based method is being scrutinised and recommendations for its improvement are outlined. The comparison of the two methodological approaches and their results is challenging since both methodological approaches deal with vulnerability in a different way. However, it is still possible to highlight their weaknesses and strengths, show clearly that both methodologies are necessary for the assessment of physical vulnerability and provide a preliminary "holistic methodological framework" for physical vulnerability assessment showing how the two approaches may be used in combination in the future.

Mental health/psychiatric issues in elder abuse and neglect.

Science.gov (United States)

Cooper, Claudia; Livingston, Gill

2014-11-01

Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.

Stress, Anxiety and Depression Levels Among Elderly Referrals to Tehran Elderly Club

Directory of Open Access Journals (Sweden)

Mohtasham Ghafari

2012-07-01

Full Text Available Objectives: Stress and anxiety have well–known effects in the pathogenesis of many physical and mental disorders. Aging adults are vulnerable to the effects of a negative stressor factors so, this study aims to investigate the level of stress anxiety and depression among the elderly referred to elderly clubs of Tehran in 2009. Methods & Materials: This is a cross-sectional study carried out on 104 aging adults, selected from elderly clubs of Tehran on 2009. Depression, Anxiety and Stress questionnaires (DASS-21, were filled out for this group. Finally obtained data was statistically analyzed by means of SPSS15 using T- test and One Way ANOVA at the significant level P≤0.05. Results: Of the total subjects under study 24% were male, and 76% female, with a mean age of 63.37±4.32 and 65.08±4.82 years respectively. The proportion of women with high anxiety score was higher than men. There were also higher anxiety levels in illness people (P<0.001. Conclusion: This study on depression, anxiety and stress as an indicator of lifestyle reveals high stress levels in the elderly population, which warrants appropriate planning and community-based interventions, to improve lifestyle and reduce stress level in aging adults.

Critical concepts in elder abuse research.

Science.gov (United States)

Goergen, Thomas; Beaulieu, Marie

2013-08-01

This paper identifies core elements in principal definitions of elder abuse or mistreatment of older adults (EA/MOA) and discusses the relevance of four crucial concepts: age, vulnerability, trust, and power balance in relationships. A critical analysis of selected literature in EA/MOA with a focus on works from the last 10 years. Current definitions of EA/MOA share commonalities regarding an understanding of elder abuse as a status offence, the inclusion of both acts and omissions, and the consideration of multiple levels of behavior and its effects. Definitions differ with regard to aspects as crucial as the intentionality of an abusive action and its actual or potential harmful effects. EA/MOA can be considered as a complex subtype of victimization in later life limited to victim-perpetrator relationships, where the perpetrator has assumed responsibility for the victim, the victim puts trust in the offender, or the role assigned to the offending person creates the perception and expectation that the victim may trust the perpetrator. Vulnerability is identified as a key variable in EA/MOA theory and research. With regard to neglect, the mere possibility of being neglected presupposes a heightened level of vulnerability. Power imbalance often characterizes victim - perpetrator relationships but is not a necessary characteristic of abuse. Research on EA/MOA needs conceptual development. Confining phenomena of EA/MOA to specific relationships and tying them to notions of vulnerability has implications for research design and sampling and points to the limits of population-based victimization surveys.

Analysis of child poverty and vulnerability in Zambia | Moonga ...

African Journals Online (AJOL)

Vulnerability is increasingly becoming synonymous with poverty in the social policy literature. There are three age-groups that are more likely to be vulnerable and in poverty at any given time although with variations. These are children, adults with children and the elderly. This study focused on the children due to their ...

Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation.

Science.gov (United States)

Ko, Dae-Sik; Jung, Dae-In; Jeong, Mi-Ae

2014-11-01

[Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles.

Are older people a vulnerable group? Philosophical and bioethical perspectives on ageing and vulnerability.

Science.gov (United States)

Bozzaro, Claudia; Boldt, Joachim; Schweda, Mark

2018-05-01

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.

Conducting research with African elderly persons: Is their ...

African Journals Online (AJOL)

The increase in social research conducted as a result of HIV/AIDS raises further concerns about the ethics of conducting research on elderly African persons with regards to issues of autonomy and informed consent. This paper examines the ethics and the notion of vulnerability of African elderly persons within the context of ...

Do depressive episodes lead to accumulation of vulnerability in the elderly?

NARCIS (Netherlands)

Oldehinkel, AJ; van den Berg, MD; Bouhuys, AL; Ormel, J

2003-01-01

The vulnerability-accumulation (or scarring) hypothesis postulates that the experience of depression induces a lasting increase in vulnerability, and through this raises the risk of recurrence. We examined the validity of the vulnerability-accumulation model for depressive episodes in later life.

Older persons' definitions and explanations of elder abuse in the Netherlands

DEFF Research Database (Denmark)

Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

2016-01-01

persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of......In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semi-structured interviews with 35 older persons who had no experience with abuse. Our findings show...... that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older...

The effect of need-based spiritual/religious intervention on spiritual well-being and anxiety of elderly people.

Science.gov (United States)

Elham, Hedayati; Hazrati, Maryam; Momennasab, Marzieh; Sareh, Keshavarzi

2015-01-01

Anxiety and spiritual distress are the most common problems among the patients admitted in intensive care units. The elderly are more vulnerable to this problem due to impairment of their adaptation mechanisms. Hence, helping to reduce anxiety is one of the most effective nursing interventions. Therefore, this study aimed at investigating the effect of need-based spiritual/religious interventions on spiritual well-being (SWB) and anxiety of the elderly admitted to coronary care unit (CCU). This quasi-experimental study with pre- and posttest control group design was conducted on 66 patients admitted to CCU of Imam Reza hospital in Lar, southern Iran, in 2014. After obtaining informed consents, the data were collected using the Spielberger State-Trait Anxiety Inventory, the SWB Scale, and a demographic questionnaire. The questionnaires were completed through interviewing the patients before and after the intervention. The participants of the intervention group underwent 60- to 90-minute sessions of spiritual and religious need-based interventions for 3 consecutive days. The results showed a significant increase in the mean scores of SWB in the intervention group after the intervention (P = .001). Also, a significant decrease was found in mean scores of trait and state anxiety in the intervention group in comparing to control group (P Spiritual/religious interventions could enhance SWB and reduce anxiety in the elderly admitted to CCU.

Tsunami survivors' perspectives on vulnerability and vulnerability reduction: evidence from Koh Phi Phi Don and Khao Lak, Thailand.

Science.gov (United States)

Steckley, Marylynn; Doberstein, Brent

2011-07-01

This paper presents the results of primary research with 40 survivors of the 2004 Indian Ocean tsunami in two communities: Khao Lak (n=20) and Koh Phi Phi Don (n=20), Thailand. It traces tsunami survivors' perceptions of vulnerability, determines whether residents felt that the tsunami affected different communities differently, identifies the populations and sub-community groups that survivors distinguished as being more vulnerable than others, highlights community-generated ideas about vulnerability reduction, and pinpoints a range of additional vulnerability reduction actions. Tsunami survivors most consistently identified the 'most vulnerable' community sub-populations as women, children, the elderly, foreigners, and the poor. In Khao Lak, however, respondents added 'Burmese migrants' to this list, whereas in Koh Phi Phi Don, they added 'Thai Muslims'. Results suggest that the two case study communities, both small, coastal, tourism-dominated communities no more than 100 kilometres apart, have differing vulnerable sub-groups and environmental vulnerabilities, requiring different post-disaster vulnerability reduction efforts. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

VuWiki: An Ontology-Based Semantic Wiki for Vulnerability Assessments

Science.gov (United States)

Khazai, Bijan; Kunz-Plapp, Tina; Büscher, Christian; Wegner, Antje

2014-05-01

The concept of vulnerability, as well as its implementation in vulnerability assessments, is used in various disciplines and contexts ranging from disaster management and reduction to ecology, public health or climate change and adaptation, and a corresponding multitude of ideas about how to conceptualize and measure vulnerability exists. Three decades of research in vulnerability have generated a complex and growing body of knowledge that challenges newcomers, practitioners and even experienced researchers. To provide a structured representation of the knowledge field "vulnerability assessment", we have set up an ontology-based semantic wiki for reviewing and representing vulnerability assessments: VuWiki, www.vuwiki.org. Based on a survey of 55 vulnerability assessment studies, we first developed an ontology as an explicit reference system for describing vulnerability assessments. We developed the ontology in a theoretically controlled manner based on general systems theory and guided by principles for ontology development in the field of earth and environment (Raskin and Pan 2005). Four key questions form the first level "branches" or categories of the developed ontology: (1) Vulnerability of what? (2) Vulnerability to what? (3) What reference framework was used in the vulnerability assessment?, and (4) What methodological approach was used in the vulnerability assessment? These questions correspond to the basic, abstract structure of the knowledge domain of vulnerability assessments and have been deduced from theories and concepts of various disciplines. The ontology was then implemented in a semantic wiki which allows for the classification and annotation of vulnerability assessments. As a semantic wiki, VuWiki does not aim at "synthesizing" a holistic and overarching model of vulnerability. Instead, it provides both scientists and practitioners with a uniform ontology as a reference system and offers easy and structured access to the knowledge field of

AVQS: Attack Route-Based Vulnerability Quantification Scheme for Smart Grid

Directory of Open Access Journals (Sweden)

Jongbin Ko

2014-01-01

Full Text Available A smart grid is a large, consolidated electrical grid system that includes heterogeneous networks and systems. Based on the data, a smart grid system has a potential security threat in its network connectivity. To solve this problem, we develop and apply a novel scheme to measure the vulnerability in a smart grid domain. Vulnerability quantification can be the first step in security analysis because it can help prioritize the security problems. However, existing vulnerability quantification schemes are not suitable for smart grid because they do not consider network vulnerabilities. We propose a novel attack route-based vulnerability quantification scheme using a network vulnerability score and an end-to-end security score, depending on the specific smart grid network environment to calculate the vulnerability score for a particular attack route. To evaluate the proposed approach, we derive several attack scenarios from the advanced metering infrastructure domain. The experimental results of the proposed approach and the existing common vulnerability scoring system clearly show that we need to consider network connectivity for more optimized vulnerability quantification.

AVQS: attack route-based vulnerability quantification scheme for smart grid.

Science.gov (United States)

Ko, Jongbin; Lim, Hyunwoo; Lee, Seokjun; Shon, Taeshik

2014-01-01

A smart grid is a large, consolidated electrical grid system that includes heterogeneous networks and systems. Based on the data, a smart grid system has a potential security threat in its network connectivity. To solve this problem, we develop and apply a novel scheme to measure the vulnerability in a smart grid domain. Vulnerability quantification can be the first step in security analysis because it can help prioritize the security problems. However, existing vulnerability quantification schemes are not suitable for smart grid because they do not consider network vulnerabilities. We propose a novel attack route-based vulnerability quantification scheme using a network vulnerability score and an end-to-end security score, depending on the specific smart grid network environment to calculate the vulnerability score for a particular attack route. To evaluate the proposed approach, we derive several attack scenarios from the advanced metering infrastructure domain. The experimental results of the proposed approach and the existing common vulnerability scoring system clearly show that we need to consider network connectivity for more optimized vulnerability quantification.

The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

Science.gov (United States)

Wang, Jye; Lin, Wender; Chang, Ling-Hui

2018-01-01

The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

Science.gov (United States)

Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari

2016-01-01

We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

Elderly who take care of elderly: a study on the Frailty Syndrome

Directory of Open Access Journals (Sweden)

Ariene Angelini dos Santos-Orlandi

Full Text Available ABSTRACT Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services.

Defining Resilience and Vulnerability Based on Ontology Engineering Approach

Science.gov (United States)

Kumazawa, T.; Matsui, T.; Endo, A.

2014-12-01

It is necessary to reflect the concepts of resilience and vulnerability into the assessment framework of "Human-Environmental Security", but it is also in difficulty to identify the linkage between both concepts because of the difference of the academic community which has discussed each concept. The authors have been developing the ontology which deals with the sustainability of the social-ecological systems (SESs). Resilience and vulnerability are also the concepts in the target world which this ontology covers. Based on this point, this paper aims at explicating the semantic relationship between the concepts of resilience and vulnerability based on ontology engineering approach. For this purpose, we first examine the definitions of resilience and vulnerability which the existing literatures proposed. Second, we incorporate the definitions in the ontology dealing with sustainability of SESs. Finally, we focus on the "Water-Energy-Food Nexus Index" to assess Human-Environmental Security, and clarify how the concepts of resilience and vulnerability are linked semantically through the concepts included in these index items.

Are Koreans Prepared for the Rapid Increase of the Single-Household Elderly? Life Satisfaction and Depression of the Single-Household Elderly in Korea

Directory of Open Access Journals (Sweden)

Mi-Ra Won

2013-01-01

Full Text Available Purpose. In Korea, it has been estimated that the number of the single-household elderly increased 45% from 2005 to 2010. This research was conducted to provide empirical resources for development of a community mental health program by an explorative investigation on depression, coping mechanism, and life satisfaction of a single-household elderly population. Design and Methods. This research applied a descriptive survey research design. Participants were 225 single-household elderlies residing in Seoul, Korea. The geriatric depression scale and the satisfaction with life scale were used to check the level of depression and life satisfaction of the participants. Results. Results showed that 46.3 percent of the participants were categorized as having light-to-severe level of depression, and 80.5 percent of the participants responded that they were dissatisfied with their lives. This research demonstrated that the level of depression and life satisfaction of the Korean single-household elderly is statistically significantly related to age and gender as well as coping resources and human resources. Implications. Current public health services in Korea for the single-household elderly are still lacking and require active support, intervention, and research to provide effective programs and services. Case management, counseling, and various programs based on Korean culture including support from family members and community-based assistance are recommended to help the vulnerable population.

Reciprocity: A Predictor of Mental Health and Continuity in Elderly People's Relationships? A Review

Directory of Open Access Journals (Sweden)

Live Fyrand

2010-01-01

Full Text Available Many studies have demonstrated that social relationships confer mental health benefits. This paper aims to identify whether and how reciprocity in social relationships predicts or is associated with mental health benefits as well as with continuity in elderly people's social relationships. The studies reviewed in this paper show that, among elders, being in a balanced or underbenefited reciprocal position predicts better mental health and life quality than being in an overbenefited position. Throughout the course of life, reciprocity evens out present and earlier reciprocal imbalances, securing continuity in close relationships—particularly between spouses and between elderly parents and adult children. In friendships, securing continuity seems to be based on the maintenance of independence based on balanced reciprocal relations, making these relationships more vulnerable. Due to the problems of conceptualization and measurement in the reviewed studies, one should be cautious in stating a final conclusion that the reciprocity norm has a universal positive effect on mental health and continuity in elderly people's relationships.

Reciprocity: A Predictor of Mental Health and Continuity in Elderly People's Relationships? A Review.

Science.gov (United States)

Fyrand, Live

2010-01-01

Many studies have demonstrated that social relationships confer mental health benefits. This paper aims to identify whether and how reciprocity in social relationships predicts or is associated with mental health benefits as well as with continuity in elderly people's social relationships. The studies reviewed in this paper show that, among elders, being in a balanced or underbenefited reciprocal position predicts better mental health and life quality than being in an overbenefited position. Throughout the course of life, reciprocity evens out present and earlier reciprocal imbalances, securing continuity in close relationships-particularly between spouses and between elderly parents and adult children. In friendships, securing continuity seems to be based on the maintenance of independence based on balanced reciprocal relations, making these relationships more vulnerable. Due to the problems of conceptualization and measurement in the reviewed studies, one should be cautious in stating a final conclusion that the reciprocity norm has a universal positive effect on mental health and continuity in elderly people's relationships.

Older persons' definitions and explanations of elder abuse in the Netherlands.

Science.gov (United States)

Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

2016-01-01

In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence.

Nutritional Status and Non-Diet Associated Factors of Hospitalized Heart-Failure Elderly Patients

Directory of Open Access Journals (Sweden)

Shirin Hosseini

2010-07-01

Full Text Available Objectives: The aim of this study was to assess nutritional status and identify the most significant MNA-items (Mini Nutritional assessment to accelerate the determination of nutritional risk of heart-failure in elderly patients. Methods and Materials: The present research was a cross-sectional descriptive analytical survey on hospitalized heart- failure elderly patients (n=225. The sampling method was enrolled nonrandomly. The MNA questionnaires (18 items were used for nutritional assessment. Results: Based on the MNA questionnaire, 9.8% of the elderly were malnourished, 80.9% were at risk of malnutrition and 9.3% were well-nourished. Conclusion: Regarding the factors related to nutritional status of heart failure elderly patient, it is indicated that bed sore, the ability of eating, self-view of nutritional status and self-rated health status relative to peers had significant relationship with the nutritional status according to MNA (P<0.005. Regarding high prevalence of vulnerable or malnourished hospitalized elderly, nutritional intervention is necessary.

Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture.

Science.gov (United States)

Dong, Xinqi

2014-04-01

Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults.

Youngest First? Why it is Wrong to Discriminate Against the Elderly ...

African Journals Online (AJOL)

In South Africa and abroad the elderly are systematically discriminated against at all levels of healthcare allocation decision-making. Such discrimination is perhaps surprising in light of the National Health Act and the Older Persons Act, which explicitly recognise the elderly as a vulnerable group whose equal rights require ...

Future research: a prospective longitudinal study of elder self-neglect.

Science.gov (United States)

Dyer, Carmel Bitondo; Franzini, Luisa; Watson, Mary; Sanchez, Luis; Prati, Laura; Mitchell, Stacy; Wallace, Robert; Pickens, Sabrina

2008-11-01

In almost every U.S. jurisdiction, elder self-neglect is the most common allegation addressed by Adult Protective Service (APS) agencies. Not only is self-neglect common, but this form of mistreatment is an independent risk factor for death. A lack of understanding of the precipitating factors and root causes and of the effect on social and medical systems persists in this field. Research in this area has been limited, because the needs of these vulnerable elderly people are complex and diverse. Moreover, these factors encompass interrelated medical, psychiatric, economic, social, and functional problems. In 2004, the National Institutes of Health Interdisciplinary Roadmap Initiative provided the means for preliminary exploration of elder self-neglect through the formation of the Consortium for Research in Elder Self-neglect of Texas (CREST). The goals of CREST include to conduct pilot studies, form interdisciplinary working groups, convene a national research conference, and appoint a national external advisory board. CREST orchestrated the work of 35 interdisciplinary investigators to achieve these goals. CREST researchers have begun to characterize the population of vulnerable elderly people who were reported to APS for neglecting themselves. The pilot studies provided a snapshot of 100 elderly people who had neglected themselves. A proposed next phase could involve a prospective longitudinal study of elderly people with severe self-neglect. This study of the clinical course, the death rate, the causes of death, the occurrence of acute and chronic medical or mental illness, and the costs to the healthcare and social systems would greatly inform the field of elder mistreatment.

Elder Abuse in a Developing Area in Bolivia.

Science.gov (United States)

Carmona-Torres, Juan Manuel; López-Soto, Pablo Jesús; Coimbra-Roca, Ana Isabel; Gálvez-Rioja, Ruth Mary; Goergen, Thomas; Rodríguez-Borrego, M Aurora

2015-10-06

In many parts of the world, elder abuse happens almost unnoticed. Until recently, this serious social problem was hidden from public view and was regarded as an essentially private matter. However, there is growing evidence that elder abuse is an important problem of public health and in the society. The objective of this study is to determine the degree of abuse of elder and vulnerable people in the families and communities of Eastern Bolivia. With this end in mind, we conducted a cross-sectional descriptive study with a sample size of 210 60-year-old people coming from different health care areas. Elder Abuse Suspicion Index (EASI) and Yaffe's Evaluation Form of Social Work were used. An abuse rate of 39% of the older adults was identified. The most common type of abuse observed was psychological abuse (32.4% of cases), followed by neglect (21.9%). Children were identified as triggers of the abuse in 66.7% of cases of abuse. The prevalence of elder abuse was similar to the prevalence of other types of abuse that exist in Bolivia, such as the gender-based abuse. Also, this prevalence is comparable to other developing countries and European countries. The profile of abused older adult is as follows: woman, widow, 70 years old, incomplete primary education, without an occupation, and an average of 4.59 children. The information obtained shows that dysfunctional families have a higher percentage of elder abuse. © The Author(s) 2015.

The experiences on dignity from the perspective of the elderly in nursing homes

DEFF Research Database (Denmark)

Høy, Bente

2016-01-01

The aim of the study was to explore nursing home residents’ practice experiences on dignity in caring situations and everyday life in order to illuminate the significance for a life in dignity. Elderly living in nursing homes are vulnerable which appeal to nursing care ethics and emphasise....... From the literature we have knowledge of how dignity is violated among persons who are sick, weak and helpless; however, the knowledge is limited on how dignity is maintained among vulnerable elderly in nursing homes. A hermeneutic approach was used to interpret the material, which was gathered during...... semi-structured interviews with elderly living in six nursing homes in Scandinavian. A total of 28 interviews were transcribed. The findings will be presented at the conference....

Cortical thinning in cognitively normal elderly cohort of 60 to 89 year old from AIBL database and vulnerable brain areas

Science.gov (United States)

Lin, Zhongmin S.; Avinash, Gopal; Yan, Litao; McMillan, Kathryn

2014-03-01

Age-related cortical thinning has been studied by many researchers using quantitative MR images for the past three decades and vastly differing results have been reported. Although results have shown age-related cortical thickening in elderly cohort statistically in some brain regions under certain conditions, cortical thinning in elderly cohort requires further systematic investigation. This paper leverages our previously reported brain surface intensity model (BSIM)1 based technique to measure cortical thickness to study cortical changes due to normal aging. We measured cortical thickness of cognitively normal persons from 60 to 89 years old using Australian Imaging Biomarkers and Lifestyle Study (AIBL) data. MRI brains of 56 healthy people including 29 women and 27 men were selected. We measured average cortical thickness of each individual in eight brain regions: parietal, frontal, temporal, occipital, visual, sensory motor, medial frontal and medial parietal. Unlike the previous published studies, our results showed consistent age-related thinning of cerebral cortex in all brain regions. The parietal, medial frontal and medial parietal showed fastest thinning rates of 0.14, 0.12 and 0.10 mm/decade respectively while the visual region showed the slowest thinning rate of 0.05 mm/decade. In sensorimotor and parietal areas, women showed higher thinning (0.09 and 0.16 mm/decade) than men while in all other regions men showed higher thinning than women. We also created high resolution cortical thinning rate maps of the cohort and compared them to typical patterns of PET metabolic reduction of moderate AD and frontotemporal dementia (FTD). The results seemed to indicate vulnerable areas of cortical deterioration that may lead to brain dementia. These results validate our cortical thickness measurement technique by demonstrating the consistency of the cortical thinning and prediction of cortical deterioration trend with AIBL database.

The Vulnerable Faces of Pathological Gambling

OpenAIRE

Fong, Timothy W.

2005-01-01

Pathological gambling is an emerging psychiatric disorder that has medical, psychiatric, and social consequences. Recently, research has been focusing on identifying which portions of the population are most vulnerable to developing problems related to ongoing gambling. Specific populations of interest have included adolescents, elderly, minorities, those with comorbid psychiatric or substance use disorders, and gender differences. Each group possesses unique biological, psychological, and/or...

GIS Based Measurement and Regulatory Zoning of Urban Ecological Vulnerability

Directory of Open Access Journals (Sweden)

Xiaorui Zhang

2015-07-01

Full Text Available Urban ecological vulnerability is measured on the basis of ecological sensitivity and resilience based on the concept analysis of vulnerability. GIS-based multicriteria decision analysis (GIS-MCDA methods are used, supported by the spatial analysis tools of GIS, to define different levels of vulnerability for areas of the urban ecology. These areas are further classified into different types of regulatory zones. Taking the city of Hefei in China as the empirical research site, this study uses GIS-MCDA, including the index system, index weights and overlay rules, to measure the degree of its ecological vulnerability on the GIS platform. There are eight indices in the system. Raking and analytical hierarchy process (AHP methods are used to calculate index weights according to the characteristics of the index system. The integrated overlay rule, including selection of the maximum value, and weighted linear combination (WLC are applied as the overlay rules. In this way, five types of vulnerability areas have been classified as follows: very low vulnerability, low vulnerability, medium vulnerability, high vulnerability and very high vulnerability. They can be further grouped into three types of regulatory zone of ecological green line, ecological grey line and ecological red line. The study demonstrates that ecological green line areas are the largest (53.61% of the total study area and can be intensively developed; ecological grey line areas (19.59% of the total area can serve as the ecological buffer zone, and ecological red line areas (26.80% cannot be developed and must be protected. The results indicate that ecological green line areas may provide sufficient room for future urban development in Hefei city. Finally, the respective regulatory countermeasures are put forward. This research provides a scientific basis for decision-making around urban ecological protection, construction and sustainable development. It also provides theoretical method

Summary of vulnerability related technologies based on machine learning

Science.gov (United States)

Zhao, Lei; Chen, Zhihao; Jia, Qiong

2018-04-01

As the scale of information system increases by an order of magnitude, the complexity of system software is getting higher. The vulnerability interaction from design, development and deployment to implementation stages greatly increases the risk of the entire information system being attacked successfully. Considering the limitations and lags of the existing mainstream security vulnerability detection techniques, this paper summarizes the development and current status of related technologies based on the machine learning methods applied to deal with massive and irregular data, and handling security vulnerabilities.

[Family functionality regarding the elderly with cognitive impairments: the caretaker's perception].

Science.gov (United States)

dos Santos, Ariene Angelini; Pavarini, Sofia Cristina Iost

2012-10-01

The objectives of this study were to characterize the caregivers of elderly individuals with cognitive impairment living in different contexts of social vulnerability, and assess the family functionality of the elderly as perceived by the caregivers. Family functionality was evaluated using the Family APGAR instrument, assessed during home interviews with 72 caretakers. All the ethical aspects were observed. Spearman's correlation and the Mann-Whitney test were used, with 5% significance level (poverload in the context of elderly persons with dementia.

Vulnerable Genders, Vulnerable Loves

DEFF Research Database (Denmark)

Schleicher, Marianne

2015-01-01

This chapter analyses religious reflections on vulnerable genders and vulnerable loves from the Hebrew Bible to early Rabbinic literature. It is based on theories by inter alia Donna Haraway on complex identities, Turner and Maryanski on love as a prerequisite for survival, Michel Foucault...... on gathering knowledge and its often unpremeditated effect of recognition and inclusion, and Judith Butler on cultural intelligibility and subversion from within. With these theories as a departing point for the analysis, the chapter links the vulnerability of complex identities with the vulnerability...... of cultures which leads to the overall understanding that culture can accommodate complex identities associated with individual and cultural vulnerability as long as the overall survival of the culture is not threatened. This understanding questions the feasibility of the ethical position of thinkers...

Home Camera-Based Fall Detection System for the Elderly.

Science.gov (United States)

de Miguel, Koldo; Brunete, Alberto; Hernando, Miguel; Gambao, Ernesto

2017-12-09

Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

Perceived vulnerability as a common basis of moral emotions.

Science.gov (United States)

Dijker, Anton J M

2010-06-01

It is theorized that many moral emotions are triggered when a mechanism for (parental) care is activated by perceived vulnerability, and changes in the care object's well-being are subsequently evaluated and causally attributed. Participants reported different moral emotions (tenderness, concern, sympathy, guilt, and moral anger) in relation to different photographs of males and females widely differing in age. Using variation between emotion objects, it was shown that emotional reactions were highly intercorrelated and strongly related to perceived vulnerability and aroused protective tendency; with children and elderly arousing the strongest, and adult males the weakest, emotions. Moreover, these intercorrelations largely disappeared when vulnerability and protective tendency were statistically controlled. Theoretical implications are discussed.

The elderly as a market--challenges to evidence.

Science.gov (United States)

Ellwood, Roger P

2014-02-01

To review the role of the oral care industry in the oral health of elders and opportunities for partnership with other key stakeholders. The elder population is growing at a faster rate than any other segment of the population. This is coupled with a greater probability of maintaining the dentition into later life and an increase in complex restorative work. If an elder's situation changes, they are highly vulnerable to a rapid onset of oral disease that can be devastating and extremely difficult to address. This manuscript reviews the role of the oral care industry in understanding this population as a market and the different approaches that might be used in promoting health. Two key market segments were identified, the vulnerable elders with high levels of chronic oral disease, systemic complications, medications and often inability to maintain good standards of oral hygiene and a wealthier, health and beauty conscious group with a keen interest in maintaining a healthy, aesthetically pleasing and functional dentition throughout their lives. It is likely that within current healthcare models, the oral care of elders will be unsustainable, with a smaller working population funding ever-increasing health care needs. 'Home care' combined with effective professional preventive and effective therapeutic options are essential. Partnerships between the oral care industry and oral care providers, to deliver education and engagement of care workers, medical practitioners, pharmacists and social services, are essential over the next few decades. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Are older people more vulnerable to long-term impacts of disasters?

Directory of Open Access Journals (Sweden)

Rafiey H

2016-12-01

Full Text Available Hassan Rafiey,1 Yadollah Abolfathi Momtaz,2,3 Fardin Alipour,1 Hamidreza Khankeh,4 Shokoufeh Ahmadi,4 Mohammad Sabzi Khoshnami,1 Sharifah Azizah Haron3 1Research Center of Social Welfare Management, Department of Social Work, 2Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Malaysian Research Institute on Ageing (MyAgeing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 4Department of Health in Emergency and Disaster, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Background: Despite the growing interest in the study of disasters, there is limited research addressing the elderly population that lead to prejudiced beliefs that older adults are more vulnerable to disasters than younger adults. This study aimed to compare positive mental health between elderly and young earthquake survivors.Method: Data for this study, consisting of 324 earthquake survivors, were obtained from a population-based cross-sectional survey conducted in Iran, 2015. The long-term effect of earthquake was assessed using the Mental Health Continuum-Short Form questionnaire. A one-way multivariate analysis of covariance (MANCOVA using SPSS (version 22 was used in data analysis.Results: Older adults scored significantly a higher level of overall positive mental health (mean [M]=34.31, standard deviation [SD]=10.52 than younger age group (M=27.48, SD=10.56, t=-4.41; P<0.001. Results of MANCOVA revealed a statistically significant difference between older and young adults on the combined positive mental health subscales (F(3,317=6.95; P<0.001, after controlling for marital status, sex, and employment status.Conclusion: The present findings showing a higher level of positive mental health among elderly earthquake survivors compared with their younger counterparts in the wake of natural disasters suggest that advancing age per se does not contribute to increasing vulnerability. Keywords

Personalized therapy in multiple myeloma according to patient age and vulnerability

DEFF Research Database (Denmark)

Palumbo, Antonio; Bringhen, Sara; Ludwig, Heinz

2011-01-01

Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most...... elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more......, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes....

Elderly women and stress. Does marriage make a difference?

Science.gov (United States)

Preston, D B; Dellasega, C

1990-04-01

Although studies of gender differences in the stress/health relationship of elderly persons have been done, few have examined the combined affect of marital status and gender on health. The experience of stress may affect elderly married women differently than elderly unmarried women. The purpose of this study was to explore the differential effects of stress on elderly married women and to identify interventions that could be used in gerontological nursing practice to promote effective coping. Roy's theory is used to explain the effects of stress on elderly women and to suggest nursing interventions. According to Roy, individuals respond to stressors in four behavioral modes: physiological, self-concept, role performance, and interdependency. The results of this study indicate that, of the four groups studied in this sample, the married women were in poorest health and the most vulnerable to stress.

Augmented reality & gesture-based architecture in games for the elderly.

Science.gov (United States)

McCallum, Simon; Boletsis, Costas

2013-01-01

Serious games for health and, more specifically, for elderly people have developed rapidly in recent years. The recent popularization of novel interaction methods of consoles, such as the Nintendo Wii and Microsoft Kinect, has provided an opportunity for the elderly to engage in computer and video games. These interaction methods, however, still present various challenges for elderly users. To address these challenges, we propose an architecture consisted of Augmented Reality (as an output mechanism) combined with gestured-based devices (as an input method). The intention of this work is to provide a theoretical justification for using these technologies and to integrate them into an architecture, acting as a basis for potentially creating suitable interaction techniques for the elderly players.

Elder abuse within the family environment in the Azores Islands

OpenAIRE

Carmona-Torres, Juan Manuel; Carvalhal-Silva, Rosa María; Viera-Mendes, Maria Helena; Recio-Andrade, Beatriz; Goergen, Thomas; Rodríguez-Borrego, María Aurora

2017-01-01

ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment ...

[Problems and strategies in the treatment of mental disorders in elderly patients with physical illness].

Science.gov (United States)

Wada, H

2000-11-01

There is a high prevalence of mental disorders in the community population of older adults, especially in medical treatment facilities. Therefore, clinicians who treat geriatric patients cannot neglect the psychiatric vulnerability of the elderly population. The fragility of psychological functioning of the elderly is caused not only by psychological contributors, such as various kinds of experiences of loss, but also by biological factors such as decreases in neurotransmitters and in the number of neurons. Another point geriatric clinicians should pay attention to is the powerful mind-body connection in the elderly. Recent psychoneuroimmunological research demonstrates that depression or other types of emotional stress damages the immune system, which can induce some physical diseases. This is especially true for the elderly, who have weakened cell-mediated immune function and are more susceptible to influence by the damaged immune function caused by such psychiatric dysfunction. Also, depression in the elderly can often lead to malnutrition or dehydration, which can induce various kinds of physical illness. On the other hand, physical illness in the elderly can induce depression, because of the psychological vulnerability of the elderly. Due to the strong mind-body connection in the elderly, the availability of psychiatric care is essential. When providing psychiatric care for the elderly, the clinician should attend to all symptoms, not minimizing the importance of biological treatment, while also trying to support the elderly patients psychologically through acceptance of their need for interdependency and respect for their narcissism.

Home Camera-Based Fall Detection System for the Elderly

Directory of Open Access Journals (Sweden)

Koldo de Miguel

2017-12-01

Full Text Available Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana.

Science.gov (United States)

Fenny, Ama P

2017-01-01

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.

LIVED EXPERIENCES OF THE ABUSED ELDERLY

Directory of Open Access Journals (Sweden)

Joel Rey U. Acob

2018-03-01

Full Text Available Aim: The study determined individual lived experiences of the abused elderly in the provinces of Leyte and Biliran. Methods: The study utilized qualitative phenomenology. Interviews are made and recorded, then later transcribed verbatim. Collaizi’s method is used as method of analysis to obtain themes of the lived experiences of the ten abused key informants. Results: Based from results, most of the abused entities are female, widowed aging 6o to 65 years old, earning less than 2000 pesos per month and are dependently living in a nuclear family structure for 40 years. Based on their responses to the open-ended guide questions, key informants revealed emotional mistreatment being the most extensive type of abuse. Physical and sexual maltreatment are also evident amidst their old age. Family members and employers are the main identified perpetrators of the elderly. Bruises on most covered areas in their body, rope burns, torn undergarments, being touched without consent are some of the objective indicators of abuse. Themes such as family violence and workplace mistreatment are the most common form of abuse experienced. Conclusion: Based from the findings, it is recommended that the local government and concerned stakeholders to timely review existing rules protecting vulnerable adults especially its implementation.

Designing an Elderly Assistance Program Based-on Home Care

Science.gov (United States)

Umusya'adah, L.; Juwaedah, A.; Jubaedah, Y.; Ratnasusanti, H.; Puspita, R. H.

2018-02-01

PKH (Program Keluarga Harapan) is a program of Indonesia’s Government through the ministry of social directorate to accelerate the poverty reduction and the achievement of Millennium Development Goals (MDGs) target as well as the policies development in social protection and social welfare domain or commonly referred to as Indonesian Conditional Cash Transfer (CCT) Program. This research is motivated that existing participants of the family expectation program (PKH) that already exist in Sumedang, Indoensia, especially in the South Sumedang on the social welfare components is only limited to the health checking, while for assisting the elderly based Home Care program there has been no structured and systematic, where as the elderly still need assistance, especially from the family and community environment. This study uses a method of Research and Development with Model Addie which include analysis, design, development, implementation and evaluation. Participants in this study using purposive sampling, where selected families of PKH who provide active assistance to the elderly with 82 participants. The program is designed consists of program components: objectives, goals, forms of assistance, organizing institutions and implementing the program, besides, program modules include assisting the elderly. Form of assistance the elderly cover physical, social, mental and spiritual. Recommended for families and companions PKH, the program can be implemented to meet the various needs of the elderly. For the elderly should introspect, especially in the health and follow the advice recommended by related parties

Design and implementation based on the classification protection vulnerability scanning system

International Nuclear Information System (INIS)

Wang Chao; Lu Zhigang; Liu Baoxu

2010-01-01

With the application and spread of the classification protection, Network Security Vulnerability Scanning should consider the efficiency and the function expansion. It proposes a kind of a system vulnerability from classification protection, and elaborates the design and implementation of a vulnerability scanning system based on vulnerability classification plug-in technology and oriented classification protection. According to the experiment, the application of classification protection has good adaptability and salability with the system, and it also approves the efficiency of scanning. (authors)

Systematization of nursing care to institutionalized elderly based on Virginia Henderson

Directory of Open Access Journals (Sweden)

Jorge Wilker Bezerra Clares

2013-07-01

Full Text Available This is an experience report that aims to describe the application of the nursing process to an institutionalized elderly, based on Virginia Henderson’s theory. The case study was developed in a long-stay institution for the elderly in Fortaleza, Ceará, Brazil, from May to August 2010, by filling out a form, physical examination and observation. Identifying the needs of elimination, communication, recreation and learning allowed to raise the nursing diagnoses, respectively: urge urinary incontinence; impaired social interaction; diversional activity deficit; and impaired memory. The nursing interventions were directed to the health and independence of the elderly. The application of systematic nursing care impacted positively on the health of the elderly, demonstrating the applicability of the nursing systematization based on Henderson’s theory in the scenery in which the study was developed.

TV-Based Caring Videophone System for the Elderly in the Smart Home Environment

Directory of Open Access Journals (Sweden)

Jingshuang Shen

2013-01-01

Full Text Available A novel videophone system for the elderly-care application is proposed. Based on the detailed analysis of the elderly’s physical and psychological characteristics, a TV-based caring videophone system for the elderly is developed: an embedded multimedia device is designed to implement the interactive video and audio processing and IP-based communication, in which TV is adopted as the display terminal to achieve a low-cost but high-quality service. Considering the user’s convenience, many personalized designs, such as photo-based address book, photo-click-dialing, and touch pad based remote controller, are developed to make the proposed videophone system more intuitive and easy to use for the elderly. Based on Support Vector Machine (SVM algorithms, an evaluation model is also developed with the data collected from the embedded multimedia device. It is useful to evaluate the physical and psychological health of the elderly.

Enhancement of global flood damage assessments using building material based vulnerability curves

Science.gov (United States)

Englhardt, Johanna; de Ruiter, Marleen; de Moel, Hans; Aerts, Jeroen

2017-04-01

This study discusses the development of an enhanced approach for flood damage and risk assessments using vulnerability curves that are based on building material information. The approach draws upon common practices in earthquake vulnerability assessments, and is an alternative for land-use or building occupancy approach in flood risk assessment models. The approach is of particular importance for studies where there is a large variation in building material, such as large scale studies or studies in developing countries. A case study of Ethiopia is used to demonstrate the impact of the different methodological approaches on direct damage assessments due to flooding. Generally, flood damage assessments use damage curves for different land-use or occupancy types (i.e. urban or residential and commercial classes). However, these categories do not necessarily relate directly to vulnerability of damage by flood waters. For this, the construction type and building material may be more important, as is used in earthquake risk assessments. For this study, we use building material classification data of the PAGER1 project to define new building material based vulnerability classes for flood damage. This approach will be compared to the widely applied land-use based vulnerability curves such as used by De Moel et al. (2011). The case of Ethiopia demonstrates and compares the feasibility of this novel flood vulnerability method on a country level which holds the potential to be scaled up to a global level. The study shows that flood vulnerability based on building material also allows for better differentiation between flood damage in urban and rural settings, opening doors to better link to poverty studies when such exposure data is available. Furthermore, this new approach paves the road to the enhancement of multi-risk assessments as the method enables the comparison of vulnerability across different natural hazard types that also use material-based vulnerability curves

A systematic review on community-based interventions for elder abuse and neglect.

Science.gov (United States)

Fearing, Gwendolyn; Sheppard, Christine L; McDonald, Lynn; Beaulieu, Marie; Hitzig, Sander L

2017-03-01

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.

The Millennium Development Goals in the millennium of the elderly

OpenAIRE

Anna Cruz de Araujo P. Silva; Hilton P. Silva

2013-01-01

The "Millennium Development Goals" (MDG) synthetize eight objectives assumed internationally to the improvement of the quality of life on this planet until 2015. Such expectations, however, do not take into consideration that there is a substantial contingent of vulnerable elderly. Even though the MDG do not address directly the elderly, a comprehensive reading, considering the emerging populational pattern, allows the inclusion of directives and actions geared to them, making urgent the inte...

Construction of road network vulnerability evaluation index based on general travel cost

Science.gov (United States)

Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

2018-03-01

With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

A population-based study of cognitive impairment in socially vulnerable adults in Argentina. The Matanza Riachuelo study preliminary results

Science.gov (United States)

Bartoloni, Leonardo; Blatt, Graciela; Insua, Iván; Furman, Mariano; González, María Agustina; Hermann, Bárbara; Kesselman, Mariana; Massautis, Alicia; Reinado, Alejandra; Senas, Patricia; Yavitz, Claudia; Lejarraga, Horacio; Nunes, Fernando; Arizaga, Raúl Luciano; Allegri, Ricardo F

2014-01-01

Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. Objective The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. Methods A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment-no dementia (CIND) and dementia. Results and Conclusions A total of 2437 elderly persons were assessed, of which 73.6% fulfilled inclusion criteria. The prevalence of CI among those over 60 was 26.4% (18.1% CIND and 8.3% dementia) with higher prevalence of dementia in younger individuals than rates reported in developed counties, probably due to low control of vascular risk factors. This information can help inform health public decisions in the generation of programs and plans for the prevention, diagnosis and treatment of cognitive impairment in this type of socially vulnerable population. PMID:29213923

Adverse effects of outdoor pollution in the elderly.

Science.gov (United States)

Simoni, Marzia; Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

2015-01-01

With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure

Elder abuse within the family environment in the Azores Islands 1

OpenAIRE

Carmona-Torres, Juan Manuel; Carvalhal-Silva, Rosa María; Viera-Mendes, Maria Helena; Recio-Andrade, Beatriz; Goergen, Thomas; Rodríguez-Borrego, María Aurora

2017-01-01

ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment ...

A user exposure based approach for non-structural road network vulnerability analysis.

Directory of Open Access Journals (Sweden)

Lei Jin

Full Text Available Aiming at the dense urban road network vulnerability without structural negative consequences, this paper proposes a novel non-structural road network vulnerability analysis framework. Three aspects of the framework are mainly described: (i the rationality of non-structural road network vulnerability, (ii the metrics for negative consequences accounting for variant road conditions, and (iii the introduction of a new vulnerability index based on user exposure. Based on the proposed methodology, a case study in the Sioux Falls network which was usually threatened by regular heavy snow during wintertime is detailedly discussed. The vulnerability ranking of links of Sioux Falls network with respect to heavy snow scenario is identified. As a result of non-structural consequences accompanied by conceivable degeneration of network, there are significant increases in generalized travel time costs which are measurements for "emotionally hurt" of topological road network.

Comparison analysis on vulnerability of metro networks based on complex network

Science.gov (United States)

Zhang, Jianhua; Wang, Shuliang; Wang, Xiaoyuan

2018-04-01

This paper analyzes the networked characteristics of three metro networks, and two malicious attacks are employed to investigate the vulnerability of metro networks based on connectivity vulnerability and functionality vulnerability. Meanwhile, the networked characteristics and vulnerability of three metro networks are compared with each other. The results show that Shanghai metro network has the largest transport capacity, Beijing metro network has the best local connectivity and Guangzhou metro network has the best global connectivity, moreover Beijing metro network has the best homogeneous degree distribution. Furthermore, we find that metro networks are very vulnerable subjected to malicious attacks, and Guangzhou metro network has the best topological structure and reliability among three metro networks. The results indicate that the proposed methodology is feasible and effective to investigate the vulnerability and to explore better topological structure of metro networks.

Grid Transmission Expansion Planning Model Based on Grid Vulnerability

Science.gov (United States)

Tang, Quan; Wang, Xi; Li, Ting; Zhang, Quanming; Zhang, Hongli; Li, Huaqiang

2018-03-01

Based on grid vulnerability and uniformity theory, proposed global network structure and state vulnerability factor model used to measure different grid models. established a multi-objective power grid planning model which considering the global power network vulnerability, economy and grid security constraint. Using improved chaos crossover and mutation genetic algorithm to optimize the optimal plan. For the problem of multi-objective optimization, dimension is not uniform, the weight is not easy given. Using principal component analysis (PCA) method to comprehensive assessment of the population every generation, make the results more objective and credible assessment. the feasibility and effectiveness of the proposed model are validated by simulation results of Garver-6 bus system and Garver-18 bus.

Outcome-based health equity across different social health insurance schemes for the elderly in China.

Science.gov (United States)

Liu, Xiaoting; Wong, Hung; Liu, Kai

2016-01-14

status. The results indicate that fragmented health insurance schemes generate inequitable health care utilization and health outcomes for the elderly. This study re-emphasizes the importance of reforming health insurance systems based on their health outcome rather than entitlement, which will particularly benefit the most vulnerable older groups.

Creating Community Resilience Through Elder-Led Physical and Social Infrastructure.

Science.gov (United States)

Aldrich, Daniel P; Kyota, Emi

2017-02-01

Natural disasters and rapidly aging populations are chronic problems for societies worldwide. We investigated the effects of an intervention in Japan known as Ibasho, which embeds elderly residents in vulnerable areas within larger social networks and encourages them to participate in leadership activities. This project sought to deepen the connections of these elderly residents to society and to build elderly leadership and community capacity for future crises. We carried out surveys of participants and nonparticipant residents across the city of Ofunato in Tohoku, Japan, 1 year after the intervention began. Our surveys included questions assessing participation levels in Ibasho, demographic characteristics, efficacy, social networks, and a sense of belonging. Regression analysis and propensity score matching of more than 1100 respondents showed that regular participation in the Ibasho project had a statistically significant and positive connection with various measures of social capital. Given its relatively low cost and focus on deepening cohesion, we suggest that this community-based project could be replicated and scaled up in other countries to deepen resilience, elder health, and social capital. Moving away from an emphasis on investing in physical infrastructure, we believe that disaster risk reduction strategies should center on social infrastructure. (Disaster Med Public Health Preparedness. 2017;11:120-126).

Association Between Home Visit Programs and Emergency Preparedness Among Elderly Vulnerable People in New South Wales, Australia

Directory of Open Access Journals (Sweden)

W. Kathy Tannous PhD

2017-03-01

Full Text Available Objective: The purpose of this study is to examine the association between home visit programs and emergency preparedness among elderly vulnerable people in New South Wales, Australia. Method: The study used data acquired from an intervention program run by emergency agencies and consisted of 370 older people. Seven emergency outcome measures were examined by adjusting for key demographic factors, using a generalized estimating equation model, to examine the association between home visit programs and emergency preparedness. Results: The study revealed that knowledge demonstrated by participants during visits and post home visits showed significant improvements in the seven emergency outcome measures. The odds of finding out what emergencies might affect one’s area were significantly lower among older participants who were born outside Australia and those who were women. Discussion: The findings suggest that the intervention via home visits and periodic reminders post these visits may be a useful intervention in improving emergency preparedness among older people, especially among men and those who were born outside of Australia. In addition, other reminders such as safety messaging via mobile or landline telephone calls may also be a supplementary and useful intervention to improve emergency preparedness among older people.

Correlates of symptomatic, minor and major depression in the elderly

NARCIS (Netherlands)

Van den Berg, MD; Oldehinkel, AJ; Brilman, EI; Bouhuys, AL; Ormel, J

2000-01-01

Background: Associations between different types of depression with clinical characteristics and putative vulnerability factors from several domains (health, disability, personality, familial psychopathology) were studied in a sample of elderly subjects, in order to find arguments that support or

Climate change and health: Indoor heat exposure in vulnerable populations

International Nuclear Information System (INIS)

White-Newsome, Jalonne L.; Sánchez, Brisa N.; Jolliet, Olivier; Zhang, Zhenzhen; Parker, Edith A.; Timothy Dvonch, J.; O'Neill, Marie S.

2012-01-01

Introduction: Climate change is increasing the frequency of heat waves and hot weather in many urban environments. Older people are more vulnerable to heat exposure but spend most of their time indoors. Few published studies have addressed indoor heat exposure in residences occupied by an elderly population. The purpose of this study is to explore the relationship between outdoor and indoor temperatures in homes occupied by the elderly and determine other predictors of indoor temperature. Materials and methods: We collected hourly indoor temperature measurements of 30 different homes; outdoor temperature, dewpoint temperature, and solar radiation data during summer 2009 in Detroit, MI. We used mixed linear regression to model indoor temperatures' responsiveness to weather, housing and environmental characteristics, and evaluated our ability to predict indoor heat exposures based on outdoor conditions. Results: Average maximum indoor temperature for all locations was 34.85 °C, 13.8 °C higher than average maximum outdoor temperature. Indoor temperatures of single family homes constructed of vinyl paneling or wood siding were more sensitive than brick homes to outdoor temperature changes and internal heat gains. Outdoor temperature, solar radiation, and dewpoint temperature predicted 38% of the variability of indoor temperatures. Conclusions: Indoor exposures to heat in Detroit exceed the comfort range among elderly occupants, and can be predicted using outdoor temperatures, characteristics of the housing stock and surroundings to improve heat exposure assessment for epidemiological investigations. Weatherizing homes and modifying home surroundings could mitigate indoor heat exposure among the elderly.

The role of the dermatologist in detecting elder abuse and neglect.

Science.gov (United States)

Danesh, Melissa J; Chang, Anne Lynn S

2015-08-01

The National Research Council of the National Academies defines elder mistreatment as: (1) intentional actions that cause harm or create serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder; or (2) failure by a caregiver to satisfy the elder's basic needs or to protect the elder from harm. Estimates of the prevalence of elder abuse have ranged from 2.2% to 18.4%. Dermatologists are uniquely positioned to identify and manage suspected cases of elder abuse given their expertise in distinguishing skin lesions of abuse from organic medical disease and their patient populations with strong elderly representation. This article discusses aspects of both the screening and management of elder abuse with particular relevance to dermatologists. Like physicians across medical specialties, dermatologists must be familiar with those aspects of elder abuse in screening, diagnosis, management, and reporting that are unique to their field and to those aspects that are applicable to all health care providers. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Environmental vulnerability assessment using Grey Analytic Hierarchy Process based model

International Nuclear Information System (INIS)

Sahoo, Satiprasad; Dhar, Anirban; Kar, Amlanjyoti

2016-01-01

Environmental management of an area describes a policy for its systematic and sustainable environmental protection. In the present study, regional environmental vulnerability assessment in Hirakud command area of Odisha, India is envisaged based on Grey Analytic Hierarchy Process method (Grey–AHP) using integrated remote sensing (RS) and geographic information system (GIS) techniques. Grey–AHP combines the advantages of classical analytic hierarchy process (AHP) and grey clustering method for accurate estimation of weight coefficients. It is a new method for environmental vulnerability assessment. Environmental vulnerability index (EVI) uses natural, environmental and human impact related factors, e.g., soil, geology, elevation, slope, rainfall, temperature, wind speed, normalized difference vegetation index, drainage density, crop intensity, agricultural DRASTIC value, population density and road density. EVI map has been classified into four environmental vulnerability zones (EVZs) namely: ‘low’, ‘moderate’ ‘high’, and ‘extreme’ encompassing 17.87%, 44.44%, 27.81% and 9.88% of the study area, respectively. EVI map indicates that the northern part of the study area is more vulnerable from an environmental point of view. EVI map shows close correlation with elevation. Effectiveness of the zone classification is evaluated by using grey clustering method. General effectiveness is in between “better” and “common classes”. This analysis demonstrates the potential applicability of the methodology. - Highlights: • Environmental vulnerability zone identification based on Grey Analytic Hierarchy Process (AHP) • The effectiveness evaluation by means of a grey clustering method with support from AHP • Use of grey approach eliminates the excessive dependency on the experience of experts.

Environmental vulnerability assessment using Grey Analytic Hierarchy Process based model

Energy Technology Data Exchange (ETDEWEB)

Sahoo, Satiprasad [School of Water Resources, Indian Institute of Technology Kharagpur (India); Dhar, Anirban, E-mail: anirban.dhar@gmail.com [Department of Civil Engineering, Indian Institute of Technology Kharagpur (India); Kar, Amlanjyoti [Central Ground Water Board, Bhujal Bhawan, Faridabad, Haryana (India)

2016-01-15

Environmental management of an area describes a policy for its systematic and sustainable environmental protection. In the present study, regional environmental vulnerability assessment in Hirakud command area of Odisha, India is envisaged based on Grey Analytic Hierarchy Process method (Grey–AHP) using integrated remote sensing (RS) and geographic information system (GIS) techniques. Grey–AHP combines the advantages of classical analytic hierarchy process (AHP) and grey clustering method for accurate estimation of weight coefficients. It is a new method for environmental vulnerability assessment. Environmental vulnerability index (EVI) uses natural, environmental and human impact related factors, e.g., soil, geology, elevation, slope, rainfall, temperature, wind speed, normalized difference vegetation index, drainage density, crop intensity, agricultural DRASTIC value, population density and road density. EVI map has been classified into four environmental vulnerability zones (EVZs) namely: ‘low’, ‘moderate’ ‘high’, and ‘extreme’ encompassing 17.87%, 44.44%, 27.81% and 9.88% of the study area, respectively. EVI map indicates that the northern part of the study area is more vulnerable from an environmental point of view. EVI map shows close correlation with elevation. Effectiveness of the zone classification is evaluated by using grey clustering method. General effectiveness is in between “better” and “common classes”. This analysis demonstrates the potential applicability of the methodology. - Highlights: • Environmental vulnerability zone identification based on Grey Analytic Hierarchy Process (AHP) • The effectiveness evaluation by means of a grey clustering method with support from AHP • Use of grey approach eliminates the excessive dependency on the experience of experts.

Pharmacological Management of Anxiety Disorders in the Elderly

Science.gov (United States)

Crocco, Elizabeth A.; Jaramillo, Sindy; Cruz-Ortiz, Caroline; Camfield, Katherine

2017-01-01

Opinion Statement Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction. Those antidepressants with more favorable pharmacokinetic profiles should be considered first-line in the treatment of anxiety. Mirtazapine and vortioxetine are also considered safe treatment options. Buspirone may have benefit, but lacks studies in elderly populations. Although tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be effective in the elderly, their side effect and safety profiles are suboptimal and thus are not recommended in late-life. Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term. In addition, antipsychotics have a black box warning for increased mortality in elderly patients with dementia. PMID:28948135

"Gray murder": characteristics of elderly compared with nonelderly homicide victims in New York City.

Science.gov (United States)

Abrams, Robert C; Leon, Andrew C; Tardiff, Kenneth; Marzuk, Peter M; Sutherland, Kari

2007-09-01

We compared characteristics of homicides among New York City residents aged 18 years and older from 1990 to 1998 to determine differences in demographics, cause and place of death, and presence of illicit drugs and alcohol in the deceased's system. All medical examiner-certified homicides among New York City residents aged 18 years and older from 1990 to 1998 were studied (n = 11,850). Nonelderly (aged 18 to 64 years) and elderly (aged 65 years and older) victims were compared by gender, race/ethnicity, cause of death, place of death, and presence of illicit drugs or alcohol. Population-based homicide rates stratified by age, gender, and race were also calculated. Nonelderly homicide victims were significantly more likely to be male, non-White, to have been shot in the city streets, and to have evidence of illicit drug or alcohol use. Elderly victims were more likely to be female, White, to have been killed by nonfirearm injuries, and to have been killed in their own homes. The gender and race differences between age groups remained but were attenuated when population-based rates were compared. The characteristics of homicide in nonelderly adults do not apply to elderly adults in New York City. Demographic factors and vulnerabilities of the elderly may underlie these differences, pointing to the need for oversight of isolated or homebound elderly persons and for protective interventions.

The Crossing Speed of Elderly Pedestrians

Directory of Open Access Journals (Sweden)

Ana Trpković

2017-04-01

Full Text Available The population of elderly people is rapidly growing and in terms of safety, senior pedestrians represent one of the most vulnerable group. The pedestrian crossing speed is a significant input parameter in traffic engineering, which can have effect on pedestrians’ safety, especially of older population. The objective of this study was to determine the value of the crossing speed of elderly pedestrians (65+ for different types of urban crossings. The research was conducted at ten intersections in the city of Belgrade, Serbia, using the method of direct observation and a questionnaire for collecting data. The data were analysed in the statistical software package IBM SPSS Statistics. The results showed that elderly pedestrians walk slower and the crossing type significantly influenced the speed of older population. The order of crossing types in relation to the measured speed is ranked as follows, from the lowest to the highest speed value: unsignalized, signalized, signalized with pedestrian countdown display, signalized with pedestrian island and pedestrian countdown display and finally signalized crossing with pedestrian island. According to the questionnaire results, the elderly recognize the importance of implementing pedestrian counters. This indicates the necessity to provide safe street crossing for the elderly using the corresponding engineering measures.

Legislative vulnerability of minority groups.

Science.gov (United States)

Paula, Carlos Eduardo Artiaga; Silva, Ana Paula da; Bittar, Cléria Maria Lôbo

2017-12-01

Minorities are in an inferior position in society and therefore vulnerable in many aspects. This study analyzes legislative vulnerability and aims to categorize as "weak" or "strong" the protection conferred by law to the following minorities: elderly, disabled, LGBT, Indians, women, children/ adolescents and black people. In order to do so, it was developed a documental research in 30 federal laws in which legal provisions were searched to protect minorities. Next, the articles were organized in the following categories: civil, criminal, administrative, labor and procedural, to be analyzed afterwards. Legal protection was considered "strong" when there were legal provisions that observed the five categories and "weak" when it did not meet this criterion. It was noted that six groups have "strong" legislative protection, which elides the assertion that minorities are outside the law. The exception is the LGBT group, whose legislative protection is weak. In addition, consecrating rights through laws strengthens the institutional channels for minorities to demand their rights. Finally, it was observed that the legislative protection granted tominorities is not homogeneous but rather discriminatory, and there is an interference by the majority group in the rights regulation of vulnerable groups.

Development of skills-based competencies for forensic nurse examiners providing elder abuse care

Science.gov (United States)

Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark

2016-01-01

Objective As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Participants and setting Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. Primary and secondary outcome measures 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Results Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. Conclusions We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component

Development of skills-based competencies for forensic nurse examiners providing elder abuse care.

Science.gov (United States)

Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark

2016-02-10

As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component that are considering the provision of a dedicated response to the abuse of older women and men

Effect of Islam-based religious program on spiritual wellbeing in elderly with hypertension

Directory of Open Access Journals (Sweden)

Mahin Moeini

2016-01-01

Conclusions: The religious program based on Islam promoted the SWB of elderly patients with hypertension; further, nurses can use these programs to promote the SWB of elderly patients with hypertension.

Intelligent Furniture Design in the Elderly Based on the Cognitive Situation

Directory of Open Access Journals (Sweden)

Lu Xinhui

2017-01-01

Full Text Available This paper analyzes the present situation of Chinese elderly furniture and the elderly has cognitive characteristics that consciousness experiences and recognitions recede, cognitive fuzzy from Information processing. Expounds the elderly intelligent furniture design elements: functional elements required the elderly furniture is easy and simple to handle; Size and shape elements should be biased towards low, light type, reduce multifunction or fold function; colour collocation should use low lightness and low purity natural materials; Emotional elements design should meet the demand of the elderly social emotion. Introduction of intelligent furniture make up the cognitive decline in the elderly, Furniture judge the elderly demand by the inductor, Supplement by hardware control module to solve the special needs of the elderly life. Build design thinking based on the cognitive process and explore the elderly intelligent furniture design. This paper discusses the design process, for example and concludes the design rules: 1.The Operating Experience Pleasure. It is the height matching of user expectation and furniture function. Pleasure in the design of the operating parts mainly embodies in two aspects. Firstly, the Fitts Law; Secondly, it’s The Movement Optimization. 2.”Unconscious” Design. Intelligent furniture need to delete unnecessary operation module, make it easy to understand, furniture function and cognitive scene match with each other. 3. Modularity Design. Modularization can indirectly regulate the scale and specification of the design. Under the premise of individual character, customization, the compression of the cost, Designer should make the elderly intelligent furniture consistent with the user action.4.Design Consistency. The consistency principle reflected in the appearance, color and operation way consistency.

Adverse effects of outdoor pollution in the elderly

Science.gov (United States)

Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

2015-01-01

With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure

Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

Science.gov (United States)

Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

2007-01-01

The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning

Road Network Vulnerability Analysis Based on Improved Ant Colony Algorithm

Directory of Open Access Journals (Sweden)

Yunpeng Wang

2014-01-01

Full Text Available We present an improved ant colony algorithm-based approach to assess the vulnerability of a road network and identify the critical infrastructures. This approach improves computational efficiency and allows for its applications in large-scale road networks. This research involves defining the vulnerability conception, modeling the traffic utility index and the vulnerability of the road network, and identifying the critical infrastructures of the road network. We apply the approach to a simple test road network and a real road network to verify the methodology. The results show that vulnerability is directly related to traffic demand and increases significantly when the demand approaches capacity. The proposed approach reduces the computational burden and may be applied in large-scale road network analysis. It can be used as a decision-supporting tool for identifying critical infrastructures in transportation planning and management.

Index-based groundwater vulnerability mapping models using hydrogeological settings: A critical evaluation

International Nuclear Information System (INIS)

Kumar, Prashant; Bansod, Baban K.S.; Debnath, Sanjit K.; Thakur, Praveen Kumar; Ghanshyam, C.

2015-01-01

Groundwater vulnerability maps are useful for decision making in land use planning and water resource management. This paper reviews the various groundwater vulnerability assessment models developed across the world. Each model has been evaluated in terms of its pros and cons and the environmental conditions of its application. The paper further discusses the validation techniques used for the generated vulnerability maps by various models. Implicit challenges associated with the development of the groundwater vulnerability assessment models have also been identified with scientific considerations to the parameter relations and their selections. - Highlights: • Various index-based groundwater vulnerability assessment models have been discussed. • A comparative analysis of the models and its applicability in different hydrogeological settings has been discussed. • Research problems of underlying vulnerability assessment models are also reported in this review paper

Index-based groundwater vulnerability mapping models using hydrogeological settings: A critical evaluation

Energy Technology Data Exchange (ETDEWEB)

Kumar, Prashant, E-mail: prashantkumar@csio.res.in [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India); Bansod, Baban K.S.; Debnath, Sanjit K. [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India); Thakur, Praveen Kumar [Indian Institute of Remote Sensing (ISRO), Dehradun 248001 (India); Ghanshyam, C. [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India)

2015-02-15

Groundwater vulnerability maps are useful for decision making in land use planning and water resource management. This paper reviews the various groundwater vulnerability assessment models developed across the world. Each model has been evaluated in terms of its pros and cons and the environmental conditions of its application. The paper further discusses the validation techniques used for the generated vulnerability maps by various models. Implicit challenges associated with the development of the groundwater vulnerability assessment models have also been identified with scientific considerations to the parameter relations and their selections. - Highlights: • Various index-based groundwater vulnerability assessment models have been discussed. • A comparative analysis of the models and its applicability in different hydrogeological settings has been discussed. • Research problems of underlying vulnerability assessment models are also reported in this review paper.

Elder abuse within the family environment in the Azores Islands

Directory of Open Access Journals (Sweden)

Juan Manuel Carmona-Torres

2017-09-01

Full Text Available ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment Form. Descriptive statistical analysis was used for qualitative and quantitative variables and multiple logistic regression was used to identify factors associated with elder mistreatment. Results: abuse suspicion was identified in 24.5% of elderly participants. Psychological abuse was the most common type of abuse and sons were the main abusers. Conclusion: being a woman and belonging to a dysfunctional family is associated with an increased risk of becoming a victim of abuse; the high level of domestic violence against the elderly in the Azores Islands is in line with the rest of Portugal.

Communication in dental medicine: importance in motivating elderly dental patients.

Science.gov (United States)

Scutariu, Mihaela Monica; Forna, Norina

2013-01-01

Dental services for elderly patients are characterized by a series of particularities related to the vulnerability of this age group, which is affected by various co morbidities, and the diminished physical, cognitive and financial capacities. Finding ways to keep elderly patients coming to a dental office is possible by improving the dentist-patient relationship and implicitly the quality of care by increasing the self-esteem of the elderly and their place in society, by increasing the role of oral health in the quality of life, and here we refer to the pleasure of eating, the pleasant physical aspect and normal diction. The present paper presents the psychological aspects that interfere in the communication process between the dentist and the elderly patient and the changes motivation undergoes when people are in pain. These data can sometimes change the reticent attitude of the dentist towards the elderly patient which is often considered to be a risk patient.

DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

Directory of Open Access Journals (Sweden)

Tanushree

2016-03-01

Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

Developing Quality of Care Indicators for the Vulnerable Elderly: The ACOVE Project

National Research Council Canada - National Science Library

2004-01-01

.... Furthermore, the goal of medical care for the elderly has progressed beyond survival to maximizing quality of life, yet little attention has been paid to the overall quality of medical care that older people receive...

Flow-based vulnerability measures for network component importance: Experimentation with preparedness planning

International Nuclear Information System (INIS)

Nicholson, Charles D.; Barker, Kash; Ramirez-Marquez, Jose E.

2016-01-01

This work develops and compares several flow-based vulnerability measures to prioritize important network edges for the implementation of preparedness options. These network vulnerability measures quantify different characteristics and perspectives on enabling maximum flow, creating bottlenecks, and partitioning into cutsets, among others. The efficacy of these vulnerability measures to motivate preparedness options against experimental geographically located disruption simulations is measured. Results suggest that a weighted flow capacity rate, which accounts for both (i) the contribution of an edge to maximum network flow and (ii) the extent to which the edge is a bottleneck in the network, shows most promise across four instances of varying network sizes and densities. - Highlights: • We develop new flow-based measures of network vulnerability. • We apply these measures to determine the importance of edges after disruptions. • Networks of varying size and density are explored.

Comparisons of complex network based models and real train flow model to analyze Chinese railway vulnerability

International Nuclear Information System (INIS)

Ouyang, Min; Zhao, Lijing; Hong, Liu; Pan, Zhezhe

2014-01-01

Recently numerous studies have applied complex network based models to study the performance and vulnerability of infrastructure systems under various types of attacks and hazards. But how effective are these models to capture their real performance response is still a question worthy of research. Taking the Chinese railway system as an example, this paper selects three typical complex network based models, including purely topological model (PTM), purely shortest path model (PSPM), and weight (link length) based shortest path model (WBSPM), to analyze railway accessibility and flow-based vulnerability and compare their results with those from the real train flow model (RTFM). The results show that the WBSPM can produce the train routines with 83% stations and 77% railway links identical to the real routines and can approach the RTFM the best for railway vulnerability under both single and multiple component failures. The correlation coefficient for accessibility vulnerability from WBSPM and RTFM under single station failures is 0.96 while it is 0.92 for flow-based vulnerability; under multiple station failures, where each station has the same failure probability fp, the WBSPM can produce almost identical vulnerability results with those from the RTFM under almost all failures scenarios when fp is larger than 0.62 for accessibility vulnerability and 0.86 for flow-based vulnerability

Assessing socioeconomic vulnerability to dengue fever in Cali, Colombia: statistical vs expert-based modeling.

Science.gov (United States)

Hagenlocher, Michael; Delmelle, Eric; Casas, Irene; Kienberger, Stefan

2013-08-14

As a result of changes in climatic conditions and greater resistance to insecticides, many regions across the globe, including Colombia, have been facing a resurgence of vector-borne diseases, and dengue fever in particular. Timely information on both (1) the spatial distribution of the disease, and (2) prevailing vulnerabilities of the population are needed to adequately plan targeted preventive intervention. We propose a methodology for the spatial assessment of current socioeconomic vulnerabilities to dengue fever in Cali, a tropical urban environment of Colombia. Based on a set of socioeconomic and demographic indicators derived from census data and ancillary geospatial datasets, we develop a spatial approach for both expert-based and purely statistical-based modeling of current vulnerability levels across 340 neighborhoods of the city using a Geographic Information System (GIS). The results of both approaches are comparatively evaluated by means of spatial statistics. A web-based approach is proposed to facilitate the visualization and the dissemination of the output vulnerability index to the community. The statistical and the expert-based modeling approach exhibit a high concordance, globally, and spatially. The expert-based approach indicates a slightly higher vulnerability mean (0.53) and vulnerability median (0.56) across all neighborhoods, compared to the purely statistical approach (mean = 0.48; median = 0.49). Both approaches reveal that high values of vulnerability tend to cluster in the eastern, north-eastern, and western part of the city. These are poor neighborhoods with high percentages of young (i.e., local expertise, statistical approaches could be used, with caution. By decomposing identified vulnerability "hotspots" into their underlying factors, our approach provides valuable information on both (1) the location of neighborhoods, and (2) vulnerability factors that should be given priority in the context of targeted intervention

Older women's health and financial vulnerability: implications of the Medicare benefit structure.

Science.gov (United States)

Sofaer, S; Abel, E

1990-01-01

Elderly women and men have different patterns of disease and utilize health services differently. This essay examines the extent to which Medicare covers the specific conditions and services associated with women and men. Elderly women experience higher rates of poverty than elderly men; consequently, elderly women are especially likely to be unable to pay high out-of-pocket costs for health care. Using a new method for simulating out-of-pocket costs, the Illness Episode Approach, the essay shows that Medicare provides better coverage for illnesses which predominate among men than for those which predominate among women. In addition, women on Medicare who supplement their basic coverage by purchasing a typical private insurance "Medigap" policy do not receive as much of an advantage from their purchases as do men. The calculations also show that the Medicare Catastrophic Coverage Act would have had little impact on the gender gap in financial vulnerability.

Assessment of Family Functionality Among the Elderly With Chronic Illness

Directory of Open Access Journals (Sweden)

Claudia Balula Chaves

2013-12-01

Full Text Available The family APGAR scale was developed by Smilkstein, Ashworth, and Montano (1982. The satisfaction assessment of the elderly with chronic illness regarding family is essential. This study aims to describe the socio-demographic and clinical profile of elderly people with chronic illness and correlate with perceived family support. This is a cross-sectional, analytical study of 294 elderly people (51.4% female, patients at the Health Centre in the district of Viseu - Portugal, diagnosed with chronic illness (77.9% cardiovascular; Mean age was 72.22 ± 6.13, 70.7% were married and 52% had 4 years of schooling; Data was gathered using a questionnaire and the Family APGAR (Adaptation, Partnership, Growth, Affection and Resolve. In relation to family functionality, 18.7% perceive families as highly functional, 26.9% mildly dysfunctional and 54.4% severely dysfunction. There is a statistically significant relationship between the family APGAR and the presence of chronic illness (p < 0.001. We found no statistical significance between the family APGAR and gender (p = 0.26, age (p = 0.26, marital status (p = 0.32 and educational level (p = 0.28. Economic, political and social changes in our society has an impact on the family and the support they provide which is manifested among vulnerable groups, as is the case of an elderly person with chronic illness. Thus, we propose specialised psychological support for this age group which is more vulnerable and without the needed support from within the family.

HEALTH STATUS OF ELDERLY A COMMUNITY BASED STUDY

Directory of Open Access Journals (Sweden)

Vartika Saxena

2013-01-01

Full Text Available Background: People at or over the age of 60, constitute above 7.7% of total population. Traditionally this segment of population depends on their children for their health and social welfare, However owing to the social and cultural changes that are taking place within the Indian society, this support may not be as readily available, as it is believed. With the changing demography of India, there is urgent need to look at the health status of elderly for planning appropriate health facilities for them. Objectives: To study biosocial, nutritional and chronic disease risk factor profile of elderly population. Methods: Cross-sectional Study was conducted in Doiwala block of Dehradun district, Uttarakhand. 122 elderly persons of age 60 years and above were interviewed on predesigned questionnaire by house to house visit in the selected village. Results: Overall prevalence of risk factors found to be higher amongst elderly females. Unutrition was higher amongst elderly males. In all, 48.6% elderly were underweight ,10.3% were overweight and 5.6% cases were in obese category. As per the Waist and hip ratio 47.2% elderly belonged to the moderate to high risk category. 30.8% people were hypertensive. Conclusions: Prevalence of high-risk factors for chronic diseases is quite high amongst elderly population, especially amongst elderly females.

Elder abuse: The role of general practitioners in community-based screening and multidisciplinary action

Science.gov (United States)

Ries, Nola M; Mansfield, Elise

2018-04-01

There are growing calls for elder abuse screening to be conducted by a range of community-based service providers, including general practitioners (GPs), practice nurses, home care workers and lawyers. Improved screening may be a valuable first step towards improving elder abuse detection and response; however, practitioners need evidence-based strategies for screening and follow-up. This article summarises several brief screening tools for various forms of elder abuse. Screening tool properties and evidence gaps are noted. As elder abuse often requires multidisciplinary responses, initiatives to connect health, legal and other service providers are highlighted. GPs are trusted professionals who are well placed to identify older patients at risk of, or experiencing, various forms of abuse. They should be aware of available screening tools and consider how best to incorporate them into their own practice. They also play an important role in multidisciplinary action to address elder abuse.  .

Performance-based methodology for assessing seismic vulnerability and capacity of buildings

Science.gov (United States)

Shibin, Lin; Lili, Xie; Maosheng, Gong; Ming, Li

2010-06-01

This paper presents a performance-based methodology for the assessment of seismic vulnerability and capacity of buildings. The vulnerability assessment methodology is based on the HAZUS methodology and the improved capacitydemand-diagram method. The spectral displacement ( S d ) of performance points on a capacity curve is used to estimate the damage level of a building. The relationship between S d and peak ground acceleration (PGA) is established, and then a new vulnerability function is expressed in terms of PGA. Furthermore, the expected value of the seismic capacity index (SCev) is provided to estimate the seismic capacity of buildings based on the probability distribution of damage levels and the corresponding seismic capacity index. The results indicate that the proposed vulnerability methodology is able to assess seismic damage of a large number of building stock directly and quickly following an earthquake. The SCev provides an effective index to measure the seismic capacity of buildings and illustrate the relationship between the seismic capacity of buildings and seismic action. The estimated result is compared with damage surveys of the cities of Dujiangyan and Jiangyou in the M8.0 Wenchuan earthquake, revealing that the methodology is acceptable for seismic risk assessment and decision making. The primary reasons for discrepancies between the estimated results and the damage surveys are discussed.

The Relationship of Health Locus of Control, Perceived Health Status and Activity Levels of Non-Institutionalized Elderly Clients.

Science.gov (United States)

Speake, Dianne L.

Individuals of all ages need to maintain an active lifestyle to promote health. The physiological changes associated with aging, however, make the elderly especially vulnerable to disuse atrophy associated with inactivity. Exercise programs for the elderly are being established in increasing numbers, but high dropout rates from these programs…

Identifying typical patterns of vulnerability: A 5-step approach based on cluster analysis

Science.gov (United States)

Sietz, Diana; Lüdeke, Matthias; Kok, Marcel; Lucas, Paul; Carsten, Walther; Janssen, Peter

2013-04-01

Specific processes that shape the vulnerability of socio-ecological systems to climate, market and other stresses derive from diverse background conditions. Within the multitude of vulnerability-creating mechanisms, distinct processes recur in various regions inspiring research on typical patterns of vulnerability. The vulnerability patterns display typical combinations of the natural and socio-economic properties that shape a systems' vulnerability to particular stresses. Based on the identification of a limited number of vulnerability patterns, pattern analysis provides an efficient approach to improving our understanding of vulnerability and decision-making for vulnerability reduction. However, current pattern analyses often miss explicit descriptions of their methods and pay insufficient attention to the validity of their groupings. Therefore, the question arises as to how do we identify typical vulnerability patterns in order to enhance our understanding of a systems' vulnerability to stresses? A cluster-based pattern recognition applied at global and local levels is scrutinised with a focus on an applicable methodology and practicable insights. Taking the example of drylands, this presentation demonstrates the conditions necessary to identify typical vulnerability patterns. They are summarised in five methodological steps comprising the elicitation of relevant cause-effect hypotheses and the quantitative indication of mechanisms as well as an evaluation of robustness, a validation and a ranking of the identified patterns. Reflecting scale-dependent opportunities, a global study is able to support decision-making with insights into the up-scaling of interventions when available funds are limited. In contrast, local investigations encourage an outcome-based validation. This constitutes a crucial step in establishing the credibility of the patterns and hence their suitability for informing extension services and individual decisions. In this respect, working at

Vulnerability mapping in kelud volcano based on village information

Science.gov (United States)

Hisbaron, D. R.; Wijayanti, H.; Iffani, M.; Winastuti, R.; Yudinugroho, M.

2018-04-01

Kelud Volcano is a basaltic andesitic stratovolcano, situated at 27 km to the east of Kediri, Indonesia. Historically, Kelud Volcano has erupted with return period of 9-75 years, had caused nearly 160,000 people living in Tulungagung, Blitar and Kediri District to be in high-risk areas. This study aims to map vulnerability towards lava flows in Kediri and Malang using detailed scale. There are four major variables, namely demography, asset, hazard, and land use variables. PGIS (Participatory Geographic Information System) is employed to collect data, while ancillary data is derived from statistics information, interpretation of high resolution satellite imagery and Unmanned Aerial Vehicles (UAVs). Data were obtained from field checks and some from high resolution satellite imagery and UAVs. The output of this research is village-based vulnerability information that becomes a valuable input for local stakeholders to improve local preparedness in areas prone to improved disaster resilience. The results indicated that the highest vulnerability to lava flood disaster in Kelud Volcano is owned by Kandangan Hamlet, Pandean Hamlet and Kacangan Hamlet, because these two hamlets are in the dominant high vulnerability position of 3 out of 4 scenarios (economic, social and equal).

Socio-economic vulnerability to natural hazards - proposal for an indicator-based model

Science.gov (United States)

Eidsvig, U.; McLean, A.; Vangelsten, B. V.; Kalsnes, B.; Ciurean, R. L.; Argyroudis, S.; Winter, M.; Corominas, J.; Mavrouli, O. C.; Fotopoulou, S.; Pitilakis, K.; Baills, A.; Malet, J. P.

2012-04-01

Vulnerability assessment, with respect to natural hazards, is a complex process that must consider multiple dimensions of vulnerability, including both physical and social factors. Physical vulnerability refers to conditions of physical assets, and may be modeled by the intensity and magnitude of the hazard, the degree of physical protection provided by the natural and built environment, and the physical robustness of the exposed elements. Social vulnerability refers to the underlying factors leading to the inability of people, organizations, and societies to withstand impacts from the natural hazards. Social vulnerability models can be used in combination with physical vulnerability models to estimate both direct losses, i.e. losses that occur during and immediately after the impact, as well as indirect losses, i.e. long-term effects of the event. Direct impact of a landslide typically includes casualties and damages to buildings and infrastructure while indirect losses may e.g. include business closures or limitations in public services. The direct losses are often assessed using physical vulnerability indicators (e.g. construction material, height of buildings), while indirect losses are mainly assessed using social indicators (e.g. economical resources, demographic conditions). Within the EC-FP7 SafeLand research project, an indicator-based method was proposed to assess relative socio-economic vulnerability to landslides. The indicators represent the underlying factors which influence a community's ability to prepare for, deal with, and recover from the damage associated with landslides. The proposed model includes indicators representing demographic, economic and social characteristics as well as indicators representing the degree of preparedness and recovery capacity. Although the model focuses primarily on the indirect losses, it could easily be extended to include more physical indicators which account for the direct losses. Each indicator is individually

Falls among the elderly: risk factors in a population-based study.

Science.gov (United States)

Rodrigues, Iara Guimarães; Fraga, Gustavo Pereira; Barros, Marilisa Berti de Azevedo

2014-01-01

The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95% CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95% CI 1.61 - 3.88), widowed (PR = 1.74; 95% CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95% CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95% CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95% CI 1.09 - 2.74), headache (PR = 1.59; 95% CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95% CI 1.12 - 2.64), dizziness (PR = 2.82; 95% CI 1.98 - 4.02), insomnia (PR = 1.75; 95% CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95% CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95% CI 1.19 - 3,93). The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

Falls among the elderly: risk factors in a population-based study

Directory of Open Access Journals (Sweden)

Iara Guimarães Rodrigues

2014-09-01

Full Text Available Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008. Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI 1.47 - 3.87, elderly adults (80 years old and older (PR = 2.50; 95%CI 1.61 - 3.88, widowed (PR = 1.74; 95%CI 1.04 - 2.89 and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48, osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49, asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74, headache (PR = 1.59; 95%CI 1.07 - 2.38, mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64, dizziness (PR = 2.82; 95%CI 1.98 - 4.02, insomnia (PR = 1.75; 95%CI 1.16 - 2.65, use of multiple medications (five or more (PR = 2.50; 95%CI 1.12 - 5.56 and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93. Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

More important vulnerability to radiations among children and elderly people

International Nuclear Information System (INIS)

Anon.

1998-01-01

from the studies made on the Hiroshima inhabitants having survived to the atomic bombs explosions, M. Alice Stewart showed the danger of radiations for pregnant women, children and elderly people. She has estimated that the risk of dying of a neoplasm is multiplied by two for persons aged of more than 55 years, comparatively with others adults; But for children aged of less than ten years this risk is one thousand time superior than for fifty five years old people. (N.C.)

Needs of frail elderly people in informal settlements

Directory of Open Access Journals (Sweden)

P du Rand

2001-09-01

Full Text Available The frail elderly in informal settlements find themselves in an extremely vulnerable position due to a number of factors, namely, their increasing dependency status, limited resources and adverse physical environment. Various aspects that influence the aged in their present environment will be highlighted. A survey method was used to explore and to describe the world in which they live in informal areas. The attitude, expectation and needs of the elderly in respect of their care was also determined. A random cluster sample was taken. Data was collected by means of interviews in terms of a semi-structured questionnaire. It appears that the frail elderly were happy in the environment in which they received care in spite of their unfavourable physical environment and limited resources. The communities where the frail elderly lived were largely unaware of the valuable inputs they can make regarding the care of the aged. This necessitates the development of programs in the heart of communities, owned by communities, where all role players in the care of the aged participate.

High Fluoride Dentifrices for Elderly and Vulnerable Adults

DEFF Research Database (Denmark)

Ekstrand, Kim Rud

2016-01-01

The primary aim of this work is to present the available evidence that toothpastes containing >1,500 ppm fluoride (2,500-2,800 and 5,000 ppm F) provide an additional caries preventive effect on root caries lesions in elderly patients compared to traditional dentifrices (1,000-1,450 ppm F......). The secondary aim of this paper is to discuss why high fluoride dentifrices in general should perform better than traditional F-containing toothpaste. When examining the few studies that have considered the preventive benefits of high fluoride products on root caries the relative risk appears to be around 0.......5, and the risk can thus be halved by exchanging traditional F-containing toothpaste for toothpaste containing 5,000 ppm F. There is reasonable evidence that high fluoride dentifrices significantly increase the fluoride concentration in saliva during the day and the fluoride concentration in plaque compared...

Variations of Aripiprazole-Induced Dyskinesia Existing with Concurrent Use of Amantadine and an Anticholinergic Agent in an Elderly Patient

Directory of Open Access Journals (Sweden)

I-Wen Sun

2012-06-01

Full Text Available Elderly patients are vulnerable to the adverse neurological effects of antipsychotics, particularly Parkinsonian symptoms and tardive dyskinesia. This vulnerability in the elderly becomes complex and unpredictable when aripiprazole is prescribed to replace other second-generation or first-generation antipsychotics. This report describes a 69-year-old female schizophrenic patient, who received aripiprazole after using a few antipsychotics, including the first- and second-generation ones. The tardive dyskinesia developed 6 weeks after switching to aripiprazole but subsided 4 weeks later when stopping the concurrent amantadine and decreasing the dosage of trihexyphenidyl. However, Parkinsonian symptoms developed insidiously thereafter, which remitted after the dosage of trihexyphenidyl was increased again. The possible mechanisms of the alternated adverse neurological events after a switch to aripiprazole in the chronic elderly psychosis are discussed.

Falls in the community-dwelling elderly with a history of cancer.

Science.gov (United States)

Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

2010-01-01

Falls place older adults at risk for injuries, resulting in functional decline, hospitalization, institutionalization, higher healthcare costs, and decreased quality of life. This study examined community-dwelling elderly to identify if individuals with a history of cancer fall at a higher rate than those without cancer, and if the occurrence of falls was influenced by individual characteristics, symptoms, or function. This was a retrospective, cross-sectional study, in 2007, examining 7,448 community-dwelling elderly 65 years or older in a state in the Midwest. Fallers were identified based on a diagnosis of cancer, age, sex, race and ethnicity, poor vision, reduced activities of daily living (ADLs), instrumental ADLs, cognition, incontinence, pain, or depression. Findings indicated that 2,125 (28.5%) had at least 1 fall. Of those who fell, 967 (13.0%) had cancer, and 363 (4.9%) with cancer had a fall. Predictors of falls in this population included race, sex, ADLs, incontinence, depression, and pain, all with P falls in this study. This study found a high frequency of falls and suggests a predictive model for fall risk in the vulnerable, community-dwelling elderly and will be used to inform future studies.

Riparian erosion vulnerability model based on environmental features.

Science.gov (United States)

Botero-Acosta, Alejandra; Chu, Maria L; Guzman, Jorge A; Starks, Patrick J; Moriasi, Daniel N

2017-12-01

Riparian erosion is one of the major causes of sediment and contaminant load to streams, degradation of riparian wildlife habitats, and land loss hazards. Land and soil management practices are implemented as conservation and restoration measures to mitigate the environmental problems brought about by riparian erosion. This, however, requires the identification of vulnerable areas to soil erosion. Because of the complex interactions between the different mechanisms that govern soil erosion and the inherent uncertainties involved in quantifying these processes, assessing erosion vulnerability at the watershed scale is challenging. The main objective of this study was to develop a methodology to identify areas along the riparian zone that are susceptible to erosion. The methodology was developed by integrating the physically-based watershed model MIKE-SHE, to simulate water movement, and a habitat suitability model, MaxEnt, to quantify the probability of presences of elevation changes (i.e., erosion) across the watershed. The presences of elevation changes were estimated based on two LiDAR-based elevation datasets taken in 2009 and 2012. The changes in elevation were grouped into four categories: low (0.5 - 0.7 m), medium (0.7 - 1.0 m), high (1.0 - 1.7 m) and very high (1.7 - 5.9 m), considering each category as a studied "species". The categories' locations were then used as "species location" map in MaxEnt. The environmental features used as constraints to the presence of erosion were land cover, soil, stream power index, overland flow, lateral inflow, and discharge. The modeling framework was evaluated in the Fort Cobb Reservoir Experimental watershed in southcentral Oklahoma. Results showed that the most vulnerable areas for erosion were located at the upper riparian zones of the Cobb and Lake sub-watersheds. The main waterways of these sub-watersheds were also found to be prone to streambank erosion. Approximatively 80% of the riparian zone (streambank

“Gray Murder”: Characteristics of Elderly Compared With Nonelderly Homicide Victims in New York City

Science.gov (United States)

Abrams, Robert C.; Leon, Andrew C.; Tardiff, Kenneth; Marzuk, Peter M.; Sutherland, Kari

2007-01-01

Objectives. We compared characteristics of homicides among New York City residents aged 18 years and older from 1990 to 1998 to determine differences in demographics, cause and place of death, and presence of illicit drugs and alcohol in the deceased’s system. Methods. All medical examiner–certified homicides among New York City residents aged 18 years and older from 1990 to 1998 were studied (n = 11 850). Nonelderly (aged 18 to 64 years) and elderly (aged 65 years and older) victims were compared by gender, race/ethnicity, cause of death, place of death, and presence of illicit drugs or alcohol. Population-based homicide rates stratified by age, gender, and race were also calculated. Results. Nonelderly homicide victims were significantly more likely to be male, non-White, to have been shot in the city streets, and to have evidence of illicit drug or alcohol use. Elderly victims were more likely to be female, White, to have been killed by nonfirearm injuries, and to have been killed in their own homes. The gender and race differences between age groups remained but were attenuated when population-based rates were compared. Conclusions. The characteristics of homicide in nonelderly adults do not apply to elderly adults in New York City. Demographic factors and vulnerabilities of the elderly may underlie these differences, pointing to the need for oversight of isolated or homebound elderly persons and for protective interventions. PMID:17666708

A Framework for a Context-Aware Elderly Entertainment Support System

Directory of Open Access Journals (Sweden)

M. Anwar Hossain

2014-06-01

Full Text Available Elderly people constitute a major portion of world’s population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living.

A Framework for a Context-Aware Elderly Entertainment Support System

Science.gov (United States)

Hossain, M. Anwar; Alamri, Atif; Almogren, Ahmad S.; Hossain, SK Alamgir; Parra, Jorge

2014-01-01

Elderly people constitute a major portion of world's population. Many of them are physically and mentally vulnerable and need continuous support for their health and well-being. There is a growing trend that these elderly people are placed in an ambient assisted living environment (AAL) with an aim to receive better care and support. In such settings, a lot of attention has been given to continuous health monitoring for maintaining physical health status. However, much less attention has been given toward understanding the entertainment needs of the elderly people, which is an important factor relevant to their mental health and joyful living. This paper thus addresses the entertainment needs of the elderly and proposes a framework of an elderly entertainment support system. The proposed framework enables different categories of residents (e.g., elderly people and caregivers) to access various media services in both implicit and explicit manner in order to enhance the quality of their living experience in different contexts. Our experimental results demonstrate the viability of the proposed framework. We believe that the proposed approach will establish the need to develop entertainment systems and services for the elderly people and allow us to sensibly address the problems associated with their independent, happy and active living. PMID:24936946

Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

Directory of Open Access Journals (Sweden)

Biehl M

2016-06-01

Full Text Available Michelle Biehl,1 Paul Y Takahashi,2 Stephen S Cha,3 Rajeev Chaudhry,2 Ognjen Gajic,1 Bjorg Thorsteinsdottir2 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2Division of Primary Care Internal Medicine, 3Health Sciences Research, Mayo Clinic, Rochester, MN, USA Rationale: Identifying patients at high risk of critical illness is necessary for the development and testing of strategies to prevent critical illness. The aim of this study was to determine the relationship between high elder risk assessment (ERA score and critical illness requiring intensive care and to see if the ERA can be used as a prediction tool to identify elderly patients at the primary care visit who are at high risk of critical illness. Methods: A population-based historical cohort study was conducted in elderly patients (age >65 years identified at the time of primary care visit in Rochester, MN, USA. Predictors including age, previous hospital days, and comorbid health conditions were identified from routine administrative data available in the electronic medical record. The main outcome was critical illness, defined as sepsis, need for mechanical ventilation, or death within 2 years of initial visit. Patients with an ERA score of 16 were considered to be at high risk. The discrimination of the ERA score was assessed using area under the receiver operating characteristic curve. Results: Of the 13,457 eligible patients, 9,872 gave consent for medical record review and had full information on intensive care unit utilization. The mean age was 75.8 years (standard deviation ±7.6 years, and 58% were female, 94% were Caucasian, 62% were married, and 13% were living in nursing homes. In the overall group, 417 patients (4.2% suffered from critical illness. In the 1,134 patients with ERA >16, 154 (14% suffered from critical illness. An ERA score ≥16 predicted critical illness (odds ratio 6.35; 95% confidence interval 3.51–11.48. The area under the

Foreign domestic workers and home-based care for elders in Singapore.

Science.gov (United States)

Yeoh, Brenda S A; Huang, Shirlena

2010-01-01

As with other developed nations where rapid population aging has led to increasing health care and social care burdens, Singapore has searched for ways of paying for and providing long-term care for its increasing numbers of elders. The Singapore state, faced with the prospect of one-fifth of the population aged 65 or older by 2030, has reinforced its basic principle of rendering the family the "primary caregiving unit" and home-based care as the highly preferred option for eldercare. Our paper demonstrates why, despite the range of alternative care arrangements available or emerging on Singapore's eldercare landscape, the employment of live-in foreign domestic workers as care workers for the elderly has become one of the more common de facto modes of providing care for the elderly. In this context, we discuss the politics of eldercare in the privatized sphere of homespace and conclude with policy implications relating to the employment of foreign domestic workers as caregivers for the elderly.

The changing climate and human vulnerability in north-central Namibia

Directory of Open Access Journals (Sweden)

Margaret N. Angula

2016-01-01

Full Text Available North-central Namibia is more vulnerable to effects of climate change and variability. Combined effects of environmental degradation, social vulnerability to poverty and a changing climate will compromise subsistence farming in north-central Namibia (NCN. This will make subsistence and small-scale farmers in the region more vulnerable to projected changes in the climate system. Thus, the aim of this article was to examine factors contributing to subsistence farmers’ vulnerability to impacts of climate change. The article further discusses different aspects of human vulnerability and existing adaptation strategies in response to impacts of climate related disasters experienced over the past three to four decades in NCN. Qualitative and quantitative research approaches and methodology were employed to obtain information from subsistence farmers in north-central Namibia. The sociodemographic characteristics of Ohangwena, Oshana and Omusati Region reveals high levels of unemployment, high adult and elderly population and high dependency on agricultural livelihood system. These indicators help understand levels of household vulnerability. The study concludes that households interviewed revealed low levels of adaptive capacity due to exposure to climate risks and combined effects of social, political and cultural factors. This article provided an understanding that is required to inform the adaptation pathways relevant for NCN.

Effects of Group Counseling Based on Logo Therapy to Decrease Loneliness in Elderly Men

Directory of Open Access Journals (Sweden)

Negin Yazdanbakhsh

2016-10-01

Conclusion Group counseling based on logo therapy was found to decrease loneliness scores of elderly men. Therefore, the approach taken in this study can be considered as an appropriate method for psychological interventions in elderly men.

Effect of β on Seismic Vulnerability Curve for RC Bridge Based on Double Damage Criterion

International Nuclear Information System (INIS)

Feng Qinghai; Yuan Wancheng

2010-01-01

In the analysis of seismic vulnerability curve based on double damage criterion, the randomness of structural parameter and randomness of seismic should be considered. Firstly, the distribution characteristics of structure capability and seismic demand are obtained based on IDA and PUSHOVER, secondly, the vulnerability of the bridge is gained based on ANN and MC and a vulnerability curve according to this bridge and seismic is drawn. Finally, the analysis for a continuous bridge is displayed as an example, and parametric analysis for the effect of β is done, which reflects the bridge vulnerability overall from the point of total probability, and in order to reduce the discreteness, large value of β are suggested.

Financial abuse in elderly Korean immigrants: mixed analysis of the role of culture on perception and help-seeking intention.

Science.gov (United States)

Lee, Hee Yun; Eaton, Charissa K

2009-07-01

This study aims to evaluate how elderly Korean immigrants perceive and respond to a hypothetical incident of financial abuse on the basis of their cultural background. By using a quota sampling strategy, 124 elderly Korean immigrants were recruited. A mixed-method approach was employed to explore the role of culture on elderly immigrants' view of financial abuse and the construct of independent and interdependent self-construal was adopted to theoretically guide the study. Mixed-method analysis confirmed considerable influence of culture, particularly in responding to the abusive situation. Although the vast majority of the elders (92%) perceived financial abuse as elder mistreatment, only two-thirds (64%) intended to seek help. Five major themes for not seeking help were produced. These are: (a) issues related to family problems, (b) tolerance of the abuse, (c) shame, (d) victim blame, and (e) mistrust toward third party intervention. A series of binary logistic regressions revealed (a) a lower likelihood of seeking formal types of help with those who had higher level of adherence to traditional values and (b) the profile of vulnerable elderly Koreans who are at higher risk of being financially abused: male and less educated. This article also discusses implications for social work practice and elder mistreatment policy, particularly focusing on how to work with elderly Korean immigrants who are vulnerable to this problem and who tend to use collectivistic cultural values in responding to financial abuse.

Elderly Suicide

Science.gov (United States)

Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

The Millennium Development Goals in the millennium of the elderly

Directory of Open Access Journals (Sweden)

Anna Cruz de Araujo P. Silva

2013-06-01

Full Text Available The "Millennium Development Goals" (MDG synthetize eight objectives assumed internationally to the improvement of the quality of life on this planet until 2015. Such expectations, however, do not take into consideration that there is a substantial contingent of vulnerable elderly. Even though the MDG do not address directly the elderly, a comprehensive reading, considering the emerging populational pattern, allows the inclusion of directives and actions geared to them, making urgent the integrated planning of public policies to attend the needs of those 60 years of age or older, not only today, but for the many decades to come.

Needs assessment with elder Syrian refugees in Lebanon: Implications for services and interventions.

Science.gov (United States)

Chemali, Zeina; Borba, Christina P C; Johnson, Kelsey; Khair, Sama; Fricchione, Gregory L

2017-09-12

Currently, over 1 million Syrian and Palestinian refugees have fled Syria to take refuge in Lebanon. Among this vulnerable population, elder refugees warrant particular concern, as they shoulder a host of additional health and safety issues that require additional resources. However, the specific needs of elder refugees are often overlooked, especially during times of crisis. Our study used a semi-structured interview to survey the needs of elder refugees and understand their perceived support from Lebanese fieldworkers. Results indicate a high prevalence of depression and cognitive deficits in elder refugees, who expressed concerns surrounding illness, loneliness, war, and instability. Elders highlighted the importance of family connectedness in fostering security and normalcy and in building resilience during times of conflict. Elders spoke of their role akin that of the social workers with whom they interacted, in that they acted as a source of emotional support for their communities. Overall, this study clarifies steps to be taken to increase well-being in elder refugee populations and urges the response of humanitarian organisations to strengthen psychological support structures within refugee encampments.

Development of a Comprehensive Hospital-Based Elder Abuse Intervention: An Initial Systematic Scoping Review

Science.gov (United States)

Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark

2015-01-01

Introduction Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review. Objectives Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation. Methods The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English. Analysis The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics. Results 649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of

Development of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping review.

Directory of Open Access Journals (Sweden)

Janice Du Mont

Full Text Available Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1 addressed a response (e.g., an intervention to elder abuse, 2 contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3 were available in English.The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser;physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.To address the lack of evidence to

Developing a probability-based model of aquifer vulnerability in an agricultural region

Science.gov (United States)

Chen, Shih-Kai; Jang, Cheng-Shin; Peng, Yi-Huei

2013-04-01

SummaryHydrogeological settings of aquifers strongly influence the regional groundwater movement and pollution processes. Establishing a map of aquifer vulnerability is considerably critical for planning a scheme of groundwater quality protection. This study developed a novel probability-based DRASTIC model of aquifer vulnerability in the Choushui River alluvial fan, Taiwan, using indicator kriging and to determine various risk categories of contamination potentials based on estimated vulnerability indexes. Categories and ratings of six parameters in the probability-based DRASTIC model were probabilistically characterized according to the parameter classification methods of selecting a maximum estimation probability and calculating an expected value. Moreover, the probability-based estimation and assessment gave us an excellent insight into propagating the uncertainty of parameters due to limited observation data. To examine the prediction capacity of pollutants for the developed probability-based DRASTIC model, medium, high, and very high risk categories of contamination potentials were compared with observed nitrate-N exceeding 0.5 mg/L indicating the anthropogenic groundwater pollution. The analyzed results reveal that the developed probability-based DRASTIC model is capable of predicting high nitrate-N groundwater pollution and characterizing the parameter uncertainty via the probability estimation processes.

An atmospheric vulnerability assessment framework for environment management and protection based on CAMx.

Science.gov (United States)

Zhang, Yang; Shen, Jing; Li, Yu

2018-02-01

This paper presents an atmospheric vulnerability assessment framework based on CAMx that should be helpful to assess potential impacts of changes in human, atmospheric environment, and social economic elements of atmospheric vulnerability. It is also a useful and effective tool that can provide policy-guidance for environmental protection and management to reduce the atmospheric vulnerability. The developed framework was applied to evaluate the atmospheric environment vulnerability of 13 cities in the Beijing-Tianjin-Hebei (BTH) region for verification. The results indicated that regional disparity of the atmospheric vulnerability existed in the study site. More specifically, the central and southern regions show more atmospheric environment vulnerability than the northern regions. The impact factors of atmospheric environment vulnerability in the BTH region mainly derived from increasing population press, frequently unfavorable meteorological conditions, extensive economic growth of secondary industry, increased environmental pollution, and accelerating population aging. The framework shown in this paper is an interpretative and heuristic tool for a better understanding of atmospheric vulnerability. This framework can also be replicated at different spatial and temporal scales using context-specific datasets to straightly support environmental managers with decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lack of Knowledge Sharing Amongst Institutions in Denmark Responsible for Vulnerable Groups

DEFF Research Database (Denmark)

Bojsen, Ann Kristina Mikkelsen

they share their knowledge about risk and policy management. In order to protect vulnerable groups such as children, disabled, sick and elderly people, we need to learn more about the general risk understanding and sharing of such according to region, responsibility, common events and hazards....... This information is needed to protect against future unintentional and intentional hazards and compare those with the institutional responsibilities. Risk understanding and knowledge sharing among professionals with responsibility for vulnerable groups can be a crucial tool for handling everyday threats as well......Lack of Knowledge Sharing Amongst Institutions in Denmark Responsible for Vulnerable Groups Ann Bojsen, Senior Lecturer Emergency and Risk Management Department, Metropolitan University College, Copenhagen, Denmark Even though understanding risk and how it is enacted is regarded as a crucial step...

Hydration, morbidity, and mortality in vulnerable populations.

Science.gov (United States)

Maughan, Ronald J

2012-11-01

Both acute and chronic fluid deficits have been shown to be associated with a number of adverse health outcomes. At the extreme, deprivation of water for more than a few days inevitably leads to death, but even modest fluid deficits may precipitate adverse events, especially in young children, in the frail elderly and in those with poor health. Epidemiological studies have shown an association, although not necessarily a causal one, between a low habitual fluid intake and some chronic diseases, including urolithiasis, constipation, asthma, cardiovascular disease, diabetic hyperglycemia, and some cancers. Acute hypohydration may be a precipitating factor in a number of acute medical conditions in elderly persons. Increased mortality, especially in vulnerable populations, is commonly observed during periods of abnormally warm weather, with at least part of this effect due to failure to increase water intake, and this may have some important implications for those responsible for forward planning in healthcare facilities. © 2012 International Life Sciences Institute.

The use of the Mini Nutritional Assessment to assess the Nutritional Status of Elderly Subjects living in The Riyadh Nursing Home

International Nuclear Information System (INIS)

Al-Hamadan, Adel Ibn Abd. Al-Wahab; Alorf, Sadaa Bent Muhamed

2005-01-01

All elderly residents (total number 74) in the Riyadh nursing home were included in this study. Body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) were measured. The Mini Nutritional Assessment (MAA), specifically designed for elderly subjects was used in the study to determine the nutritional status. 27% and 43% of elderly subjects were found to be malnourished and at risk of being malnourished, respectively. The means the (BMI), (MAC), and (CC) were about 24 Kg/m2, 26 cm and 29.5 cm, respectively. Elderly people, who were classified as malnourished, according to the (MNA), had the lowest (BMI), (MAC). When the score of the (MNA) was based on the diagnosis of the elderly, the results show the elderly subjects with more one main diagnosis had the lowest score. Based on the score of the (MNA) test, more than 1/4 of the subjects were malnourished. Most of the subjects were consuming three whole meals and more than two serving of fruit and vegetables per day. It seems that food intake, in the nursing home, was satisfactory, among the subjects. Despite that the percentage of malnourished subjects reached 27%. The results of the (MNA) test indicated the necessity of performing national nutritional assessment for this vulnerable group of people in other nursing homes and in the community. (author)

Functional disability in elderly with dementia

Directory of Open Access Journals (Sweden)

Tainã Alves Fagundes

2017-03-01

Full Text Available Introduction: Dementia represents one of the major causes of disability and dependence in old age and can affect functional capacity in all areas of occupational performance, including basic and instrumental activities of daily living (BADL and IADL, respectively, leisure, social participation and others. Objectives: To characterize the functional disability level in elderly people with dementia and verify the existence of correlation between functionality and the stage or type of dementia. Method: Quantitative, exploratory, cross-sectional study, with a sample of 25 caregivers of elderly with dementia. For the characterization of the participants were used structured questionnaires and to assess functional disability, the Disability Assessment Scale for Dementia - DAD was applied. Results: Greater incapacity was observed in the IADL sub item. This finding is compatible with the literature on the hierarchy in functional decline in the elderly: decline begins in IADL, while BADL remain unaffected for a longer period. There was no significant correlation between the type of dementia, age or gender and disability. It was verified through the Spearman coefficient (rho = 0.87, a significant correlation of high magnitude between functional disability and stage of dementia (p = 0.0001. Conclusion: Such findings reiterate the importance of giving priority to early detection and prevention of the functional decline, which is the manifestation of vulnerability among the elderly.

Comparison of prescription drug use between community-dwelling and institutionalized elderly in Sweden.

Science.gov (United States)

Johnell, Kristina; Fastbom, Johan

2012-09-01

Most previous studies about drug use in the elderly population have either investigated drug use in institutions or in the community-dwelling setting. Hence, very few studies have compared drug use in institutionalized and community-dwelling elderly, maybe because of a lack of sufficiently large databases. The aim of the study was to investigate differences in drug use patterns between community-dwelling and institutionalized elderly, after adjustment for age, gender and number of other drugs (used as a proxy for overall co-morbidity). We analysed data from individuals aged ≥65 years who filled at least one drug prescription between July and September 2008 and were consequently registered in the Swedish Prescribed Drug Register (n = 1,347,564; 1,260,843 community-dwelling and 86,721 institutionalized elderly). A list of current prescriptions was constructed for every individual on the arbitrarily chosen date 30 September 2008. Outcome measures were the 20 most common drug classes and the 20 most common individual drugs. Logistic regression analysis was used to investigate whether institutionalization was associated with use of these drugs, after adjustment for age, gender and number of other drugs. Institutionalized elderly were more likely than community-dwelling elderly to use antidepressants, laxatives, minor analgesics, opioids and hypnotics/sedatives, after adjustment for age, gender and number of other drugs. On the contrary, institutionalization was negatively associated with use of lipid modifying agents, angiotensin II antagonists, selective calcium channel blockers, β-blocking agents and ACE inhibitors, after adjustment for age, gender and number of other drugs. Our results indicate that institutionalized elderly are more likely than community-dwelling elderly to use psychotropics, analgesics and laxatives, but less likely to receive recommended cardiovascular drug therapy, which may indicate a need for implementation of evidence-based guidelines for

INSTITUTION FOR THE AGED: ASSESSING THE CONDITIONS OF ACCESSIBILITY AND FUNCTIONALITY OF THE ELDERLY.

Directory of Open Access Journals (Sweden)

Raphaella Lomanto Santos de Almeida

2015-04-01

Full Text Available The study aim was to assess the capacity to undertake the Basic Activities of Daily Living (BADL of elderly residents of an Institution for the Aged (IA and their level of accessibility. This is an observational, descriptive, cross-sectional study. The level of independence for BADL was assessed by the Barthel Index and the degree of accessibility of IA was verified through a check-list, based on the Brazilian Standard (NBR 9050/2004, the Brazilian Association of Technical Standards (ABNT. Of the 62 seniors who participated in the study, 64.5% had some degree of functional dependence. Noteworthy the level of functional dependency for activities undertaken in the bathroom among elderly on wheelchair. The assessed physical structure does not fully follow the technical standards established by NBR 9050, with differences mainly in the parameters of bedrooms, bathrooms and stairs. Although much of the institutionalized elderly presenting advanced and most functional vulnerability ages, level of IA architectural accessibility is still insufficient. Rooms and bathrooms are the places with the highest deficit of accessibility and also higher prevalence of falls among the elderly residents. A good level of accessibility in IA, can be an important factor in improving the level of independence for everyday activities and to prevent the risk of falls.

Which Stratum of Urban Elderly Is Most Vulnerable for Dementia?

Science.gov (United States)

2016-01-01

Many factors associated with a patient's lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia. PMID:27550494

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse.

Science.gov (United States)

Khanlary, Zahra; Maarefvand, Masoomeh; Biglarian, Akbar; Heravi-Karimooi, Majideh

2016-01-01

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.

Feasibility, reliability, and validity of a smartphone based application for the assessment of cognitive function in the elderly.

Science.gov (United States)

Brouillette, Robert M; Foil, Heather; Fontenot, Stephanie; Correro, Anthony; Allen, Ray; Martin, Corby K; Bruce-Keller, Annadora J; Keller, Jeffrey N

2013-01-01

While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these "next-generation" assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST) in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, psmartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries of cognitive and motor function in the elderly is discussed.

[Impact of frailty over the functional state of hospitalized elderly].

Science.gov (United States)

García-Cruz, Juan Carlos; García-Peña, Carmen

2016-01-01

Frailty in elderly results from impaired physiological reserve in multiple systems. Establishing if frail elderly inpatients develop more functional impairment at discharge, will allow the development of strategies for preventing or limiting the deterioration in this vulnerable group. Prospective cohort in 133 elderly inpatients. At admission, frailty, functional status, comorbidity and comprehensive geriatric evaluation were determined. The main outcome was functional state at hospital discharge. 64 patients presented frailty (48.1%) and 69 did not present that state (51.9%), with a mean age of 73 and 68 years, respectively. Mean decrement in functional state at discharge was -8.06 % (IC 95 % -10.38 to -5.74), from 97.97 % to 89.91 % (p model, frailty (beta -14.73, IC 95 % -19.39 to -10.07, p decrement. Frailty independently predicts functional impairment at hospital discharge.

Mobility Behavior of the Elderly: an attitude-based segmentation approach for a heterogeneous target group

DEFF Research Database (Denmark)

Haustein, Sonja

2012-01-01

The western population is ageing. Based on the assumption that the elderly are a quite heterogeneous population group with an increasing impact on the transport system, mobility types of the elderly were identified. By means of 1,500 standardized telephone interviews, mobility behavior and possib...... of the diverse lifestyles, attitudes, travel behavior and needs of the elderly. Furthermore, it identifies starting points for the reduction of car use....

Assessing flash flood vulnerability using a multi-vulnerability approach

Directory of Open Access Journals (Sweden)

Karagiorgos Konstantinos

2016-01-01

Full Text Available In the framework of flood risk assessment, while the understanding of hazard and exposure has significantly improved over the last years, knowledge on vulnerability remains one of the challenges. Current approaches in vulnerability research are characterised by a division between social scientists and natural scientists. In order to close this gap, we present an approach that combines information on physical and social vulnerability in order to merge information on the susceptibility of elements at risk and society. With respect to physical vulnerability, the study is based on local-scale vulnerability models using nonlinear regression approaches. Modified Weibull distributions were fit to the data in order to represent the relationship between process magnitude and degree of loss. With respect to social vulnerability we conducted a door-to-door survey which resulted in particular insights on flood risk awareness and resilience strategies of exposed communities. In general, both physical and social vulnerability were low in comparison with other European studies, which may result from (a specific building regulations in the four Mediterranean test sites as well as general design principles leading to low structural susceptibility of elements at risk, and (b relatively low social vulnerability of citizens exposed. As a result it is shown that a combination of different perspectives of vulnerability will lead to a better understanding of exposure and capacities in flood risk management.

Development of a heat vulnerability index for New York State.

Science.gov (United States)

Nayak, S G; Shrestha, S; Kinney, P L; Ross, Z; Sheridan, S C; Pantea, C I; Hsu, W H; Muscatiello, N; Hwang, S A

2017-12-01

The frequency and intensity of extreme heat events are increasing in New York State (NYS) and have been linked with increased heat-related morbidity and mortality. But these effects are not uniform across the state and can vary across large regions due to regional sociodemographic and environmental factors which impact an individual's response or adaptive capacity to heat and in turn contribute to vulnerability among certain populations. We developed a heat vulnerability index (HVI) to identify heat-vulnerable populations and regions in NYS. Census tract level environmental and sociodemographic heat-vulnerability variables were used to develop the HVI to identify heat-vulnerable populations and areas. Variables were identified from a comprehensive literature review and climate-health research in NYS. We obtained data from 2010 US Census Bureau and 2011 National Land Cover Database. We used principal component analysis to reduce correlated variables to fewer uncorrelated components, and then calculated the cumulative HVI for each census tract by summing up the scores across the components. The HVI was then mapped across NYS (excluding New York City) to display spatial vulnerability. The prevalence rates of heat stress were compared across HVI score categories. Thirteen variables were reduced to four meaningful components representing 1) social/language vulnerability; 2) socioeconomic vulnerability; 3) environmental/urban vulnerability; and 4) elderly/ social isolation. Vulnerability to heat varied spatially in NYS with the HVI showing that metropolitan areas were most vulnerable, with language barriers and socioeconomic disadvantage contributing to the most vulnerability. Reliability of the HVI was supported by preliminary results where higher rates of heat stress were collocated in the regions with the highest HVI. The NYS HVI showed spatial variability in heat vulnerability across the state. Mapping the HVI allows quick identification of regions in NYS that could

Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland.

LENUS (Irish Health Repository)

Ryan, C

2009-08-01

Elderly patients are particularly vulnerable to inappropriate prescribing, with increased risk of adverse drug reactions and consequently higher rates of morbidity and mortality. A large proportion of inappropriate prescribing is preventable by adherence to prescribing guidelines, suitable monitoring and regular medication review. As a result, screening tools have been developed to help clinicians improve their prescribing.

Aquatic exercises versus land based exercises for elderly patients after a total hip replacement

OpenAIRE

Miroljub Jakovljevič; Renata Vauhnik

2011-01-01

Background: Aquatic therapy allows secure, active exercise with pain reduction using a combination of the water’s buoyancy, hydrostatic pressure, resistance and warmth. By aquatic therapy, elderly patients after total hip replacement can achieve more positive effects than by land-based exercise. The aim of the study was to investigate the use of aquatic-based exercises in the rehabilitation programme after a hip fracture surgery in elderly adults. Results: Both groups, regardless of the ty...

Multiple flood vulnerability assessment approach based on fuzzy comprehensive evaluation method and coordinated development degree model.

Science.gov (United States)

Yang, Weichao; Xu, Kui; Lian, Jijian; Bin, Lingling; Ma, Chao

2018-05-01

Flood is a serious challenge that increasingly affects the residents as well as policymakers. Flood vulnerability assessment is becoming gradually relevant in the world. The purpose of this study is to develop an approach to reveal the relationship between exposure, sensitivity and adaptive capacity for better flood vulnerability assessment, based on the fuzzy comprehensive evaluation method (FCEM) and coordinated development degree model (CDDM). The approach is organized into three parts: establishment of index system, assessment of exposure, sensitivity and adaptive capacity, and multiple flood vulnerability assessment. Hydrodynamic model and statistical data are employed for the establishment of index system; FCEM is used to evaluate exposure, sensitivity and adaptive capacity; and CDDM is applied to express the relationship of the three components of vulnerability. Six multiple flood vulnerability types and four levels are proposed to assess flood vulnerability from multiple perspectives. Then the approach is applied to assess the spatiality of flood vulnerability in Hainan's eastern area, China. Based on the results of multiple flood vulnerability, a decision-making process for rational allocation of limited resources is proposed and applied to the study area. The study shows that multiple flood vulnerability assessment can evaluate vulnerability more completely, and help decision makers learn more information about making decisions in a more comprehensive way. In summary, this study provides a new way for flood vulnerability assessment and disaster prevention decision. Copyright © 2018 Elsevier Ltd. All rights reserved.

Security Vulnerabilities of the Web Based Open Source Information ...

African Journals Online (AJOL)

This paper exposes security vulnerabilities of the web based Open Source Information Systems (OSIS) from both system angle and human perspectives.It shows the extent of risk that can likely hinder adopting organization from attaning full intended benefits of using OSIS software. To undertake this study, a case study ...

[Facing a dilemma in elderly complex and vulnerable patients: to stop or not to stop prevention?

Science.gov (United States)

Llobet Vila, Laura; Manresa Domínguez, Josep Maria; Carmona Segado, José Manuel; Franzi Sisó, Alícia; Vallès Balasch, Rosa; Martínez Díaz, Isabel

2017-12-05

1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication. Retrospective observational study. Four Primary Health Centres, Castellar del Vallès (Barcelona). 128 patients, 70 ACD and 58 PCC. Number of drugs at the time of death from the 6 selected group, deprescription (6 months prior to death due to advanced chronic disease), primary or secondary prevention and inappropriate prescription of PPI. Average age of 85'3 years (10,3). 40% took an antiplatelet drug, avoidable in 60% of the ACD, since they did not present any previous cardiovascular episode. 20% of the patients took statins, in which 48% of the cases were primary prevention. The PPI prescription was 67% with inadequate indication for use in 49% of these cases. 20% took calcium / Vitamin D and 1,6% of the ACD a bisphosphonate. There was a 16% deprescription. A high percentage of our patients with advanced chronic disease and short life expectancy still continue to take preventive and avoidable treatments, potentially dangerous due to their side effects. There is a need to reflect on what we do with these vulnerable patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

The Design of Smart Home for the Elderly Based on ZigBee

Directory of Open Access Journals (Sweden)

He Junhan

2016-01-01

Full Text Available In recent years, as the pace of people’s life is speeding up, more young people working far from their parents, the elderly have to live alone. With the increase of age, they tend to forget things which may create safety accidents. Therefore, a smart home system for the elderly will have good application prospects. In this paper, a smart system based on ZigBee wireless network is proposed. This system uses wireless network for transmitting information between sensor nodes and uses embedded technology to analyse the data. Once an emergency occurs, the system will send an alarm to notify the elderly. At the same time, the young people can know the situation of the house through mobile phone

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Science.gov (United States)

2018-01-01

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Directory of Open Access Journals (Sweden)

Raoul S. Liévanos

2018-04-01

Full Text Available The California Community Environmental Health Screening Tool (CalEnviroScreen advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

Science.gov (United States)

Liévanos, Raoul S

2018-04-16

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department

DEFF Research Database (Denmark)

Nielsen, Louise M.; Kirkegaard, Hans; Østergaard, Lisa Gregersen

2016-01-01

Background Assessment of functional ability in elderly patients is often based on self-reported rather than performance-based measures. This study aims to compare self-reported and performance-based measures of functional ability in a population of elderly patients at an emergency department (ED)...

Aging in balance : physical exercise and nutrient dense foods for the vulnerable elderly

NARCIS (Netherlands)

Chin A Paw, M.

1999-01-01

The main goal of prevention and health care for elderly people is optimizing 'quality of life'. Frail older persons have limited reserves and are therefore at an increased risk of a decline in health, which may lead to dependency and disability. This thesis focuses on the health-related effects of

Novel Kinds of Random Access Memory and New Vulnerabilities of Computer Aids based on Them

Directory of Open Access Journals (Sweden)

Alexander Mihaylovich Korotin

2014-09-01

Full Text Available The article discusses vulnerabilities of computer aids based on existing RAM and mechanisms for restricting exploitation of such vulnerabilities. In addition, the article discusses features and work methods of different RAM.

A watershed-based method for environmental vulnerability assessment with a case study of the Mid-Atlantic region

Energy Technology Data Exchange (ETDEWEB)

Tran, Liem T., E-mail: ltran1@utk.edu [Department of Geography, University of Tennessee, Knoxville, TN (United States); O& #x27; Neill, Robert V. [OTIE and Associates, Oak Ridge, TN (United States); Smith, Elizabeth R. [U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC (United States)

2012-04-15

The paper presents a method for environmental vulnerability assessment with a case study of the Mid-Atlantic region. The method is based on the concept of 'self-/peer-appraisal' of a watershed in term of vulnerability. The self-/peer-appraisal process is facilitated by two separate linear optimization programs. The analysis provided insights on the environmental conditions, in general, and the relative vulnerability pattern, in particular, of the Mid-Atlantic region. The suggested method offers a simple but effective and objective way to perform a regional environmental vulnerability assessment. Consequently the method can be used in various steps in environmental assessment and planning. - Highlights: Black-Right-Pointing-Pointer We present a method for regional environmental vulnerability assessment. Black-Right-Pointing-Pointer It is based on the self-/peer-appraisal concept in term of vulnerability. Black-Right-Pointing-Pointer The analysis is facilitated by two separate linear optimization programs. Black-Right-Pointing-Pointer The method provides insights on the regional relative vulnerability pattern.

A vulnerability-centric requirements engineering framework : Analyzing security attacks, countermeasures, and requirements based on vulnerabilities

NARCIS (Netherlands)

Elahi, G.; Yu, E.; Zannone, N.

2010-01-01

Many security breaches occur because of exploitation of vulnerabilities within the system. Vulnerabilities are weaknesses in the requirements, design, and implementation, which attackers exploit to compromise the system. This paper proposes a methodological framework for security requirements

Sociodemographic profile and hospitalization process of elderly assisted at a emergency hospital

Directory of Open Access Journals (Sweden)

Maria Luciene Nobre Coutinho

2015-12-01

Full Text Available Objectives: to investigate the sociodemographic profile and the process of hospitalization of elderly assisted in an emergency hospital. Methods: descriptive epidemiological study conducted at an emergency hospital with 300 elderly patients using a form with hospitalization process and sociodemographic variables. Results: there was a predominance of females (56.0%, between 80 and 89 years old (45.4%, illiterate or with elementary education (86.7%, married or living in stable union (42.6%, with non-communicable chronic disease (54.7% and regular use of medications. The main reason for hospitalization was fall (54.7% at home and in the morning hours (42.4%, with admission in the afternoon, transported by ambulance. Conclusion: the findings contribute to the development of strategies directed to assist and care of the healthy elderly and in vulnerable situations.

Prevalence and determinants of depression among elderly persons in a rural community from northern India.

Science.gov (United States)

Behera, Priyamadhaba; Sharan, Pratap; Mishra, Ashwani Kumar; Nongkynrih, Baridalyne; Kant, Shashi; Gupta, Sanjeev Kumar

2016-01-01

Globally, more than 350 million people of all ages suffer from depression. Elderly persons are more vulnerable to depression. We conducted this study to estimate the prevalence of depression, and to study the association of depression with sociodemographic and clinical variables among elderly persons in a rural community. We conducted a community-based cross-sectional study among 395 randomly selected elderly persons aged 60 years and above in a rural area of Ballabgarh, Haryana, India. The participants were screened by using the Geriatric Depression Scale, and diagnosis was confirmed by the Mini International Neuropsychiatric Interview. Multivariate analysis was done for independent predictors of depression. The prevalence of depression was 11.4% (95% CI 8.6%-14.9%). Living in a nuclear family (adjusted odds ratio [AOR] 8.98, 95% CI 3.40-23.71), lack of physical activity (AOR 4.95, 95% CI 2.00-12.27), whole-time involvement in household work (AOR 4.47, 95% CI 1.18-16.93), presence of two or more chronic diseases (AOR 4.45, 95% CI 1.60-12.35), having no role in family decision-making (AOR 2.77, 95% CI 1.19-6.42), sleep problems in past one year (AOR 2.97, 95% CI 1.32-6.69) and bilateral hearing impairment (AOR 4.00, 95% CI 1.80-8.88) were factors associated with depression in elderly persons. Depression is common among elderly persons in rural areas. Individuals providing healthcare to elderly persons need to be trained to identify depression and take appropriate action; elderly persons with chronic diseases and hearing impairment deserve special attention.

Qualitative study on suicide attempts and ideations with 60 elderly in Brazil.

Science.gov (United States)

Cavalcante, Fátima Gonçalves; Minayo, Maria Cecília de Souza

2015-06-01

Sixty cases of suicidal attempts and ideations among elderly people from thirteen Brazilian municipalities were studied, with the objective of discovering, from what they had to say, their reasons and interpretations for attempting to take their own life. The study, with a hermeneutic and dialectic basis, was based on an interview guide, to steer the conversation with these individuals. It starts with a sociodemographic classification and looks in depth at the person's situation according to their social, community and family circumstances and their physical and mental health, functional capacity, and the reasons given for the suicidal ideations and attempts. This field information was first analysed locally and then cross-categorized according to the method used, severity of the events and reasons given by the elderly people, by sex, age, socioeconomic profile and risk and protection factors. A comprehensive, critical and interpretative summary was made of the material. The results show that failure to listen to and the isolation of elderly people, lack of awareness of the risks on the part of family, the association with physical and mental, functional, social and family losses and violence are predisposing factors, and concurrent in many cases. The conclusion is that vulnerability and self-neglect are reduced where there is family support, care and bonds of unity.

[Physical exercise in the frail elderly: an update].

Science.gov (United States)

Casas Herrero, Álvaro; Cadore, Eduardo L; Martínez Velilla, Nicolás; Izquierdo Redin, Mikel

2015-01-01

Frailty is a state of vulnerability that involves an increased risk of adverse events and disability in older adults. It is a condition with a complex etiology and pathophysiology. Skeletal muscle power decreases earlier than muscle strength with advancing age and is more strongly associated with functional capacity than muscle strength in frail elderly populations. Multicomponent exercise programs, and especially resistance exercise that includes muscle power training, are currently the most relevant interventions to slow down disability and other adverse outcomes, even in the oldest-old. Moreover, these programs are valuable interventions in other frailty domains, such as falls and cognitive decline. Physical exercise, in the frail elderly, should be prescribed with a progressive individualized plan and just like other medical treatments. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Social vulnerability to heat in Greater Atlanta, USA: spatial pattern of heat, NDVI, socioeconomics and household composition

Science.gov (United States)

Sim, Sunhui

2017-10-01

The purpose of the article is evaluating spatial patterns of social vulnerability to heat in Greater Atlanta in 2015. The social vulnerability to heat is an index of socioeconomic status, household composition, land surface temperature and normalized differential vegetation index (NDVI). Land surface temperature and NDVI were derived from the red, NIR and thermal infrared (TIR) of a Landsat OLI/TIRS images collected on September 14, 2015. The research focus is on the variation of heat vulnerability in Greater Atlanta. The study found that heat vulnerability is highly clustered spatially, resulting in "hot spots" and "cool spots". The results show significant health disparities. The hotspots of social vulnerability to heat occurred in neighborhoods with lower socioeconomic status as measured by low education, low income and more poverty, greater proportion of elderly people and young children. The findings of this study are important for identifying clusters of heat vulnerability and the relationships with social factors. These significant results provide a basis for heat intervention services.

Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN)

DEFF Research Database (Denmark)

Palumbo, Antonio; Bringhen, Sara; Ludwig, Heinz

2011-01-01

Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most...... elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more......, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes....

Depression in elderly women resident in a long-stay nursing home.

Science.gov (United States)

Lampert, Melissa Agostini; Rosso, Ana Luiza Pereira

2015-01-01

Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH). This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version) above 5. Other clinical and psychiatric diagnoses were obtained from medical files. Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3%) of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

Depression in elderly women resident in a long-stay nursing home

Directory of Open Access Journals (Sweden)

Melissa Agostini Lampert

Full Text Available Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. OBJECTIVE: To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH. METHODS: This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version above 5. Other clinical and psychiatric diagnoses were obtained from medical files. RESULTS: Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3% of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. CONCLUSION: The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

Clinical Course of Acute Kidney Injury in Elderly Individuals Above 80 Years

Directory of Open Access Journals (Sweden)

Isabell Funk

2016-12-01

Full Text Available Background/Aims: Aging is associated with renal function decline and elderly patients are more vulnerable to acute kidney injury (AKI. The causes and prognosis of AKI according to new KDIGO definition that broadened the diagnosis and included more patients without dialysis dependence have not yet been compared between younger and elderly patients. Methods: In a retrospective analysis all patients with AKI admitted to a tertiary care Nephrology department (N=424 were included. Individuals were stratified by age (≤80 years, >80 years. Primary end-point was death or dialysis dependence at hospital discharge, secondary analyses addressed the need for dialysis, creatinine at discharge, mortality, and length of stay. Results: The distribution of AKI causes was different between the age groups. Circulatory AKI was the most important cause in both groups; however, septic or toxic AKI contributed relevantly in younger patients. Nevertheless, the number of patients reaching the primary end-point was similar (younger, 20.4%; older, 18.0%; OR 1.17, 95%CI, 0.703-1.948. While mortality tended to be higher in the older population, none of the secondary analyses indicated worse outcome for the older patients. Conclusion: The prognosis of AKI in elderly patients is not necessarily worse than in middle aged individuals. Nevertheless, older patients may be particularly vulnerable to circulatory or ischemic insults of the kidneys.

Voices from the Gila: health care issues for rural elders in south-western New Mexico.

Science.gov (United States)

Averill, Jennifer B

2002-12-01

A goal of the Healthy People 2010 initiative is to reduce or eliminate health disparities in vulnerable populations, including populations from rural and minority ethnic backgrounds. Rural communities, including elderly populations, experience lower rates of personal income, educational attainment, health-insurance coverage, access to emergency and specialty care services, and reported health status than do urban communities. A need exists to address identified research priorities, such as the perceptions of rural elders, their family members, and health care providers. The purposes of this study were to explore the health care perceptions, needs, and definitions of health for multicultural rural elders in one county of south-western New Mexico, and to consider practice implications. Informed consent procedures followed the University of New Mexico Health Sciences Center Human Research Review Committee guidelines. Research methods. This critical ethnography incorporated ethnographic interviews, ethnographic participant observation, photography, review of pertinent documents, and analysis of contextual factors. The sample consisted of 22 participants. Definitions of health varied with socioeconomic status, encompassing avoidance of contact with the health care system, obtaining needed medications, remaining independent, a sense of spiritual belonging, eating wisely, and exercising moderately. Three major concerns emerged from the analysis: the escalating cost of prescription drugs, access-to-care issues, and social isolation. The primary limitation was the small sample size. Although the researcher's position as an outsider to local communities may also have affected the outcome, it provided fresh insight to regional problems. The study addressed national research priorities for a vulnerable group of rural elders. Nursing implications include the need for expanded knowledge and educational preparation regarding elder issues and community-level services, inclusion of

The Impacts of Cellular Senescence in Elderly Pneumonia and in Age-Related Lung Diseases That Increase the Risk of Respiratory Infections.

Science.gov (United States)

Yanagi, Shigehisa; Tsubouchi, Hironobu; Miura, Ayako; Matsuo, Ayako; Matsumoto, Nobuhiro; Nakazato, Masamitsu

2017-02-25

Pneumonia generates considerable negative impacts on the elderly. Despite the widespread uses of vaccines and appropriate antibiotics, the morbidity and mortality of elderly pneumonia are significantly higher compared to the counterparts of young populations. The definitive mechanisms of high vulnerability in the elderly against pathogen threats are unclear. Age-associated, chronic low-grade inflammation augments the susceptibility and severity of pneumonia in the elderly. Cellular senescence, one of the hallmarks of aging, has its own characteristics, cell growth arrest and senescence-associated secretory phenotype (SASP). These properties are beneficial if the sequence of senescence-clearance-regeneration is transient in manner. However, persisting senescent cell accumulation and excessive SASP might induce sustained low-grade inflammation and disruption of normal tissue microenvironments in aged tissue. Emerging evidence indicates that cellular senescence is a key component in the pathogenesis of chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), which are known to be age-related and increase the risk of pneumonia. In addition to their structural collapses, COPD and IPF might increase the vulnerability to pathogen insults through SASP. Here, we discuss the current advances in understanding of the impacts of cellular senescence in elderly pneumonia and in these chronic lung disorders that heighten the risk of respiratory infections.

Between crisis, agency and return: the vulnerability of Bolivian migrants in Italy

Directory of Open Access Journals (Sweden)

Isabel Yépez del Castillo

2014-09-01

Full Text Available This article addresses the interrelationships between the economic crisis, international migration and the labour market, and their impact on female migration agency, both in the decision to migrate and in the subsequent possibility of return to Bolivia. Based on information collected in a large survey conducted in the city of Cochabamba and the tracing of multiple female migration trajectories, the extreme vulnerability of these women, who are the heads of single-parent households, working in elderly care in Bergamo, is shown. Despite their deteriorating working conditions in the context of current Italian economic crisis and the competition of immigrant care workers from countries of Eastern Europe, they choose to remain in Italy instead of returning to Bolivia.

Mapping eco-environmental vulnerability patterns: An assessment framework based on remote sensing, GIS, and AHP

Science.gov (United States)

Anh, N. K.; Liou, Y. A.; Li, M. H.

2016-12-01

The motivation for this study is assessment of the eco-environment vulnerability based on four independent determinants: hydro-meteorology, topography, land resources, and human activities. An assessment framework is proposed to assess the vulnerable eco-environment by using 16 variables with 6 of them constructed from Landsat 8 satellite images. The remaining variables were extracted from digital maps. Each variable was evaluated and spatially mapped with the aid of an analytical hierarchy process (AHP) and geographical information system (GIS). The Thua Thien - Hue Province that has been experiencing natural disasters and urbanization in the recent decades is selected as our study area. An eco-environmental vulnerability map is assorted into six vulnerable levels consisting of potential, slight, light, medium, heavy, and very heavy vulnerabilities, representing 14%, 27%, 17%, 26%, 13%, 3% of the study area, respectively. It is found that heavy and very heavy vulnerable areas appear mainly in the low and medium lands with high intensification of social-economic activities and often suffer from flooding. Tiny percentages of medium and heavy vulnerable levels occur in high land areas probably caused by agricultural practices in highlands, slash and burn cultivation and removal of natural forests with new plantation forests and these regions are usually influenced by landslides, flash flooding. Based on our results, three ecological zones requiring different development and protection solutions are proposed to restore local eco-environment toward sustainable development. Our findings support the idea that eco-environmental vulnerability is driven by anthropogenic processes and enhanced by natural disaster in the Thua Thien-Hue Province.

Effect of Islam-based religious program on spiritual wellbeing in elderly with hypertension.

Science.gov (United States)

Moeini, Mahin; Sharifi, Somaye; Kajbaf, Mohamed Bagher

2016-01-01

Lack of spiritual health in patients with hypertension leads to many mental, social, and physical effects, On the other hand, considering the prevalence of hypertension among the elderly, interventions to enhance their spiritual wellbeing is essential. Therefore, the aim of this study was to examine the effect of religious programs based on Islam on spiritual wellbeing in elderly patients with hypertension who referred to the health centers of Isfahan in 2014. This study was a randomized clinical trial. The participants (52 elderly patients with hypertension) were randomly divided in to experimental and control groups. Religious program was implemented for the experimental group in eight sessions in two Isfahan health centers. Spirituality wellbeing survey (SWB) questionnaire was completed in three steps, namely, pretest, posttest and follow-up (1 month) in two groups. In the study, Chi-square test, independent t -test, and repeated-measures analysis of variance were performed for analyzing the data. Before the intervention, there was no significant difference between the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing of the two groups. However in the posttest step and follow-up stage, the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing in the experimental group was significantly higher than in the control group ( P < 0.001). The religious program based on Islam promoted the SWB of elderly patients with hypertension; further, nurses can use these programs to promote the SWB of elderly patients with hypertension.

Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China.

Science.gov (United States)

Zeng, Yi; Chen, Huashuai; Wang, Zhenglian; Land, Kenneth C

2015-04-01

To better understand future home-based care needs and costs for disabled elders in China. To further develop and apply the ProFamy extended cohort-component method and the most recent census and survey data. (a) Chinese disabled elders and the annual growth rate of the percentage of national gross domestic product (GDP) devoted to home-based care costs for disabled elders will increase much more rapidly than the growth of total elderly population; (b) home-based care needs and costs for disabled oldest-old aged 80+ will increase much faster than that for disabled young-old aged 65-79 after 2030; (c) disabled unmarried elders living alone and their home-based care costs increase substantially faster than those disabled unmarried elders living with children; (d) percent of rural disabled oldest-old will be substantially higher than that of rural population after 2030; (e) sensitivity analyses show that possible changes in mortality and elderly disability status are the major direct factors affecting home-based care needs and costs; (f) caregivers resources under the universal two-child policy will be substantially better than that under the rigorous fertility policy unchanged. We discuss policy recommendations concerning pathways to healthy aging with relatively reduced care costs, including reductions of the prevalence of disability, gender equality, the universal two-child policy and resources of caregivers, encouragements of rural-to-urban family migration and elder's residential proximity to their adult children, and remarriages of not-married elders. © The Author(s) 2014.

The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics.

OpenAIRE

Boulos , Christa; Salameh , Pascale; Barberger-Gateau , Pascale

2013-01-01

International audience; BACKGROUND: Lebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of communit...

ESB-Based Sensor Web Integration for the Prediction of Electric Power Supply System Vulnerability

Directory of Open Access Journals (Sweden)

Milos Bogdanovic

2013-08-01

Full Text Available Electric power supply companies increasingly rely on enterprise IT systems to provide them with a comprehensive view of the state of the distribution network. Within a utility-wide network, enterprise IT systems collect data from various metering devices. Such data can be effectively used for the prediction of power supply network vulnerability. The purpose of this paper is to present the Enterprise Service Bus (ESB-based Sensor Web integration solution that we have developed with the purpose of enabling prediction of power supply network vulnerability, in terms of a prediction of defect probability for a particular network element. We will give an example of its usage and demonstrate our vulnerability prediction model on data collected from two different power supply companies. The proposed solution is an extension of the GinisSense Sensor Web-based architecture for collecting, processing, analyzing, decision making and alerting based on the data received from heterogeneous data sources. In this case, GinisSense has been upgraded to be capable of operating in an ESB environment and combine Sensor Web and GIS technologies to enable prediction of electric power supply system vulnerability. Aside from electrical values, the proposed solution gathers ambient values from additional sensors installed in the existing power supply network infrastructure. GinisSense aggregates gathered data according to an adapted Omnibus data fusion model and applies decision-making logic on the aggregated data. Detected vulnerabilities are visualized to end-users through means of a specialized Web GIS application.

ESB-based Sensor Web integration for the prediction of electric power supply system vulnerability.

Science.gov (United States)

Stoimenov, Leonid; Bogdanovic, Milos; Bogdanovic-Dinic, Sanja

2013-08-15

Electric power supply companies increasingly rely on enterprise IT systems to provide them with a comprehensive view of the state of the distribution network. Within a utility-wide network, enterprise IT systems collect data from various metering devices. Such data can be effectively used for the prediction of power supply network vulnerability. The purpose of this paper is to present the Enterprise Service Bus (ESB)-based Sensor Web integration solution that we have developed with the purpose of enabling prediction of power supply network vulnerability, in terms of a prediction of defect probability for a particular network element. We will give an example of its usage and demonstrate our vulnerability prediction model on data collected from two different power supply companies. The proposed solution is an extension of the GinisSense Sensor Web-based architecture for collecting, processing, analyzing, decision making and alerting based on the data received from heterogeneous data sources. In this case, GinisSense has been upgraded to be capable of operating in an ESB environment and combine Sensor Web and GIS technologies to enable prediction of electric power supply system vulnerability. Aside from electrical values, the proposed solution gathers ambient values from additional sensors installed in the existing power supply network infrastructure. GinisSense aggregates gathered data according to an adapted Omnibus data fusion model and applies decision-making logic on the aggregated data. Detected vulnerabilities are visualized to end-users through means of a specialized Web GIS application.

ESB-Based Sensor Web Integration for the Prediction of Electric Power Supply System Vulnerability

Science.gov (United States)

Stoimenov, Leonid; Bogdanovic, Milos; Bogdanovic-Dinic, Sanja

2013-01-01

Electric power supply companies increasingly rely on enterprise IT systems to provide them with a comprehensive view of the state of the distribution network. Within a utility-wide network, enterprise IT systems collect data from various metering devices. Such data can be effectively used for the prediction of power supply network vulnerability. The purpose of this paper is to present the Enterprise Service Bus (ESB)-based Sensor Web integration solution that we have developed with the purpose of enabling prediction of power supply network vulnerability, in terms of a prediction of defect probability for a particular network element. We will give an example of its usage and demonstrate our vulnerability prediction model on data collected from two different power supply companies. The proposed solution is an extension of the GinisSense Sensor Web-based architecture for collecting, processing, analyzing, decision making and alerting based on the data received from heterogeneous data sources. In this case, GinisSense has been upgraded to be capable of operating in an ESB environment and combine Sensor Web and GIS technologies to enable prediction of electric power supply system vulnerability. Aside from electrical values, the proposed solution gathers ambient values from additional sensors installed in the existing power supply network infrastructure. GinisSense aggregates gathered data according to an adapted Omnibus data fusion model and applies decision-making logic on the aggregated data. Detected vulnerabilities are visualized to end-users through means of a specialized Web GIS application. PMID:23955435

Target specific oral anticoagulants in the management of thromboembolic disease in the elderly.

Science.gov (United States)

Maddula, Surekha; Ansell, Jack

2013-08-01

The elderly population represents a population at highest risk of thromboembolism, but also the most vulnerable to hemorrhage. In the community setting there is a general tendency to under- treat this patient group. Specific consideration must be taken with elderly patients because they have reduced renal function, co-morbidities and risk of falls, altered pharmacodynamics, and challenges with adherence. Vitamin K antagonists, most often warfarin, have been the first line choice of therapy for long-term anticoagulation and enjoyed an unopposed position in the market for the last 70 years. Recently several new oral anticoagulants have been developed and found to be equally effective as warfarin in phase III studies and may provide an optimal treatment option in the elderly population. In this review we explore the target-specific oral anticoagulants and the pharmacological differences between them with a focus on the elderly population in whom these new drugs would constitute a possible alternative to warfarin therapy.

The Relationship Between Social Isolation and Health Among the Tehranian Elderly

Directory of Open Access Journals (Sweden)

Ali Seyfzadeh

2017-12-01

Full Text Available Background and Objectives: Given the growing population of the elderly and the increasing age-related disability, age-related social isolation and the role of health are important in reducing this phenomenon. The main purpose of the research is to investigate the relationship between social isolation and health in the elderly in Tehran. Materials and Methods: This cross-sectional study was a correlation study. The present study was conducted in 1396 and among 382 elderly people 65 years old and above Tehran who were selected by multi-stage cluster sampling method. The data gathering tool was Goldberg General Health Questionnaire (GHQ, Daily Living Ability Questionnaire (ADL and Keizer Health Social Questionnaire. Data were analyzed by SPSS software version 22 using descriptive and analytical methods with Pearson correlation coefficient.52.4 Results: % 52.4 of the respondents had physical health,% 56.8 of social health and% 60.5 of mental health, and the average social isolation in the elderly was about 62%. The results of Pearson correlation coefficient indicated that there was a significant and inverse relationship between mental health and social isolation of elderly people, which means that with increasing mental and social health, the social isolation of the elderly is reduced. Conclusion: There is a reverse relationship between health and social isolation in elderly people and Having mental and social health can have a positive effect on reducing the social isolation of this vulnerable stratum

Ethical challenges related to elder care. High level decision-makers' experiences

Directory of Open Access Journals (Sweden)

Kihlgren Mona

2007-04-01

Full Text Available Abstract Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to

Ethical challenges related to elder care. High level decision-makers' experiences.

Science.gov (United States)

Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

2007-04-10

Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

OpenAIRE

Guan, Kai; Shao, Minggang; Wu, Shuicai

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) ...

PSA based vulnerability and protectability analysis for NPPs

International Nuclear Information System (INIS)

Gopika, V.; Sanyasi Rao, V.V.S.; Ghosh, A.K.; Kushwaha, H.S.

2012-01-01

Highlights: ► The paper describes the generation of location sets and protection sets. ► Vulnerability and protectability used to rank location sets and protection sets. ► Ranking helps in adequacy of protection measures employed in various locations. ► The procedure for PSA based vital area identification is demonstrated. ► This method has found practical applicability for Indian NPP. -- Abstract: Identification of vital areas in a facility involves assessing the facility and the locations, whose sabotage can result in undesirable (radiological) consequences. Probabilistic Safety Assessment (PSA) technique can find the component failures leading to core damage (a surrogate for radiological consequence) in a systematic manner, which can be extended to identification of vital areas. This paper describes the procedure for the generation of location sets (set of locations whose sabotage can lead to possible core damage) and protection sets (set of locations that must be protected to prevent possible core damage). In addition, measures such as vulnerability and protectability have been introduced, which can be used to rank location sets and protection sets.

[Strategies for protecting the elderly from the health-risks of heat-waves: measures undertaken in Italy in the summer of 2004].

Science.gov (United States)

de Martino, Annamaria; Vasselli, Stefania; D'Argenio, Paolo

2005-01-01

Heat waves constitute an important public health problem because of their potential serious health impact on vulnerable populations such as the elderly and individuals living in poor health, socioeconomic, cultural or environmental conditions. The summer of 2003 was the hottest summer, with respect to both minimum and maximum temperatures, of the last fifty years. During that summer, an increased mortality was found especially in the elderly population = 75 years. The Ministry of Health therefore released guidelines for the regions and other local authorities, regarding the measures be undertaken in order to safeguard the elderly and other vulnerable populations from the health risks associated with heat waves. Subsequently, a survey was performed to collect information regarding the projects put into practice in the summer of 2004 by the various regions and local authorities. The aim of the study was to promote a comparison and sharing of appropriately documented experiences. This article classifies and describes the various interventions that were put into practice.

Putting the puzzle together: Reducing vulnerability through people-focused planning

International Nuclear Information System (INIS)

Hutton, D.

2009-01-01

Supporting and integrating vulnerable persons into emergency management has emerged as an increasing priority in emergency management in Canada. Events such as the 2003 European heat wave and Hurricane Katrina have shown that disasters almost always have the harshest affects on the frail elderly, people with disabilities, the disadvantaged and the least able. While it is neither possible-nor the role of emergency management-to eliminate or reduce many factors that make people vulnerable to hazards, it is important that emergency managers work closely with communities to not only identify risks and vulnerabilities, but also to build on the resources and capacities that enable people to effectively prepare for, respond to and recover from threats of all types. To this end, emergency management must take into account the level of capacities and resources that a community has to prepare for emergencies and disasters, in addition to people's vulnerabilities to extreme events. To be successful, people must be viewed not as a part of the problem to be solved or managed during an emergency, but rather a part of the solution to building more resilient and disaster-resistant societies. This requires 'people-focused' planning methodologies that move beyond planning for to planning with all segments of society, including the most vulnerable and marginalised groups that are more readily overlooked. This not only begins to ensure that emergency planning and response capacities can effectively address the diverse needs of all people, but is also an important step to empowering the most vulnerable to prepare themselves for emergencies and other critical events. (authors)

A rainfall risk analysis thanks to an GIS based estimation of urban vulnerability

Science.gov (United States)

Renard, Florent; Pierre-Marie, Chapon

2010-05-01

heavy rains, to locate areas of risk in the urban area. The targets that share the same rank of this vulnerability index do not possess the same importance, or the same sensitivity to the flood hazard. Therefore, the second part of this work is to define the priorities and sensitivities of different targets based on the judgments of experts. Multicriteria decision methods are used to prioritize elements and are therefore adapted to the modelling of the sensitivity of the issues of greater Lyon (Griot, 2008). The purpose of these methods is the assessment of priorities between the different components of the situation. Thomas Saaty's analytic hierarchy process (1980) is the most frequently used because of its many advantages. On this basis, the formal calculations of priorities and sensitivities of the elements have been conducted. These calculations are based on the judgments of experts. Indeed, during semi-structured interview, the 38 experts in our sample delivered a verdict on issues that seem relatively more important than others by binary comparison. They carry the same manner to determine sensitivity's stakes to hazard flooding. Finally, the consistency of answers given by experts is validated by calculating a ratio of coherence, and their results are aggregated to provide functions of priority (based on the relative importance of each stakes), and functions of sensitivity (based on the relative sensitivity of each stakes). From these functions of priority and sensitivity is obtained the general function of vulnerability. The vulnerability functions allow defining the importance of the stakes of Greater Lyon and their sensitivity to hydrological hazards. The global vulnerability function is obtained from sensitivity and priority functions and shows the great importance of human issues (75 %). The vulnerability factor of environmental targets represents 12 % of the global vulnerability function, as much as the materials issues. However, it can be seen that the

METHODOLOGICAL APPROACH TO ANALYSIS AND EVALUATION OF INFORMATION PROTECTION IN INFORMATION SYSTEMS BASED ON VULNERABILITY DANGER

Directory of Open Access Journals (Sweden)

Y. M. Krotiuk

2008-01-01

Full Text Available The paper considers a methodological approach to an analysis and estimation of information security in the information systems which is based on the analysis of vulnerabilities and an extent of their hazard. By vulnerability hazard it is meant a complexity of its operation as a part of an information system. The required and sufficient vulnerability operational conditions  have  been  determined in the paper. The paper proposes a generalized model for attack realization which is used as a basis for construction of an attack realization model for an operation of a particular vulnerability. A criterion for estimation of information protection in the information systems which is based on the estimation of vulnerability hazard is formulated in the paper. The proposed approach allows to obtain a quantitative estimation of the information system security on the basis of the proposed schemes on realization of typical attacks for the distinguished classes of vulnerabilities.The methodical approach is used for choosing variants to be applied for realization of protection mechanisms in the information systems as well as for estimation of information safety in the operating information systems.

The use of community-based social services by elderly people at risk of institutionalization: An evaluation

NARCIS (Netherlands)

van Bilsen, P.M.A.; Hamers, J.P.H.; Groot, W.; Spreeuwenberg, C.

2008-01-01

Objective: To examine the use of community-based social services by elderly people at risk of institutionalization, who prefer to remain at home. Methods: A study with a longitudinal design (measurements at two points in time) was conducted. Results: One hundred and thirty-four elderly people (mean

Physically-Based Assessment of Intrinsic Groundwater Resource Vulnerability in AN Urban Catchment

Science.gov (United States)

Graf, T.; Therrien, R.; Lemieux, J.; Molson, J. W.

2013-12-01

Several methods exist to assess intrinsic groundwater (re)source vulnerability for the purpose of sustainable groundwater management and protection. However, several methods are empirical and limited in their application to specific types of hydrogeological systems. Recent studies suggest that a physically-based approach could be better suited to provide a general, conceptual and operational basis for groundwater vulnerability assessment. A novel method for physically-based assessment of intrinsic aquifer vulnerability is currently under development and tested to explore the potential of an integrated modelling approach, combining groundwater travel time probability and future scenario modelling in conjunction with the fully integrated HydroGeoSphere model. To determine the intrinsic groundwater resource vulnerability, a fully coupled 2D surface water and 3D variably-saturated groundwater flow model in conjunction with a 3D geological model (GoCAD) has been developed for a case study of the Rivière Saint-Charles (Québec/Canada) regional scale, urban watershed. The model has been calibrated under transient flow conditions for the hydrogeological, variably-saturated subsurface system, coupled with the overland flow zone by taking into account monthly recharge variation and evapotranspiration. To better determine the intrinsic groundwater vulnerability, two independent approaches are considered and subsequently combined in a simple, holistic multi-criteria-decision analyse. Most data for the model comes from an extensive hydrogeological database for the watershed, whereas data gaps have been complemented via field tests and literature review. The subsurface is composed of nine hydrofacies, ranging from unconsolidated fluvioglacial sediments to low permeability bedrock. The overland flow zone is divided into five major zones (Urban, Rural, Forest, River and Lake) to simulate the differences in landuse, whereas the unsaturated zone is represented via the model

Short- and long-term neurocognitive functioning after electroconvulsive therapy in depressed elderly: a prospective naturalistic study

NARCIS (Netherlands)

Verwijk, E.; Comijs, H.C.; Kok, R.M.; Spaans, H.P.; Tielkes, C.E.M.; Scherder, E.J.A.; Stek, M.L.

2014-01-01

Background: It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressed patients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning

Sociodemographic characteristics of the elderly forced migrants in Serbia

Directory of Open Access Journals (Sweden)

Lukić Vesna

2015-01-01

Full Text Available In the context of the needs and rights of older migrants, migration history is particularly important where the elderly forced migrants are twice as vulnerable. Bearing in mind the intense process of population aging in Serbia which holds the attention of scientists and experts, and the large number of refugees who immigrated in the 90-ies from the former Yugoslav republics, selected sociodemographic structures of the elderly forced migrants in Serbia were analyzed as well as the relevant legal and strategic framework. The aim was to contribute to increasing knowledge of the demographic challenges of this subpopulation of forced migrants, as well as the differences relative to the domicile aging population. The data used in this study included a contingent of forced migrants aged 65 and over, on the basis of additionally processed Census data from 2011, based on questions about the place of birth of the person, year of arrival, the country in which the person lived and the reasons for migration. Hence, the category which is the subject of research, is not defined on the basis of formal refugee status. A comparison of selected sociodemographic characteristics was made in relation to the domicile population, which in the paper means the population of Serbia without forced migrants. The research results indicate that older forced migrants in Serbia have characteristics of the general population of older people in Serbia. Their age gender and marital structures are relatively similar. Most older women are widows who are heads of households, while a significant number are persons with disabilities as well. However, the process of aging of the elderly, present within the local population has not affected forced migrants yet, so this population is to some extent more vital. Data on the economic activity of the elderly forced migrants in Serbia point out to the lack of income as the main problem they are faced with. Older forced migrants are

Overweight and obesity among elderly in an urban slum of Puducherry: A facility-based descriptive study

Directory of Open Access Journals (Sweden)

Bijaya Nanda Naik

2018-01-01

Full Text Available Background: Overweight and obesity are important addendum to the pool of risk factors for noncommunicable disease (NCD among the elderly. Objectives: The objectives of this study were to find (1 the proportion of overweight and obesity and (2 the distribution of overweight and obesity based on sociodemographic characteristics and four major risk factors for NCDs (smoking, alcohol consumption, unhealthy diet, and physical inactivity among the elderly attending the out-patient department/NCD clinic of a Urban Health and Training Centre (UHTC. Materials and Methods: This facility-based descriptive study was conducted among 181 elderly attending one UHTC, in Puducherry during June and July 2015. A pretested interview schedule was used to obtain information on sociodemographic details and history of NCD risk factors after obtaining verbal informed consent. Anthropometric measurements were taken as per standard procedures prescribed by the World Health Organization. Body mass index (BMI was calculated and classified using BMI classification for the Asian population. Results: Among the elderly, 18% were overweight and 51% were obese. The proportion of obesity was more among females than males. Obesity was found to be decreasing with increase in age. Overweight and obesity were found to be significantly inversely related to chronic disease status. Overweight and obesity were proportionately more among elderly who were consuming alcohol and doing less physical activity than prescribes. However, the proportion of overweight/obees elderly with no tobacco use and not having unhealthy diet was found to be more than their counterpart. Conclusion: Overweight and obesity are important public health problems in the study population. Hence, interventions should be implemented targeting elderly as well as the adult to decrease the obesity and overweight among the elderly.

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway.

Science.gov (United States)

Guan, Kai; Shao, Minggang; Wu, Shuicai

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

Science.gov (United States)

Shao, Minggang

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly. PMID:29204258

Interference Control In Elderly Bilinguals: Appearances Can Be Misleading.

Science.gov (United States)

Ansaldo, Ana Inés; Ghazi-Saidi, Ladan; Adrover-Roig, Daniel

2015-01-01

Bilingualism has been associated with successful aging. In particular, research on the cognitive advantages of bilingualism suggests that it can enhance control over interference and help delay the onset of dementia signs. However, the evidence on the so-called cognitive advantage is not unanimous; furthermore, little is known about the neural basis of this supposed cognitive advantage in bilingual as opposed to monolingual elderly populations. In this study, elderly bilingual and monolingual participants performed a visuospatial interference control task during functional magnetic resonance imaging (fMRI) scanning. Response times and accuracy rates were calculated for congruent and incongruent conditions of the Simon task, and the neurofunctional correlates of performance on the Simon task were examined. The results showed equivalent performance on the Simon task across groups but different underlying neural substrates in the two groups. With incongruent trials, monolinguals activated the right middle frontal gyrus, whereas bilinguals relied upon the left inferior parietal lobule. These results show that elderly bilinguals and monolinguals have equivalent interference control abilities, but relay on different neural substrates. Thus, while monolinguals show a classical PASA (posterior-anterior shift in aging) effect, recruiting frontal areas, bilinguals activate visuospatial processing alone and thus do not show this posterior-anterior shift. Moreover, a modulation of frontal activity with task-dynamic control of interference, observed in the elderly bilingual group alone, suggests that elderly bilinguals deal with interference control without recruiting a circuit that is particularly vulnerable to aging.

Noise and poise: Enhancement of postural complexity in the elderly with a stochastic-resonance based therapy

Science.gov (United States)

Costa, M.; Priplata, A. A.; Lipsitz, L. A.; Wu, Z.; Huang, N. E.; Goldberger, A. L.; Peng, C.-K.

2007-03-01

Pathologic states are associated with a loss of dynamical complexity. Therefore, therapeutic interventions that increase physiologic complexity may enhance health status. Using multiscale entropy analysis, we show that the postural sway dynamics of healthy young and healthy elderly subjects are more complex than that of elderly subjects with a history of falls. Application of subsensory noise to the feet has been demonstrated to improve postural stability in the elderly. We next show that this therapy significantly increases the multiscale complexity of sway fluctuations in healthy elderly subjects. Quantification of changes in dynamical complexity of biologic variability may be the basis of a new approach to assessing risk and to predicting the efficacy of clinical interventions, including noise-based therapies.

An Educational Program to Assist Clinicians in Identifying Elder Investment Fraud and Financial Exploitation

Science.gov (United States)

Mills, Whitney L.; Roush, Robert E.; Moye, Jennifer; Kunik, Mark E.; Wilson, Nancy L.; Taffet, George E.; Naik, Aanand D.

2012-01-01

Due to age-related factors and illnesses, older adults may become vulnerable to elder investment fraud and financial exploitation (EIFFE). The authors describe the development and preliminary evaluation of an educational program to raise awareness and assist clinicians in identifying older adults at risk. Participants (n = 127) gave high ratings…

spatially identifying vulnerable areas

African Journals Online (AJOL)

The model structure is aimed at understanding the critical vulnerable factors that ... This paper incorporates multiple criteria and rank risk factors. ..... In terms of quantifying vulnerable areas within the country, the analysis is done based on 9 ...

Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

Science.gov (United States)

Burnes, David; Pillemer, Karl; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Lachs, Mark S

2015-09-01

To estimate past-year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect. Cross-sectional, population-based study using random-digit-dial sampling and direct telephone interviews. New York State households. Representative (race, ethnicity, sex) sample (N = 4,156) of English- or Spanish-speaking, community-dwelling, cognitively intact individuals aged 60 and older. The Conflict Tactics Scale was adapted to assess elder emotional and physical abuse. Elder neglect was evaluated according to failure of a responsible caregiver to meet an older adult's needs using the Duke Older Americans Resources and Services (OARS) scale. Caseness thresholds were based on mistreatment behavior frequencies and elder perceptions of problem seriousness. Past-year prevalence of elder emotional abuse was 1.9%, of physical abuse was 1.8%, and of neglect was 1.8%, with an aggregate prevalence of 4.6%. Emotional and physical abuse were associated with being separated or divorced, living in a lower-income household, functional impairment, and younger age. Neglect was associated with poor health, being separated or divorced, living below the poverty line, and younger age. Neglect was less likely in older adults of Hispanic ethnicity. Elder abuse and neglect are common problems, with divergent risk and protective factor profiles. These findings have direct implications for public screening and education and awareness efforts designed to prevent elder mistreatment. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Take a Multidisciplinary, Team-based Approach on Elder Abuse.

Science.gov (United States)

2016-07-01

While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem. Providing great care to a victim of elder abuse requires time and setting up a circumstance whereby one can actually communicate with the patient reliably and alone. While most states require providers to report suspected cases of elder abuse to Adult Protective Services, there is little evidence this requirement has incentivized more reports in the same way a similar requirement has prompted providers to report cases of suspected child abuse. Investigators advise ED leaders to train and empower every member of their team to identify potential signs of elder abuse.

Two Principles of good elderly care

DEFF Research Database (Denmark)

Dahl, Hanne Marlene; Eskelinen, Leena; Boll Hansen, Eigil

) which is a possibility for the elderly to choose a private provider. Stressing the self-determination of the elderly and the help provided as service is potentially at odds with one of the existing principles of elderly care, namely the professional principle of help-to-self help. It aims at activating...... the elderly person to manage as much as possible themselves and is based upon a socio-pedagogical culture, where the professional is teaching elderly people about the proper behavior. It’s based upon a formal knowledge of aging and upon different techniques to motivate and involve the elderly....... These are clearly different logics. However, no research has so far studied how these concepts are translated from a national to the municipal level to groups of home helpers and to individual home helpers. And how are these principles played out in different contexts of private firms and public providers...

Restoring the quantity and quality of elderly human mesenchymal stem cells for autologous cell-based therapies.

Science.gov (United States)

Block, Travis J; Marinkovic, Milos; Tran, Olivia N; Gonzalez, Aaron O; Marshall, Amanda; Dean, David D; Chen, Xiao-Dong

2017-10-27

Degenerative diseases are a major public health concern for the aging population and mesenchymal stem cells (MSCs) have great potential for treating many of these diseases. However, the quantity and quality of MSCs declines with aging, limiting the potential efficacy of autologous MSCs for treating the elderly population. Human bone marrow (BM)-derived MSCs from young and elderly donors were obtained and characterized using standard cell surface marker criteria (CD73, CD90, CD105) as recommended by the International Society for Cellular Therapy (ISCT). The elderly MSC population was isolated into four subpopulations based on size and stage-specific embryonic antigen-4 (SSEA-4) expression using fluorescence-activated cell sorting (FACS), and subpopulations were compared to the unfractionated young and elderly MSCs using assays that evaluate MSC proliferation, quality, morphology, intracellular reactive oxygen species, β-galactosidase expression, and adenosine triphosphate (ATP) content. The ISCT-recommended cell surface markers failed to detect any differences between young and elderly MSCs. Here, we report that elderly MSCs were larger in size and displayed substantially higher concentrations of intracellular reactive oxygen species and β-galactosidase expression and lower amounts of ATP and SSEA-4 expression. Based on these findings, cell size and SSEA-4 expression were used to separate the elderly MSCs into four subpopulations by FACS. The original populations (young and elderly MSCs), as well as the four subpopulations, were then characterized before and after culture on tissue culture plastic and BM-derived extracellular matrix (BM-ECM). The small SSEA-4-positive subpopulation representing ~ 8% of the original elderly MSC population exhibited a "youthful" phenotype that was similar to that of young MSCs. The biological activity of this elderly subpopulation was inhibited by senescence-associated factors produced by the unfractionated parent population

Identifying novel phenotypes of vulnerability and resistance to activity-based anorexia in adolescent female rats.

Science.gov (United States)

Barbarich-Marsteller, Nicole C; Underwood, Mark D; Foltin, Richard W; Myers, Michael M; Walsh, B Timothy; Barrett, Jeffrey S; Marsteller, Douglas A

2013-11-01

Activity-based anorexia is a translational rodent model that results in severe weight loss, hyperactivity, and voluntary self-starvation. The goal of our investigation was to identify vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats. Sprague-Dawley rats were maintained under conditions of restricted access to food (N = 64; or unlimited access, N = 16) until experimental exit, predefined as a target weight loss of 30-35% or meeting predefined criteria for animal health. Nonlinear mixed effects statistical modeling was used to describe wheel running behavior, time to event analysis was used to assess experimental exit, and a regressive partitioning algorithm was used to classify phenotypes. Objective criteria were identified for distinguishing novel phenotypes of activity-based anorexia, including a vulnerable phenotype that conferred maximal hyperactivity, minimal food intake, and the shortest time to experimental exit, and a resistant phenotype that conferred minimal activity and the longest time to experimental exit. The identification of objective criteria for defining vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats provides an important framework for studying the neural mechanisms that promote vulnerability to or protection against the development of self-starvation and hyperactivity during adolescence. Ultimately, future studies using these novel phenotypes may provide important translational insights into the mechanisms that promote these maladaptive behaviors characteristic of anorexia nervosa. Copyright © 2013 Wiley Periodicals, Inc.

Groundwater vulnerability map for South Africa

African Journals Online (AJOL)

Chiedza Musekiwa

Coastal vulnerability is the degree to which a coastal system is susceptible to, ... methods, indicator-based approaches, GIS-based decision support systems and ..... E 2005, 'Coastal Vulnerability and Risk Parameters', European Water, vol.

The Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the U.S

Science.gov (United States)

Dong, XinQi; Chen, Ruijia; Wu, Bei; Zhang, Ning Jackie; Mui, Ada Chan Yuk-Sim; Chi, Iris

2015-01-01

Background Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. Objectives To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the U.S. Methods Guided by a community-based participatory research approach, this study conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago Area from 2011–2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstok Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results Overall, 3,159 Chinese older adults participated in this study and the mean age was 72.8. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with increased risk for 2-week suicidal ideation (OR 2.46, 95% CI 1.52 – 4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62 – 3.73). With respect to gender differences, the study found that the association remained significant in older women but not in older men after adjusting for all confounding factors. Conclusion As the largest epidemiology study conducted among Chinese older adults in the U.S., this study suggests that elder mistreatment was a risk factor for 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation. PMID:26336817

Feasibility, reliability, and validity of a smartphone based application for the assessment of cognitive function in the elderly.

Directory of Open Access Journals (Sweden)

Robert M Brouillette

Full Text Available While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these "next-generation" assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, p<0.0001 and multiple measures of processing speed and attention (Digit Span: r = 0.427, p<0.0001; Trail Making Test: r = -0.651, p<0.00001; Digit Symbol Test: r = 0.508, p<0.0001. The CST was not correlated with naming and verbal fluency tasks (Boston Naming Test, Vegetable/Animal Naming or memory tasks (Logical Memory Test. Test re-test reliability was observed to be significant (r = 0.726; p = 0.02. Together, these data are the first to demonstrate the feasibility, reliability, and validity of using a smartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries

The Effects of Augmented Reality-based Otago Exercise on Balance, Gait, and Falls Efficacy of Elderly Women.

Science.gov (United States)

Yoo, Ha-Na; Chung, Eunjung; Lee, Byoung-Hee

2013-07-01

[Purpose] The purpose of this study was to determine the effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. [Subjects] The subjects were 21 elderly women, who were randomly divided into two groups: an augmented reality-based Otago exercise group of 10 subjects and an Otago exercise group of 11 subjects. [Methods] All subjects were evaluated for balance (Berg Balance Scale, BBS), gait parameters (velocity, cadence, step length, and stride length), and falls efficacy. Within 12 weeks, Otago exercise for muscle strengthening and balance training was conducted three times, for a period of 60 minutes each, and subjects in the experimental group performed augmented reality-based Otago exercise. [Results] Following intervention, the augmented reality-based Otago exercise group showed significant increases in BBS, velocity, cadence, step length (right side), stride length (right side and left side) and falls efficacy. [Conclusion] The results of this study suggest the feasibility and suitability of this augmented reality-based Otago exercise for elderly women.

Assessment of intrinsic vulnerability of an alluvial aquifer under anthropogenic pressure: cross comparison of 4 index-based groundwater vulnerability mapping models within the Biguglia lagoon watershed (Corsica, France).

Science.gov (United States)

Jaunat, Jessy; Huneau, Frédéric; Garel, Emilie; Devos, Alain; Lejeune, Olivier

2016-04-01

KEYWORDS: Alluvial aquifer, Vulnerability mapping, Index-based methods, DRASTIC, SINTACS, SI, GOD The geographical position of the Biguglia lagoon watershed south of the Bastia city (80 000 inhabitants), lead to a highly vulnerable hydrosystem setting. This littoral plain is the unique territory available for the urbanisation and for the agriculture activities (cattle breeding). All the activities developed are likely to have a qualitative impact on water infiltration and therefore on groundwater, which is in hydraulic connection with the lagoon system. Beyond this ecological issue, groundwater of this watershed is intensively used as drinking water supply. It appears essential to control the long-term groundwater quality of the Biguglia plain which is the major economic zone of Corsica. Achievement of this issue requires the identification of the areas where the alluvial aquifer is mostly vulnerable to anthropogenic activities. The results given by 4 of the most popular index-based vulnerability mapping methods (DRASTIC, SI, SINTACS and GOD) are compared. The water table, net recharge, aquifer and soils properties, topography, vadose zone and land uses have been precisely mapped and numerically translated in GIS with a 25m precision. 4 final maps were finally compiled according to the weighting factors of each methods. Hydrochemical investigations were also carried out on 30 sampling points (major ions and anthropogenic tracers) to evaluate the effect of anthropogenic activities on groundwater quality and also to validate the results of the vulnerability mapping. A comparison between the parametric models shows a significant agreement between the DRASTIC, SINTACS and SI results (2% to 5% of the total area in very low vulnerability class, 10% to 13% in low vulnerability, 16% to 23% in medium vulnerability, 31% to 53% in high vulnerability and 14% to 23% in very high vulnerability). The two first methods are quite similar, which explains the proximity of the

Older persons' views and experience of elder abuse in South Western Nigeria: a community-based qualitative survey.

Science.gov (United States)

Cadmus, Eniola Olubukola; Owoaje, Eme Theodora; Akinyemi, Oluwaseun Oladapo

2015-06-01

Conventionally, existing information on elder abuse has been institution based, professionally driven, and in high-income countries. This study addresses the prevailing gap in knowledge through direct consultation of older persons in the community about their perceptions of elder abuse. Eight focus group discussions were carried out among males and females aged 60 years and above in a rural and an urban community in south western Nigeria. Data were transcribed and analyzed based on emergent themes. Findings from the study show that the perception of abuse by the respondents included the standard typologies except sexual abuse as well as societal issues such as disrespect and lack of recognition. Our study revealed a high level of awareness and experience of elder abuse among the participants in both communities. Effective social welfare and health services aided by targeted government policies are needed to improve the quality of life of the elderly. © The Author(s) 2014.

Noise and health in vulnerable groups: A review

Directory of Open Access Journals (Sweden)

Irene van Kamp

2013-01-01

Full Text Available Vulnerable or susceptible groups are mentioned in most reviews and documents regarding noise and health. But only a few studies address this issue in a concrete and focused way. Groups at risk most often mentioned in the literature are children, the elderly, the chronically ill and people with a hearing impairment. The other categories encountered are those of sensitive persons, shiftworkers, people with mental illness (e.g., schizophrenia or autism, people suffering from tinnitus, and fetuses and neonates. The mechanism for this vulnerability has not been clearly described and relevant research has seldom focused on the health effects of noise in these groups in an integrated manner. This paper summarizes the outcomes and major conclusions of a systematic, qualitative review of studies over the past 5 years. This review was prepared for the 10 th Conference on Noise as a Public Health Problem (ICBEN, 2011. Evidence is reviewed describing effects, groups assumed to be at risk, and mechanisms pertaining to noise sensitivity and learned helplessness.

An Exploitability Analysis Technique for Binary Vulnerability Based on Automatic Exception Suppression

Directory of Open Access Journals (Sweden)

Zhiyuan Jiang

2018-01-01

Full Text Available To quickly verify and fix vulnerabilities, it is necessary to judge the exploitability of the massive crash generated by the automated vulnerability mining tool. While the current manual analysis of the crash process is inefficient and time-consuming, the existing automated tools can only handle execute exceptions and some write exceptions but cannot handle common read exceptions. To address this problem, we propose a method of determining the exploitability based on the exception type suppression. This method enables the program to continue to execute until an exploitable exception is triggered. The method performs a symbolic replay of the crash sample, constructing and reusing data gadget, to bypass the complex exception, thereby improving the efficiency and accuracy of vulnerability exploitability analysis. The testing of typical CGC/RHG binary software shows that this method can automatically convert a crash that cannot be judged by existing analysis tools into a different crash type and judge the exploitability successfully.

Cotton genetic resources and crop vulnerability

Science.gov (United States)

A report on the genetic vulnerability of cotton was provided to the National Genetic Resources Advisory Council. The report discussed crop vulnerabilities associated with emerging diseases, emerging pests, and a narrowing genetic base. To address these crop vulnerabilities, the report discussed the ...

PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR.

Science.gov (United States)

Du Mont, Janice; Mirzaei, Aftab; Macdonald, Sheila; White, Meghan; Kosa, Daisy; Reimer, Linda

2014-12-01

Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way. Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada. In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers. We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner. The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

Vulnerability to temperature-related mortality in Seoul, Korea

International Nuclear Information System (INIS)

Son, Ji-Young; Anderson, G Brooke; Bell, Michelle L; Lee, Jong-Tae

2011-01-01

Studies indicate that the mortality effects of temperature may vary by population and region, although little is known about the vulnerability of subgroups to these risks in Korea. This study examined the relationship between temperature and cause-specific mortality for Seoul, Korea, for the period 2000-7, including whether some subgroups are particularly vulnerable with respect to sex, age, education and place of death. The authors applied time-series models allowing nonlinear relationships for heat- and cold-related mortality, and generated exposure-response curves. Both high and low ambient temperatures were associated with increased risk for daily mortality. Mortality risk was 10.2% (95% confidence interval 7.43, 13.0%) higher at the 90th percentile of daily mean temperatures (25 deg. C) compared to the 50th percentile (15 deg. C). Mortality risk was 12.2% (3.69, 21.3%) comparing the 10th (-1 deg. C) and 50th percentiles of temperature. Cardiovascular deaths showed a higher risk to cold, whereas respiratory deaths showed a higher risk to heat effect, although the differences were not statistically significant. Susceptible populations were identified such as females, the elderly, those with no education, and deaths occurring outside of a hospital for heat- and cold-related total mortality. Our findings provide supportive evidence of a temperature-mortality relationship in Korea and indicate that some subpopulations are particularly vulnerable.

Household characteristics and influenza vaccination uptake in the community-dwelling elderly: a cross-sectional study

Science.gov (United States)

Chan, Denise P.C.; Wong, Ngai Sze; Wong, Eliza L.Y.; Cheung, Annie W.L.; Lee, Shui Shan

2015-01-01

Elderly people are at higher risk of influenza diseases. The morbidity benefit of vaccination is often offset by its low and variable coverage in elderly people in the community. To assess household and individual factors associated with influenza vaccination uptake in the community-dwelling elderly of age ≥ 65, data from a cross-sectional Thematic Household Survey conducted in 2011/12 in Hong Kong were analysed, using vaccination in the past 12 months as the outcome variable. Households comprising an elderly person living with non-elderly member(s) of age ≤ 64 were also evaluated. Data fields included socio-demographics, household structures, health status, eligibility to financial subsidy, and subscription to health insurance. The influenza vaccination rate was 27% in 4204 elderly persons from 3224 households. Being male, being economically active, attaining primary education, having smoking behaviours were negatively associated with vaccination, while chronic illness and age ≥ 70 were positively associated factors. Elderly people living alone gave a variable rate of vaccination ranging from 16.4% in males of age 65–69 to 36.3% in females ≥ 70. Household size per se was not associated with vaccination, but a positive correlation could be seen if the household was composed of vaccinated non-elderly member(s). Influenza vaccination uptake in the community-dwelling elderly is dependent on both individual and household characteristics, the latter including the influence of vaccinated non-elderly member(s). The low vaccination coverage of “younger” (age 65–69) elderly men living alone is particularly worrisome. Interventions focusing on vulnerable elderly people and their social networks would be desirable. PMID:26844153

[Integrated assessment of eco-environmental vulnerability in Pearl River Delta based on RS and GIS].

Science.gov (United States)

Xu, Qing-Yong; Huang, Mei; Liu, Hong-Sheng; Yan, Hui-Min

2011-11-01

Based on the remote sensing data and with the help of geographic information system, an integrated assessment was conducted on the eco-environmental vulnerability of Pearl River Delta in 2004-2008. Spatial principal component analysis was used to generate the evaluation indicators, and analytic hierarchy process (AHP) was applied to determine the weights of the evaluation factors. The reasons causing the vulnerability of the eco- environment in Pearl River Delta were discussed. In the study area, its middle part was the most vulnerable region, occupying 34.0% of the total, eastern part was the moderately vulnerable region, accounting for 25.5%, and western part was the lightly and slightly vulnerable areas, accounting for 28.7 and 11.8%, respectively. Totally, the moderately and lightly vulnerable areas occupied 54.2%, indicating that a majority of the Delta was under moderate and light vulnerability. The natural factors affecting the eco-environmental vulnerability of the Delta were altitude, heavy rain days, water and soil erosion rate, flooded infield rate, normalized difference vegetation index (ND VI) and landscape diversity index, whereas the human factors were population density, waste discharge per unit area, exhaust emission per unit area, land use change, chemical fertilization intensity, pesticide application intensity, amount of motor vehicles possessed by ten thousands people, and index of environmental protection investment. The main characteristics of the extremely and heavily vulnerable regions were low altitude, high frequency of flood disaster, large flooded infield, serious vegetation degradation, high pollution level and low environment protection investment index.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes.

Science.gov (United States)

Ali, Bako; Awad, Ali Ismail

2018-03-08

The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or "things" to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

Social exclusion domains of the elderly: A systematic review

Directory of Open Access Journals (Sweden)

Maliheh Khalvati

2015-03-01

Full Text Available Background: The elderly are considered as one of the vulnerable groups as they are subjected to the risk of decrease of participation in different domains of their life due to losing their jobs, a drop in salary and the increase of health-related problems. The current research was aimed to seek the elderly social exclusion domains in various countries around the world. Methods: This systematic review analyzed the published studies from 1999 to 2013. The articles were searched using the keywords of social exclusion along with old people, aging, elderly both in Persian and English in Google search engine and the Iranian and international databases. From among 77 studies obtained, 16 studies met the inclusion criteria for this research. Results: the findings indicated that the majority of studies (9 were conducted in Britain and the most common logical model was distributional and relational approach. Indicators were categorized in 5 domains: economic, social, health, environmental and neighborhood, and discrimination and elderly-oriented. In 50 percent of studies, access or lack of access to services, civil participations and social relations, in 12.5 percent of studies, access to proper health and in 18.7 percent of studies, living in secure environment and neighborhood were the indicators which attracted the most attention in evaluating the elderly social exclusion. Conclusion: Generally, choosing a logical and proper model to design and evaluate social exclusion contributed to decreasing the problems of social exclusion evaluation. Using the data gathered in family panels can also facilitate access to the data related to periodical evaluation of social exclusion.

The hydrological vulnerability of western North American boreal tree species based on ground-based observations of tree mortality

Science.gov (United States)

Hember, R. A.; Kurz, W. A.; Coops, N. C.

2017-12-01

Several studies indicate that climate change has increased rates of tree mortality, adversely affecting timber supply and carbon storage in western North American boreal forests. Statistical models of tree mortality can play a complimentary role in detecting and diagnosing forest change. Yet, such models struggle to address real-world complexity, including expectations that hydrological vulnerability arises from both drought stress and excess-water stress, and that these effects vary by species, tree size, and competitive status. Here, we describe models that predict annual probability of tree mortality (Pm) of common boreal tree species based on tree height (H), biomass of larger trees (BLT), soil water content (W), reference evapotranspiration (E), and two-way interactions. We show that interactions among H and hydrological variables are consistently significant. Vulnerability to extreme droughts consistently increases as H approaches maximum observed values of each species, while some species additionally show increasing vulnerability at low H. Some species additionally show increasing vulnerability to low W under high BLT, or increasing drought vulnerability under low BLT. These results suggest that vulnerability of trees to increasingly severe droughts depends on the hydraulic efficiency, competitive status, and microclimate of individual trees. Static simulations of Pm across a 1-km grid (i.e., with time-independent inputs of H, BLT, and species composition) indicate complex spatial patterns in the time trends during 1965-2014 and a mean change in Pm of 42 %. Lastly, we discuss how the size-dependence of hydrological vulnerability, in concert with increasingly severe drought events, may shape future responses of stand-level biomass production to continued warming and increasing carbon dioxide concentration in the region.

The Elderly: A New Social Actor ahead of the finitude/death

Directory of Open Access Journals (Sweden)

Rita de Cássia da Silva Oliveira

2014-11-01

Full Text Available Longevity is one of humanity’s greatest conquests, however the aging process and old age itself are still filed with stereotypes and negative stigmas. Despite all of the prejudice suffered by the elderly in the Brazilian culture, this age group has been gaining more visibility as far as public policies are concerned, and have also been understood in a distinctive manner by the research field. In spite of the demographic growth and aging, Brazil did not satisfactorily equate the issues regarding the demands of this age segment.  Today, the elderly Brazilian population represents 22 million people, or 12% of the total population. According to projections of the Instituto Brasileiro de Geografia e Estatística, in 2025 Brazil will have an elderly population of 34 million: how will these elderlies? The goal of the article is after to identify the stereotypes that impregnated the old aged, reflect about the elderly in your new paper as a social actor while identifying the social movements focused for this segment. A bibliography research was performed. The conclusion was because of a hostile scenario imposed by a contemporary society to the elderly, the need for public policies recognize and guaranteeing basic rights for them is imperative. Despite the prejudices, the elderly mobilizations enable them to overcome situations of vulnerability, which they are exposed especially when in the proximity of your finitude. To the consolidation of a social actor, we need educational actions directed to that segment, bringing knowledge and information for all elderly. Education throughout life has a relevant role, in order to equip and empower the elderly. Hence, it will be possible to think, in actuality, of an elderly that is more active, participative and integrated to society, it is positioned to searching for their rights and engaging in social movements, ultimately escaping the stereotype still widespread in society that nothing else in life would

[ELDERLY ADULTS IN NURSING HOMES IN THE PROVINCE OF CORDOBA: OBJECTS OF CARE OR LEGAL SUBJECTS?].

Science.gov (United States)

Butinof, Mariana; Guri, Ana Karina; Rodríguez, Guadalupe; Abraham, María Daniela; Vera, Yanina; Gassmann, Jesica

2015-01-01

Argentina is among the Ibero-American countries with the greatest old age population, and is going through a process of advanced demographic transition. Elderly adults have long been considered a vulnerable group in need of care. The purpose of this work was to problematize the conceptions underlying the care given to the elderly in nursing homes, and the possible slides this involves from a human rights stance. An approach to this problem was built up by resorting to secondary documentary sources and interviews with key informants located in institutions for the elderly in the Province of Cordoba. This approach revealed a predominantly asylum-oriented conception centered on caring for others as objects, and a noticeable lack of consideration for the elderly as legal subjects, visible in numerous serious infringements of human rights, mostly silenced and rendered invisible. It seems that to overcome these situations it will be necessary not merely to review legal loopholes and current programs but also to reconsider the place given to the elderly in society. Regardless of their age and other social differences, the elderly require the same opportunities to claim full respect and exercise their human rights and fundamental freedoms.

A need for evidence-based clinical practice guidelines for the use of heparins in the elderly

Directory of Open Access Journals (Sweden)

Isabelle Gouin-Thibault

2010-04-01

Full Text Available Isabelle Gouin-Thibault1,2, Virginie Siguret1,2, Eric Pautas2,31Assistance Publique Hôpitaux de Paris, Laboratoire d’Hématologie, Hôpital Charles Foix, Paris, France; 2Université Paris Descartes, INSERM U, Paris, France; 3Assistance Publique Hôpitaux de Paris, Unité de Gériatrie Aiguë, Hôpital Charles Foix, Paris, FranceAbstract: Low-molecular-weight heparins (LMWHs have been widely studied in pivotal clinical trials or in several meta-analyses. However, the safety and optimal use of LMWHs in high-risk patients such as the very elderly remains uncertain since these patients are usually excluded from clinical trials. In terms of LMWHs in the elderly, the main concerns are renal failure and the risk of accumulation. A clinical approach consisting of a LMWH dose reduction in the elderly should be considered with great caution in terms of efficacy, since it has been tested neither in the treatment of VTE nor in VTE prophylaxis. If monitoring is considered in patients receiving therapeutic dose LMWHs, appropriate target ranges for peak anti-Xa activity levels should be used and so far, no anti-Xa activity-based guidelines have been issued. Moreover, no data support any laboratory monitoring in elderly patients treated with prophylactic dose LMWHs.Keywords: elderly patients, low-molecular-weight heparin, renal insufficiency, evidence-based medicine

Theories and measures of elder abuse.

Science.gov (United States)

Abolfathi Momtaz, Yadollah; Hamid, Tengku Aizan; Ibrahim, Rahimah

2013-09-01

Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

Prevention and early identification of elder abuse.

Science.gov (United States)

Burnett, Jason; Achenbaum, W Andrew; Murphy, Kathleen Pace

2014-11-01

Elder abuse is a public health problem growing more pervasive despite being grossly underreported and underdetected. Annually, many vulnerable older adults suffer various forms of abuse threatening their overall health, quality of life, and survival. To better protect our aging population, we must overcome obstacles such as ageism, lack of geriatric health professional training, and low screening practices in clinical settings. Addressing these challenges is not sufficient for eliminating the abuse of older adults, but it is necessary for diminishing the potential for abuse and the associated negative health outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

An Integrated Model of Co-ordinated Community-Based Care.

Science.gov (United States)

Scharlach, Andrew E; Graham, Carrie L; Berridge, Clara

2015-08-01

Co-ordinated approaches to community-based care are a central component of current and proposed efforts to help vulnerable older adults obtain needed services and supports and reduce unnecessary use of health care resources. This study examines ElderHelp Concierge Club, an integrated community-based care model that includes comprehensive personal and environmental assessment, multilevel care co-ordination, a mix of professional and volunteer service providers, and a capitated, income-adjusted fee model. Evaluation includes a retrospective study (n = 96) of service use and perceived program impact, and a prospective study (n = 21) of changes in participant physical and social well-being and health services utilization. Over the period of this study, participants showed greater mobility, greater ability to meet household needs, greater access to health care, reduced social isolation, reduced home hazards, fewer falls, and greater perceived ability to obtain assistance needed to age in place. This study provides preliminary evidence that an integrated multilevel care co-ordination approach may be an effective and efficient model for serving vulnerable community-based elders, especially low and moderate-income elders who otherwise could not afford the cost of care. The findings suggest the need for multisite controlled studies to more rigorously evaluate program impacts and the optimal mix of various program components. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

OpenAIRE

Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

2010-01-01

Abstract Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by...

A Systematic Review of Elderly Suicide Prevention Programs

Science.gov (United States)

Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda; De Leo, Diego; Oyama, Hirofumi; Scocco, Paolo; Gallo, Joseph; Szanto, Katalin; Conwell, Yeates; Draper, Brian; Quinnett, Paul

2013-01-01

Background Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. Aims We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas needing further exploration. Methods Searches through various electronic databases yielded 19 studies with an empirical evaluation of a suicide prevention or intervention program designed especially for adults aged 60 years and older. Results Most studies were centered on the reduction of risk factors (depression screening and treatment, and decreasing isolation), but when gender was considered, programs were mostly efficient for women. The empirical evaluations of programs attending to the needs of high-risk older adults seemed positive; most studies showed a reduction in the level of suicidal ideation of patients or in the suicide rate of the participating communities. However, not all studies used measures of suicidality to evaluate the outcome of the intervention, and rarely did they aim at improving protective factors. Conclusions Innovative strategies should improve resilience and positive aging, engage family and community gatekeepers, use telecommunications to reach vulnerable older adult, and evaluate the effects of means restriction and physicians education on elderly suicide. PMID:21602163

The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey.

Science.gov (United States)

Sooryanarayana, Rajini; Choo, Wan Yuen; Hairi, Noran N; Chinna, Karuthan; Hairi, Farizah; Ali, Zainudin Mohamad; Ahmad, Sharifah Nor; Razak, Inayah Abdul; Aziz, Suriyati Abdul; Ramli, Rohaya; Mohamad, Rosmala; Mohammad, Zaiton Lal; Peramalah, Devi; Ahmad, Noor Ani; Aris, Tahir; Bulgiba, Awang

2017-09-01

As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. Cross-sectional study, analysing baseline findings of a cohort of older adults. Kuala Pilah district, Negeri Sembilan state, Malaysia. To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach.

Science.gov (United States)

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-04-10

Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.

A New Remote Health-Care System Based on Moving Robot Intended for the Elderly at Home

Directory of Open Access Journals (Sweden)

Bing Zhou

2018-01-01

Full Text Available Nowadays, due to the growing need for remote care and the constantly increasing popularity of mobile devices, a large amount of mobile applications for remote care support has been developed. Although mobile phones are very suitable for young people, there are still many problems related to remote health care of the elderly. Due to hearing loss or limited movements, it is difficult for the elderly to contact their families or doctors via real-time video call. In this paper, we introduce a new remote health-care system based on moving robots intended for the elderly at home. Since the proposed system is an online system, the elderly can contact their families and doctors quickly anytime and anywhere. Besides call, our system involves the accurate indoor object detection algorithms and automatic health data collection, which are not included in existing remote care systems. Therefore, the proposed system solves some challenging problems related to the elderly care. The experiment has shown that the proposed care system achieves excellent performance and provides good user experience.

Handling a challenging context: experiences of facilitating evidence-based elderly care.

Science.gov (United States)

Nygårdh, Annette; Ahlström, Gerd; Wann-Hansson, Christine

2016-03-01

To explore improvement facilitators' experiences of handling their commission to implement evidence-based practice in elderly care for frail older persons. Improvement facilitators were put in place across Sweden in a time-limited project by the government, with one part of the project being to evaluate the model before establishing this facilitation of evidence-based practice in elderly care. Two focus groups were interviewed twice. Each group comprised three respondents. The interviews were analysed using qualitative content analysis. A main theme, 'Moving forward by adjusting to the circumstances', described how the improvement facilitators handle their commitment. Five subthemes emerged: identifying barriers, keeping focus, maintaining motivation, building bridges and finding balance. The improvement facilitators' commitment is ambiguous because of unclear leadership of, and responsibility for the national investment. They have to handle leaders' different approaches and justify the need for evidence-based practice. The improvement facilitators did not reflect on the impact of programme adaptations on evidence-based practice. The findings emphasise the need for collaboration between the improvement facilitator and the nurse manager. To fully implement evidence-based practice, negotiations with current practitioners for adaptation to local conditions are necessary. Furthermore, the value of improving organisational performance needs to be rigorously communicated throughout the organisation. © 2015 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Review of Effects of Physical Activity on Strength, Balance, Mobility and ADL Performance in Elderly Subjects with Dementia

NARCIS (Netherlands)

Blankevoort, Christiaan G.; van Heuvelen, Marieke J. G.; Boersma, Froukje; Luning, Helga; de Jong, Jeltsje; Scherder, Erik J. A.

2010-01-01

Background/Aims: Elderly individuals with dementia are vulnerable for a decline in physical functioning and basic activities of daily living (BADL) which can lead to a decline in autonomy and participation. This study reviews the effect of physical activity on physical functioning and BADL in

Use of telemedicine-based care for the aging and elderly: promises and pitfalls

Directory of Open Access Journals (Sweden)

Bujnowska-Fedak MM

2015-05-01

Full Text Available Maria Magdalena Bujnowska-Fedak, Urszula Grata-Borkowska Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland Abstract: Telemedicine-based care provides remote health and social care to maintain people's autonomy and increase their quality of life. The rapidly aging population has come with a significant increase in the prevalence of chronic diseases and their effects, and thus the need for increased care and welfare. The elderly have become one of the main target groups for telecare technologies. Smart home systems allow older adults to live in the environment of their choice and protect them against institutionalization or placement in a nursing home. It gives the elderly person a feeling of reassurance and safety, and appears to be one of the most promising approaches to facilitate independent living in a community-dwelling situation. Telecare solutions give a new opportunity for diagnosis, treatment, education, and rehabilitation, and make it possible to monitor patients with a number of chronic diseases. It also reduces socioeconomic disparity with regard to access to care and gives equal chances to patients from urban and rural areas. However, although telecare has undisputed benefits, it also has some limitations. Older people are often resistant to use of new technology, in particular acquiring the knowledge and skills necessary for use of electronic devices and computer systems. Further, privacy and security are important elements when building confidence in telemedicine systems. Leaking of sensitive information, such as health or test results, may have a negative and far-reaching impact on the personal and professional life of the patient. Telemedicine-based care should now be personalized for the needs, capabilities, and preferences of the elderly, with adaptation over time as care needs evolve. If technologies are introduced that are familiar, usable, desirable, and cost-effective, and able to be adapted to

Robots in Elderly Care

OpenAIRE

Alessandro Vercelli; Innocenzo Rainero; Ludovico Ciferri; Marina Boido; Fabrizio Pirri

2018-01-01

Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general p...

Preventive palliation in the elderly - Organizing health camps for the rural aged

Directory of Open Access Journals (Sweden)

Abhijit Dam

2010-01-01

Full Text Available Most of the needs of elders for support and assistance in the later stages of life are fulfilled by informal helpers. The position of a large number of older persons has become vulnerable due to which it cannot be taken for granted that their children will be able to look after them when they need care in old age, specially in view of the longer life span implying an extended period of dependency and higher costs to meet health and other needs. The condition of the rural elderly is even more pitiable, contrary to our beliefs, as availability, affordability and accessibility to medicare facilities are poor. We undertook the task of organizing a health camp in a rural set-up with the idea of implementing our concept of "preventive palliation" in which excellent palliative care was coupled with a pinch of prevention, like routine checks of blood pressure, routine physical check-ups, etc, so that any aberration can be detected early and necessary rectification measures can be implemented. These periods of routine check-ups can also be used to assess the psycho-social, cultural and emotional problems, if any. Such an approach, say every monthly, gives the elderly something to look forward to and ensures a high degree of customer satisfaction and greatly reduces the burden on the current health system. The challenges faced and the data obtained from this study were shocking. The elderly living in rural areas of the tribal state of Jharkhand suffer from poor physical and mental health, a factor which was rather unexpected in the Indian cultural system in the rural setting. Simple strategies like implementing routine health check ups with provision of "nutritious meal program" can go a long way in mitigating these problems in a cost-effective and simple manner. To make the government-based programs accessible and available to the end-users, participation of local bodies like NGOs is mandatory. Preventive palliation, a concept introduced by Kosish, is

Tablet-Based Well-Being Check for the Elderly: Development and Evaluation of Usability and Acceptability.

Science.gov (United States)

Ray, Pradeep; Li, Junhua; Ariani, Arni; Kapadia, Vasvi

2017-05-12

Many elderly people prefer to live at home independently. One of the major concerns raised by the family members is the safety and well-being of their elderly family members when living independently in a home environment. To address this issue, assistive technology solutions have been available in the market. Despite their availability and proliferation, these types of solutions are not popular with the elderly due to their intrusive nature, privacy-related issues, social stigma, and fear of losing human interaction. This study shares the experience in the development of a digital photo frame system that helps family members to check the well-being of the elderly, exploiting their desire to remain socially connected. The aim of this study was to iteratively design, implement, and assess the usability, user friendliness, and acceptability of a tablet-based system to check the well-being of the elderly. Our study methodology comprises three separate stages: initial system development, contextual assessment, and comparative case study evaluation. In the first stage, requirements were elicited from the elderly to design a well-being check prototype. In the second stage, areas for improvements (eg, privacy features) were identified. Also, additional features (such as medication prompts or food reminders) were suggested to help aged and health care service providers with effective but subtle monitoring of the elderly. These would lower their operating cost by reducing visits by care providers to the homes of the elderly. In the third stage, the results highlighted the difference (between users in India and Australia) in the levels of familiarity of the elderly with this technology. Some elderly participants at the Kalyani Institute for Study, Planning and Action for Rural Change, India latched onto this technology quickly while a few refused to use the system. However, in all cases, the support of family members was crucial for their willingness to use the technology

A before and after study of medical students' and house staff members' knowledge of ACOVE quality of pharmacologic care standards on an acute care for elders unit.

Science.gov (United States)

Jellinek, Samantha P; Cohen, Victor; Nelson, Marcia; Likourezos, Antonios; Goldman, William; Paris, Barbara

2008-06-01

The Assessing Care of Vulnerable Elders (ACOVE) comprehensive set of quality assessment tools for ill older persons is a standard designed to measure overall care delivered to vulnerable elders (ie, those aged > or =65 years) at the level of a health care system or plan. The goal of this research was to quantify the pretest and posttest results of medical students and house staff participating in a pharmacotherapist-led educational intervention that focused on the ACOVE quality of pharmacologic care standards. This was a before and after study assessing the knowledge ofACOVE standards following exposure to an educational intervention led by a pharmacotherapist. It was conducted at the 29-bed Acute Care for Elders (ACE) unit of Maimonides Medical Center, a 705-bed, independent teaching hospital located in Brooklyn, New York. Participants included all medical students and house staff completing a rotation on the ACE unit from August 2004 through May 2005 who completed both the pre-and posttests. A pharmacotherapist provided a 1-hour active learning session reviewing the evidence supporting the quality indicators and reviewed case-based questions with the medical students and house staff. Educational interventions also occurred daily through pharmacotherapeutic consultations and during work rounds. Medical students and house staff were administered the same 15-question, patient-specific, case-based, multiple-choice pre-and posttest to assess knowledge of the standards before and after receiving the intervention. A total of 54 medical students and house staff (median age, 28.58 years; 40 men, 14 women) completed the study. Significantly higher median scores were achieved on the multiple-choice test after the intervention than before (median scores, 14/15 [93.3%] vs 12/15 [80.0%], respectively; P = 0.001). A pharmacotherapist-led educational intervention improved the scores of medical students and house staff on a test evaluating knowledge of evidence-based

Model based on diffuse logic for the construction of indicators of urban vulnerability in natural phenomena

International Nuclear Information System (INIS)

Garcia L, Carlos Eduardo; Hurtado G, Jorge Eduardo

2003-01-01

Upon considering the vulnerability of a urban system in a holistic way and taking into account some natural, technological and social factors, a model based upon a system of fuzzy logic, allowing to estimate the vulnerability of any system under natural phenomena potentially catastrophic is proposed. The model incorporates quantitative and qualitative variables in a dynamic system, in which variations in one of them have a positive or negative impact over the rest. An urban system model and an indicator model to determine the vulnerability due to natural phenomena were designed

The SAVI vulnerability assessment model

International Nuclear Information System (INIS)

Winblad, A.E.

1987-01-01

The assessment model ''Systematic Analysis of Vulnerability to Intrusion'' (SAVI) presented in this report is a PC-based path analysis model. It can provide estimates of protection system effectiveness (or vulnerability) against a spectrum of outsider threats including collusion with an insider adversary. It calculates one measure of system effectiveness, the probability of interruption P(I), for all potential adversary paths. SAVI can perform both theft and sabotage vulnerability analyses. For theft, the analysis is based on the assumption that adversaries should be interrupted either before they can accomplish removal of the target material from its normal location or removal from the site boundary. For sabotage, the analysis is based on the assumption that adversaries should be interrupted before completion of their sabotage task

Vulnerability of hydropower generation to climate change in China: Results based on Grey forecasting model

International Nuclear Information System (INIS)

Wang, Bing; Liang, Xiao-Jie; Zhang, Hao; Wang, Lu; Wei, Yi-Ming

2014-01-01

This paper analyzes the long-term relationships between hydropower generation and climate factors (precipitation), hydropower generation capacity (installed capacity of hydropower station) to quantify the vulnerability of renewable energy production in China for the case of hydropower generation. Furthermore, this study applies Grey forecasting model to forecast precipitation in different provinces, and then sets up different scenarios for precipitation based on the IPCC Special Report on Emission Scenarios and results from PRECIS (Providing Regional Climate projections for Impacts Studies) model. The most important result found in this research is the increasing hydropower vulnerability of the poorest regions and the main hydropower generation provinces of China to climate change. Other main empirical results reveal that the impacts of climate change on the supply of hydropower generation in China will be noteworthy for the society. Different scenarios have different effects on hydropower generation, of which A2 scenario (pessimistic, high emission) has the largest. Meanwhile, the impacts of climate change on hydropower generation of every province are distinctly different, of which the Southwest part has the higher vulnerability than the average level while the central part lower. - Highlights: • The hydropower vulnerability will be enlarged with the rapid increase of hydropower capacity. • Modeling the vulnerability of hydropower in different scenarios and different provinces. • The increasing hydropower vulnerability of the poorest regions to climate change. • The increasing hydropower vulnerability of the main hydropower generation provinces. • Rainfall pattern caused by climate change would be the reason for the increasing vulnerability

Seismic Failure Mechanism of Reinforced Cold-Formed Steel Shear Wall System Based on Structural Vulnerability Analysis

Directory of Open Access Journals (Sweden)

Jihong Ye

2017-02-01

Full Text Available A series of structural vulnerability analyses are conducted on a reinforced cold-formed steel (RCFS shear wall system and a traditional cold-formed steel (CFS shear wall system subjected to earthquake hazard based on forms in order to investigate their failure mechanisms. The RCFS shear wall adopts rigid beam-column joints and continuous concrete-filled CFS tube end studs rather than coupled-C section end studs that are used in traditional CFS shear walls, to achieve the rigid connections in both beam-column joints and column bases. The results show that: the RCFS and traditional CFS shear wall systems both exhibit the maximum vulnerability index associated with the failure mode in the first story. Therefore, the first story is likely to be a weakness of the CFS shear wall system. Once the wall is damaged, the traditional CFS shear wall system would collapse because the shear wall is the only lateral-resisting component. However, the collapse resistance of the RCFS shear wall system is effectively enhanced by the second defense, which is provided by a framework integrated by rigid beam-column joints and fixed column bases. The predicted collapse mode with maximum vulnerability index that was obtained by structural vulnerability analysis agrees well with the experimental result, and the structural vulnerability method is thereby verified to be reasonable to identify the weaknesses of framed structures and predict their collapse modes. Additionally, the quantitative vulnerability index indicates that the RCFS shear wall system exhibits better robustness compared to the traditional one. Furthermore, the “strong frame weak wallboard” and the “strong column weak beam” are proposed in this study as conceptional designations for the RCFS shear wall systems.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

Directory of Open Access Journals (Sweden)

Bako Ali

2018-03-01

Full Text Available The Internet of Things (IoT is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

Science.gov (United States)

2018-01-01

The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes. PMID:29518023

The drought risk of maize in the farming-pastoral ecotone in Northern China based on physical vulnerability assessment

Science.gov (United States)

Wang, Zhiqiang; Jiang, Jingyi; Ma, Qing

2016-12-01

Climate change is affecting every aspect of human activities, especially the agriculture. In China, extreme drought events caused by climate change have posed a great threat to food safety. In this work we aimed to study the drought risk of maize in the farming-pastoral ecotone in Northern China based on physical vulnerability assessment. The physical vulnerability curve was constructed from the relationship between drought hazard intensity index and yield loss rate. The risk assessment of agricultural drought was conducted from the drought hazard intensity index and physical vulnerability curve. The probability distribution of drought hazard intensity index decreased from south-west to north-east and increased from south-east to north-west along the rainfall isoline. The physical vulnerability curve had a reduction effect in three parts of the farming-pastoral ecotone in Northern China, which helped to reduce drought hazard vulnerability on spring maize. The risk of yield loss ratio calculated based on physical vulnerability curve was lower compared with the drought hazard intensity index, which suggested that the capacity of spring maize to resist and adapt to drought is increasing. In conclusion, the farming-pastoral ecotone in Northern China is greatly sensitive to climate change and has a high probability of severe drought hazard. Risk assessment of physical vulnerability can help better understand the physical vulnerability to agricultural drought and can also promote measurements to adapt to climate change.

The Canadian elder standard - pricing the cost of basic needs for the Canadian elderly.

Science.gov (United States)

MacDonald, Bonnie-Jeanne; Andrews, Doug; Brown, Robert L

2010-03-01

We determined the after-tax income required to finance basic needs for Canadian elders living with different circumstances in terms of age, gender, city of residence, household size, homeowner or renter status, means of transportation, and health status. Using 2001 as our base year, we priced the typical expenses for food, shelter, medical, transportation, miscellaneous basic living items and home-based long-term care for elders living in five Canadian cities. This is the first Canadian study of basic living expenses tailored to elders instead of adults in general, prepared on an absolute rather than a relative basis. We also accounted for an individual's unique life circumstances and established the varying effect that they have on the cost of basic expenses, particularly for home care. We found that the maximum Guaranteed Income Supplement and Old Age Security benefit did not meet the cost of basic needs for an elder living in poor circumstances.

GIS BASED AQUIFER VULNERABILITY ASSESSMENT IN HANGZHOU-JIAXINGHUZHOU PLAIN, CHINA

Directory of Open Access Journals (Sweden)

Jean de Dieu Bazimenyera

2014-01-01

Full Text Available Hangzhou-Jiaxing-Huzhou plain is among the regions which faces the shortage of water due to its increasing population, industrialization, agriculture and domestic use; hence the high dependence on groundwater. In China, the exploitation of aquifers has been historically undertaken without proper concern for environmental impacts or even the concept of sustainable yield. In order to maintain basin aquifer as a source of water for the area, it is necessary to find out whether certain locations in this groundwater basin are susceptible to receive and transmit pollution, this is why the main objective of this research is to find out the groundwater vulnerable zones using Geographical Information System (GIS model in Hangzhou-Jiaxing-Huzhou plain. GIS was used to create groundwater vulnerability map by overlaying hydro-geological data. The input of the model was provided by the following seven data layers: Depth to water, net Recharge, Aquifer media, Soil media, Topography, Impact of vadose zone and hydraulic Conductivity. This study showed that Hangzhou-Jiaxing-Huzhou area is grouped into three categories: High vulnerable zone with 27.4% of the total area, moderate vulnerable zone which occupy the great part of that area 60.5% and low vulnerable zone with 12.1%. This research suggests first the prioritization of high vulnerable areas in order to prevent the further pollution to already polluted areas; next the frequent monitoring of vulnerable zones to monitor the changing level of pollutants; and finally suggests that this model can be an effective tool for local authorities who are responsible for managing groundwater resources in that area.

A method proposal for cumulative environmental impact assessment based on the landscape vulnerability evaluation

International Nuclear Information System (INIS)

Pavlickova, Katarina; Vyskupova, Monika

2015-01-01

Cumulative environmental impact assessment deals with the occasional use in practical application of environmental impact assessment process. The main reasons are the difficulty of cumulative impact identification caused by lack of data, inability to measure the intensity and spatial effect of all types of impacts and the uncertainty of their future evolution. This work presents a method proposal to predict cumulative impacts on the basis of landscape vulnerability evaluation. For this purpose, qualitative assessment of landscape ecological stability is conducted and major vulnerability indicators of environmental and socio-economic receptors are specified and valuated. Potential cumulative impacts and the overall impact significance are predicted quantitatively in modified Argonne multiple matrixes while considering the vulnerability of affected landscape receptors and the significance of impacts identified individually. The method was employed in the concrete environmental impact assessment process conducted in Slovakia. The results obtained in this case study reflect that this methodology is simple to apply, valid for all types of impacts and projects, inexpensive and not time-consuming. The objectivity of the partial methods used in this procedure is improved by quantitative landscape ecological stability evaluation, assignment of weights to vulnerability indicators based on the detailed characteristics of affected factors, and grading impact significance. - Highlights: • This paper suggests a method proposal for cumulative impact prediction. • The method includes landscape vulnerability evaluation. • The vulnerability of affected receptors is determined by their sensitivity. • This method can increase the objectivity of impact prediction in the EIA process

Markov Chain-Based Acute Effect Estimation of Air Pollution on Elder Asthma Hospitalization

Directory of Open Access Journals (Sweden)

Li Luo

2017-01-01

Full Text Available Background. Asthma caused substantial economic and health care burden and is susceptible to air pollution. Particularly, when it comes to elder asthma patient (older than 65, the phenomenon is more significant. The aim of this study is to investigate the Markov-based acute effects of air pollution on elder asthma hospitalizations, in forms of transition probabilities. Methods. A retrospective, population-based study design was used to assess temporal patterns in hospitalizations for asthma in a region of Sichuan province, China. Approximately 12 million residents were covered during this period. Relative risk analysis and Markov chain model were employed on daily hospitalization state estimation. Results. Among PM2.5, PM10, NO2, and SO2, only SO2 was significant. When air pollution is severe, the transition probability from a low-admission state (previous day to high-admission state (next day is 35.46%, while it is 20.08% when air pollution is mild. In particular, for female-cold subgroup, the counterparts are 30.06% and 0.01%, respectively. Conclusions. SO2 was a significant risk factor for elder asthma hospitalization. When air pollution worsened, the transition probabilities from each state to high admission states increase dramatically. This phenomenon appeared more evidently, especially in female-cold subgroup (which is in cold season for female admissions. Based on our work, admission amount forecast, asthma intervention, and corresponding healthcare allocation can be done.

Health related vulnerability due to chronic diseases: Impact on clinical services across emergency shelters in mass disasters

Science.gov (United States)

Koleva, Yordanka Nikolova

Chronic diseases are increasingly recognized as major contributors to the global burden of disease. Individuals with chronic disease are particularly vulnerable during mass emergencies as they may suffer an interruption in their therapeutic programs, leading to life-threatening conditions and complications. Based on the individual and community risk factors framework, three categories are defined as the most vulnerable to extreme natural events: physically, psychologically, and socially vulnerable. Complex emergencies that occurred in the recent decade have provided evidence that these groups suffer more pronounced effects than others. Individuals seeking community support during emergencies have been predominantly medically dependent, elderly, children, people with chronic health conditions, and lower socioeconomic status. The purpose of this study was to investigate the effect of health-related vulnerability on shelter operations, and to estimate the burden of chronic disease on community resources following catastrophic events. A comprehensive survey data collection conducted by the United States Public Health Service in 2005 was used to evaluate clinical services for populations with health conditions accommodated by Louisiana temporary disaster shelters. Correlation and multiple regression analyses determined the relationship between shelter characteristics and the factors predicting shelters' needs for short-term assistance. Significant predictors were identified in all three explored domains: structural shelter characteristics (sponsor, interpreter needed); clinical characteristics (access to health providers, clinic on site, staff had no days off); population characteristics (census, compromised mental health alone, or in combination with chronic conditions and diseases with epidemic potential). Shelters sponsored by faith-based organizations were less likely to be in risk of rapid resource depletion. Shelters with large census demonstrated association with

The Improvement of Low Salt Diet Behavior based on Theory of Planned Behavior on Elderly with Hypertension

Directory of Open Access Journals (Sweden)

Lembunai Tat Alberta

2016-09-01

Full Text Available Introduction: Hypertension in elderly is triggered by the thickening and stiffness of arterial wall due to ageing processes. One attempt to prevent the complications of hypertension is by change their lifestyle, such as perform a low-salt diet. The implementation of a low-salt diet on elderly should be adjusted with their behavior and habits. TPB is one of theoretical attempt to identify the relationship between elderly’s attitude and their behavior, and to emphasize the importancy of intention as determinant of behavior, focused on cognitif and rational decission making process. This study was aimed to analyze the improvement of low salt diet behavior based on TPB on elderly with hypertension. Method: This research was used descriptive design with observational analytic method. Population were elderly with hypertension recorded at Puskesmas Pucang, Kota Surabaya. Samples were 32 respondents, taken randomly. Data were collected by using questionnaires and direct interview. Data were then analyzed by using Partial Least Square (PLS. Result: The results had showed that intention to implement a low-salt diet was built by attitudes toward behavior, subjective norms, and perceived behavioral control (PBC on elderly with hypertension. A low-salt diet behavior was built by intention to implement a low-salt diet on elderly with hypertension. Discussion: These results can be used as a model to improve low salt diet behavior on elderly with hypertension. Keywords: low-salt diet, hypertension, elderly, TPB

Older people's perspectives on an elderly-friendly hospital environment: an exploratory study

Directory of Open Access Journals (Sweden)

Karki S

2015-05-01

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

Health conditions of young and old elderly

Directory of Open Access Journals (Sweden)

Cibelle Barbosa Reis

2016-02-01

Full Text Available Objective: to evaluate the elderly about the socio-demographic profile and health conditions in the age groups from 60 to 75 years old (“young” elderly and above 76 years (“old” elderly. Methods: this is a cross-sectional study and home based. The data were collected applying a questionnaire based on the model developed by the Older Americans Resources and Services. Results: 118 elderly participated in the study, being 68.6% “young”, 58% illiterate, 85.2% with income less than two minimum wages and 70.4% with non-white skin. The “old” elderly had a higher proportion of loss of the companion (p=0.002, non-communicable chronic diseases (p=0.023 and dependence to perform activities of daily living (p=0.036. Both age groups had low physical activity, excessive consumption of medicaments and chewing problems. Conclusion: the model of health facing the elderly, should not be restricted to treatment of diseases but cover their functional capacity.

Older people’s perspectives on an elderly-friendly hospital environment: an exploratory study

Science.gov (United States)

Karki, Sushmita; Bhatta, Dharma Nand; Aryal, Umesh Raj

2015-01-01

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

Vulnerability

Science.gov (United States)

Taback, I.

1979-01-01

The discussion of vulnerability begins with a description of some of the electrical characteristics of fibers before definiting how vulnerability calculations are done. The vulnerability results secured to date are presented. The discussion touches on post exposure vulnerability. After a description of some shock hazard work now underway, the discussion leads into a description of the planned effort and some preliminary conclusions are presented.

Perception of ageism and self-esteem among Lebanese elders at home and abroad.

Science.gov (United States)

El Bcheraoui, Charbel; Adib, Salim; Chapuis-Lucciani, Nicole

2015-01-01

Discrimination against old age leads to depressive symptoms and lower self-esteem. This issue is not studied in the Lebanese society where a demographic transition is taking place and the population is aging. We assess the perception of age discrimination among Lebanese and its relation to self-esteem. We interviewed a convenience sample of 320 Lebanese elders (mean age 69.3 years +/- 6.2; 55% males) living in an urban setting (Beirut) and a rural setting (Ras-Baalbeck) a well as those who immigrated to Dakar using a preestablished questionnaire. Perception of age discrimination and socio-demographic information were collected; self-esteem was measured using the Toulouse scale. Results: More elders living in Beirut (OR = 9.7, 95% CI = 3.5-26.6) and Ras-Baalbeck (OR = 11.42, 95% CI = 3.95-33.1) perceived age-related discrimination than those living in Dakar. This perception was significantly associated to lower self-esteem (OR = 2.2, 95% CI = 1.3-3.6). Supporting emotionally vulnerable elders should be a target for policy makers in Lebanon. It is important to preserve a better quality of life for elders still playing a major role in families.

[Effect of anticholinergic drugs on cognitive impairment in the elderly].

Science.gov (United States)

López-Álvarez, Jorge; Zea Sevilla, María Ascensión; Agüera Ortiz, Luis; Fernández Blázquez, Miguel Ángel; Valentí Soler, Meritxell; Martínez-Martín, Pablo

2015-01-01

The use of anticholinergic drugs is common in the elderly, even in people with cognitive impairment. A systematic search was conducted in PubMed (anticholinergic effects, anticholinergic and dementia) to define the effects of anticholinergic drugs in the elderly. We emphasized the search in patterns of use, the combined use with AChEIs, the measurement of the Serum Anticholinergic Activity, and the short-term and long-term cognitive effects. The conclusions are that the use of anticholinergic drugs is common in the elderly, even more so than the medical prescription of AChEIs in Alzheimer's disease. The use of anticholinergic drugs may result in cognitive impairment. In long-term use it may generate a worsening of cognitive functions. It can lead to a wrong diagnosis of mild cognitive impairment or dementia, and they can also initiate signs of dementia. Greater cognitive effects appear when there is a previous deficit, but cognitive effects from anticholinergic drugs disappear in severe dementia. The presence of ApoEɛ4 increases the vulnerability for cognitive impairment when these drugs are employed. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Cryotherapy as a method of choice in the treatment of cylindromas on the elderly

Directory of Open Access Journals (Sweden)

Piotr Brzezinski

2016-10-01

Full Text Available The elderly (i.e., geriatric group are often vulnerable to skin cancer. These patients often cannot cope with biopsies and surgical excisions. A good alternative is cryotherapy. Cylindroma is a benign adnexal tumor of the skin with eccrine and apocrine differentiation, and commonly occurs in the scalp. We present the case of an 82- year-old woman with a number of large tumors located on the head, which were effectively removed via cryotherapy with liquid nitrogen as a palliative treatment. No recurrence was detected during the two-year follow-up. Cryotherapy with liquid nitrogen is an effective and non-invasive method for the treatment of benign skin tumors in the elderly.

Review Article: A comparison of flood and earthquake vulnerability assessment indicators

Science.gov (United States)

de Ruiter, Marleen C.; Ward, Philip J.; Daniell, James E.; Aerts, Jeroen C. J. H.

2017-07-01

In a cross-disciplinary study, we carried out an extensive literature review to increase understanding of vulnerability indicators used in the disciplines of earthquake- and flood vulnerability assessments. We provide insights into potential improvements in both fields by identifying and comparing quantitative vulnerability indicators grouped into physical and social categories. Next, a selection of index- and curve-based vulnerability models that use these indicators are described, comparing several characteristics such as temporal and spatial aspects. Earthquake vulnerability methods traditionally have a strong focus on object-based physical attributes used in vulnerability curve-based models, while flood vulnerability studies focus more on indicators applied to aggregated land-use classes in curve-based models. In assessing the differences and similarities between indicators used in earthquake and flood vulnerability models, we only include models that separately assess either of the two hazard types. Flood vulnerability studies could be improved using approaches from earthquake studies, such as developing object-based physical vulnerability curve assessments and incorporating time-of-the-day-based building occupation patterns. Likewise, earthquake assessments could learn from flood studies by refining their selection of social vulnerability indicators. Based on the lessons obtained in this study, we recommend future studies for exploring risk assessment methodologies across different hazard types.

Mortality associated with traumatic injuries in the elderly: a population based study.

Science.gov (United States)

O'Neill, Stephen; Brady, Richard R; Kerssens, Jan J; Parks, Rowan W

2012-01-01

Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients. A retrospective analysis was performed of data that was obtained from a prospectively collected multi-centre trauma database maintained by The Scottish Trauma Audit Group (STAG) containing details of 52,887 trauma patients admitted to 25 participating Scottish Hospitals over an 11-year period. Elderly trauma patients (aged >80 years) were separately analyzed and compared to younger trauma patients (aged 13-80). Of 52,887 trauma patients identified, 4791 were elderly (9.1%). Elderly patients had a higher absolute mortality rate following traumatic injury (9.9% versus 4%, pelderly was higher in males, following a high fall, with lower Glasgow Coma Scale (GCS), in those with higher Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS), in those with concomitant injuries, hemodynamic compromise and following delayed presentation. Multiple logistic regression analysis confirmed an independent relationship between mortality and low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) in the elderly. In conclusion, trauma in elderly patients is associated with significantly higher mortality. Low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) have the strongest independent relationships with mortality after trauma in the elderly population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Modeling groundwater vulnerability to pollution using Optimized DRASTIC model

International Nuclear Information System (INIS)

Mogaji, Kehinde Anthony; Lim, Hwee San; Abdullar, Khiruddin

2014-01-01

The prediction accuracy of the conventional DRASTIC model (CDM) algorithm for groundwater vulnerability assessment is severely limited by the inherent subjectivity and uncertainty in the integration of data obtained from various sources. This study attempts to overcome these problems by exploring the potential of the analytic hierarchy process (AHP) technique as a decision support model to optimize the CDM algorithm. The AHP technique was utilized to compute the normalized weights for the seven parameters of the CDM to generate an optimized DRASTIC model (ODM) algorithm. The DRASTIC parameters integrated with the ODM algorithm predicted which among the study areas is more likely to become contaminated as a result of activities at or near the land surface potential. Five vulnerability zones, namely: no vulnerable(NV), very low vulnerable (VLV), low vulnerable (LV), moderate vulnerable (MV) and high vulnerable (HV) were identified based on the vulnerability index values estimated with the ODM algorithm. Results show that more than 50% of the area belongs to both moderate and high vulnerable zones on the account of the spatial analysis of the produced ODM-based groundwater vulnerability prediction map (GVPM).The prediction accuracy of the ODM-based – GVPM with the groundwater pH and manganese (Mn) concentrations established correlation factors (CRs) result of 90 % and 86 % compared to the CRs result of 62 % and 50 % obtained for the validation accuracy of the CDM – based GVPM. The comparative results, indicated that the ODM-based produced GVPM is more reliable than the CDM – based produced GVPM in the study area. The study established the efficacy of AHP as a spatial decision support technique in enhancing environmental decision making with particular reference to future groundwater vulnerability assessment

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

Directory of Open Access Journals (Sweden)

Kai Guan

2017-01-01

Full Text Available This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly’s electrocardiogram (ECG and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.

Vulnerability assessment of archaeological sites to earthquake hazard: An indicator based method integrating spatial and temporal aspects

Directory of Open Access Journals (Sweden)

Despina Minos-Minopoulos

2017-07-01

Full Text Available Across the world, numerous sites of cultural heritage value are at risk from a variety of human-induced and natural hazards such as war and earthquakes. Here we present and test a novel indicator-based method for assessing the vulnerability of archaeological sites to earthquakes. Vulnerability is approached as a dynamic element assessed through a combination of spatial and temporal parameters. The spatial parameters examine the susceptibility of the sites to the secondary Earthquake Environmental Effects of ground liquefaction, landslides and tsunami and are expressed through the Spatial Susceptibility Index (SSi. Parameters of physical vulnerability, economic importance and visitors density examine the temporal vulnerability of the sites expressed through the Temporal Vulnerability Index (TVi. The equally weighted sum of the spatial and temporal indexes represents the total Archaeological Site Vulnerability Index (A.S.V.I.. The A.S.V.I method is applied at 16 archaeological sites across Greece, allowing an assessment of their vulnerability. This then allows the establishment of a regional and national priority list for considering future risk mitigation. Results indicate that i the majority of the sites have low to moderate vulnerability to earthquake hazard, ii Neratzia Fortress on Kos and Heraion on Samos are characterised as highly vulnerable and should be prioritised for further studies and mitigation measures, and iii the majority of the sites are susceptible to at least one Earthquake Environmental Effect and present relatively high physical vulnerability attributed to the existing limited conservation works. This approach highlights the necessity for an effective vulnerability assessment methodology within the existing framework of disaster risk management for cultural heritage.

Mobile Phone Based Falling Detection Sensor and Computer-Aided Algorithm for Elderly People

Directory of Open Access Journals (Sweden)

Lee Jong-Ha

2016-01-01

Full Text Available Falls are dangerous for the elderly population; therefore many fall detection systems have been developed. However, previous methods are bulky for elderly people or only use a single sensor to isolate falls from daily living activities, which makes a fall difficult to distinguish. In this paper, we present a cost-effective and easy-to-use portable fall-detection sensor and algorithm. Specifically, to detect human falls, we used a three-axis accelerator and a three-axis gyroscope in a mobile phone. We used the Fourier descriptor-based frequency analysis method to classify both normal and falling status. From the experimental results, the proposed method detects falling status with 96.14% accuracy.

Vulnerability maps for Druzba crude oil pipeline

International Nuclear Information System (INIS)

Hladik, P.; Hosnedl, P.; Buresova, H.; Corbet, J.

2012-01-01

Maps of risk for individual environmental aspects within the protection zone of the Czech part of the Druzba crude oil pipeline (505.7 km) were developed based on a modified 'H and V index' method. Risk data were added into a GIS of the Druzba pipeline so that the system could be used as conceptual material in the field of environmental protection (a base for the new SCADA system). Considered environmental aspects were assessed in terms of their vulnerability. The criteria were defined as the vulnerability of the aquatic environment (surface waters and ground waters), the vulnerability of soil environment and the vulnerability of biotic components of the environment. (authors)

Elderly fall risk prediction based on a physiological profile approach using artificial neural networks.

Science.gov (United States)

Razmara, Jafar; Zaboli, Mohammad Hassan; Hassankhani, Hadi

2016-11-01

Falls play a critical role in older people's life as it is an important source of morbidity and mortality in elders. In this article, elders fall risk is predicted based on a physiological profile approach using a multilayer neural network with back-propagation learning algorithm. The personal physiological profile of 200 elders was collected through a questionnaire and used as the experimental data for learning and testing the neural network. The profile contains a series of simple factors putting elders at risk for falls such as vision abilities, muscle forces, and some other daily activities and grouped into two sets: psychological factors and public factors. The experimental data were investigated to select factors with high impact using principal component analysis. The experimental results show an accuracy of ≈90 percent and ≈87.5 percent for fall prediction among the psychological and public factors, respectively. Furthermore, combining these two datasets yield an accuracy of ≈91 percent that is better than the accuracy of single datasets. The proposed method suggests a set of valid and reliable measurements that can be employed in a range of health care systems and physical therapy to distinguish people who are at risk for falls.

IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008.

Science.gov (United States)

Lakatos, Peter Laszlo; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos S; Lakatos, Laszlo

2011-02-01

Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD 15.9 years; CD: 506, age at diagnosis: 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. 106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset. Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates.

Science.gov (United States)

Sathasivam, Jeyanthini; Kamaruzzaman, Shahrul Bahyah; Hairi, Farizah; Ng, Chiu Wan; Chinna, Karuthan

2015-11-01

In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state. © 2015 APJPH.

Spatial vulnerability of Australian urban populations to extreme heat events

Science.gov (United States)

Loughnan, Margaret; Tapper, Nigel; Phan, Thu; Lynch, Kellie; McInnes, Judith

2013-04-01

Extreme heat events pose a risk to the health of all individuals, especially the elderly and the chronically ill, and are associated with an increased demand for healthcare services. In order to address this problem, policy makers' need information about temperatures above which mortality and morbidity of the exposed population is likely to increase, where the vulnerable groups in the community are located, and how the risks from extreme heat events are likely to change in the future. This study identified threshold temperatures for all Australian capital cities, developed a spatial index of population vulnerability, and used climate model output to predict changes in the number of days exceeding temperature thresholds in the future, as well as changes in risk related to changes in urban density and an ageing population. The study has shown that daily maximum and minimum temperatures from the Bureau of Meteorology forecasts can be used to calculate temperature thresholds for heat alert days. The key risk factors related to adverse health outcomes were found to be areas with intense urban heat islands, areas with higher proportions of older people, and areas with ethnic communities. Maps of spatial vulnerability have been developed to provide information to assist emergency managers, healthcare professionals, and ancillary services develop heatwave preparedness plans at a local scale that target vulnerable groups and address heat-related health risks. The numbers of days exceeding current heat thresholds are predicted to increase over the next 20 to 40 years in all Australian capital cities.

Special management needs of the elderly hypertensive patient

Directory of Open Access Journals (Sweden)

Henry L Elliott

2002-03-01

Full Text Available Cardiovascular (CV disease will progressively assume greater importance as the number of elderly individuals in the population of the world increases with a parallel increase in the incidence of hypertension. Elderly patients with hypertension are often difficult to manage. Pathophysiological changes associated with ageing are also associated with long-standing, uncontrolled hypertension. Diagnosis may not be straightforward and the incidence of concomitant disease will be higher than in younger patients. The preventative benefits of antihypertensive therapy in the elderly is well established and treatment of hypertension is of greatest value in older patients who, because of additional risk factors or prevalent CV disease, are at a higher risk of developing a CV event. However, established benefits are based upon the evidence from randomised, controlled trials in selected patient groups, which may not be universally applicable to many elderly hypertensives. Thus, the treatment of hypertension in the elderly should be based upon an individualised approach which inevitably cannot be strictly evidence-based. However, there is a compelling case for an approach based upon a recognition that high blood pressure (BP in the elderly should be treated early and vigorously whilst at the same time exercising some caution to avoid the development of hypotensive BP levels.

[Social and family support to the elderly in urban areas].

Science.gov (United States)

Zapata-López, Bertha I; Delgado-Villamizar, Norma L; Cardona-Arango, Doris

2015-12-01

Objective To describe the social and family support networks available to the elderly living in urban areas of the municipality of Angelópolis-Antioquia during the year 2011. Materials A descriptive transversal study was conductedusing the population experience to determine the social support received by the 239 seniors in the urban area of Angelópolis-Antioquia. The data was obtained from primary sources and univariate and bivariate analysis was conducted. Results Mostly women were interviewed (59.8 %) aged between 60 and 74 (66.9 %). The social status that appeared with the highest percentage was "married" (47.3 %) though with the interviewed women the social status with the highest occurrence was "widow" (40.6 %). 69,5 % had an elementary school educational level and 16,7 % had no formal education at all. 60.3 % were registered in the subsidized program. The support from families and friends was qualified as satisfactory. A statistically significant connection was found between gender and undertaking different activities in free time (value of p=0,004). Conclusions the study indicates that loneliness is an aspect that makes the elderly feel unprotected and vulnerable. Despite the general feeling of satisfaction regarding family support, some of them, especially women, expressed feeling mistreated. The data along with the lack of activities for spare time must be taken into account to formulate intervention strategies for effective support networks to improve the situation of this vulnerable population of the municipality.

Protocol vulnerability detection based on network traffic analysis and binary reverse engineering.

Science.gov (United States)

Wen, Shameng; Meng, Qingkun; Feng, Chao; Tang, Chaojing

2017-01-01

Network protocol vulnerability detection plays an important role in many domains, including protocol security analysis, application security, and network intrusion detection. In this study, by analyzing the general fuzzing method of network protocols, we propose a novel approach that combines network traffic analysis with the binary reverse engineering method. For network traffic analysis, the block-based protocol description language is introduced to construct test scripts, while the binary reverse engineering method employs the genetic algorithm with a fitness function designed to focus on code coverage. This combination leads to a substantial improvement in fuzz testing for network protocols. We build a prototype system and use it to test several real-world network protocol implementations. The experimental results show that the proposed approach detects vulnerabilities more efficiently and effectively than general fuzzing methods such as SPIKE.

Elderly who take care of elderly: a study on the Frailty Syndrome.

Science.gov (United States)

Santos-Orlandi, Ariene Angelini Dos; Brito, Tábatta Renata Pereira de; Ottaviani, Ana Carolina; Rossetti, Estefani Serafim; Zazzetta, Marisa Silvana; Pavarini, Sofia Cristina Iost

2017-01-01

Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services. Identificar a prevalência de fragilidade em cuidadores idosos inseridos em contexto de alta vulnerabilidade social e sua correlação com aspectos sociodemográficos e de saúde. Estudo descritivo, correlacional, transversal. Foram avaliados 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. As entrevistas foram realizadas no domicílio, sendo previamente agendadas. Todos os cuidados éticos foram observados. Os dados foram analisados com apoio do pacote estatístico Stata versão 11.0. 10,0% dos cuidadores idosos eram frágeis. Houve correlação significativa entre fragilidade e: sexo, atividades instrumentais de vida diária e cognição. Conclusão: Cuidadoras do sexo feminino, indivíduos parcialmente dependentes em relação às atividades instrumentais de vida

Metabolic syndrome and physical activity in southern Brazilian community-dwelling elders: a population-based, cross-sectional study

Directory of Open Access Journals (Sweden)

Reichert César L

2009-01-01

Full Text Available Abstract Background - The association between a sedentary lifestyle and obesity is well documented, and is linked to an increased prevalence of metabolic syndrome (MS. There is some evidence that information regarding the health benefits of physical activity is beginning to impact on the elderly people and is beginning to change their behavior. We aimed to investigate the level of physical activity undertaken by elderly people with MS and those without this condition. Methods - We evaluated 362 community-dwelling elders of Novo Hamburgo, southern Brazil. Diagnosis of MS was based on the International Diabetes Federation criteria and the physical activity (PA level was estimated by the International Physical Activity Questionnaire. Analysis of covariance was carried out to verify associations between MS risk factors and the level of PA. Logistic regression was used to estimate the MS odds ratio for each level of PA. Results - No significant association was found between MS and the level of physical activity, irrespective of sex. The odds ratio for the presence of MS adjusted for sex and age and using insufficiently active elderly people as reference was 1.04 (95% CI, 0.6 to 1.7 in sufficiently active elderly people and 1.15 (95% CI, 0.7 to 2.0 in very active elderly people. Conclusion - The elderly citizens of a southern Brazilian community who were diagnosed with MS presented the same levels of PA as the individuals who did not have this diagnosis. This may imply that information on the importance of physical activity has already reached this higher risk population.

Hearing aid-related satisfaction based on type and degree of hearing loss in elderly

Directory of Open Access Journals (Sweden)

Farzad FarajiKhiavi

2015-02-01

Full Text Available Background and Aim: Hearing loss is one of the most prevalent chronic diseases in the elderly; using a hearing aid to alleviate auditory impairment can positively affect their quality of life. This research aimed to determine the level of satisfaction concerning hearing aids in elderly people with hearing impairment based on the type and degree of hearing loss.Methods: An analytic cross-sectional research design was used ; the sample included 40 elderly people who used hearing aids. According to the World Health Organization (WHO age classification, participants were divided into two age groups: 65-74 years (n=20 and 75-90 years (n=20. Satisfaction levels were assessed using a standard satisfaction with amplification in daily life (SADL questionnaire.Results: Satisfaction levels in the 65-74 age group were significantly higher than that in the 75-90 age group (p=0.02. Participants with mixed hearing loss revealed higher satisfaction levels than participants with sensorineural hearing loss (p=0.02. On the negative effects dimension, participants with severe hearing loss exhibited significantly higher satisfaction levels than participants with moderate or moderate to severe hearing loss (p=0.01.Conclusion: Total satisfaction mean scores were relatively high in the elderly participants . Negative features could be reduced via careful consultation regarding the aids’ amplifying capabilities and limitations in groups with moderate or moderate to severe hearing loss.

The secure base script and the task of caring for elderly parents: implications for attachment theory and clinical practice.

Science.gov (United States)

Chen, Cory K; Waters, Harriet Salatas; Hartman, Marilyn; Zimmerman, Sheryl; Miklowitz, David J; Waters, Everett

2013-01-01

This study explores links between adults' attachment representations and the task of caring for elderly parents with dementia. Participants were 87 adults serving as primary caregivers of a parent or parent-in-law with dementia. Waters and Waters' ( 2006 ) Attachment Script Assessment was adapted to assess script-like attachment representation in the context of caring for their elderly parent. The quality of adult-elderly parent interactions was assessed using the Level of Expressed Emotions Scale (Cole & Kazarian, 1988 ) and self-report measures of caregivers' perception of caregiving as difficult. Caregivers' secure base script knowledge predicted lower levels of negative expressed emotion. This effect was moderated by the extent to which participants experienced caring for elderly parents as difficult. Attachment representations played a greater role in caregiving when caregiving tasks were perceived as more difficult. These results support the hypothesis that attachment representations influence the quality of care that adults provide their elderly parents. Clinical implications are discussed.

Protocol vulnerability detection based on network traffic analysis and binary reverse engineering.

Directory of Open Access Journals (Sweden)

Shameng Wen

Full Text Available Network protocol vulnerability detection plays an important role in many domains, including protocol security analysis, application security, and network intrusion detection. In this study, by analyzing the general fuzzing method of network protocols, we propose a novel approach that combines network traffic analysis with the binary reverse engineering method. For network traffic analysis, the block-based protocol description language is introduced to construct test scripts, while the binary reverse engineering method employs the genetic algorithm with a fitness function designed to focus on code coverage. This combination leads to a substantial improvement in fuzz testing for network protocols. We build a prototype system and use it to test several real-world network protocol implementations. The experimental results show that the proposed approach detects vulnerabilities more efficiently and effectively than general fuzzing methods such as SPIKE.

Groundwater Vulnerability Map for South Africa | Musekiwa | South ...

African Journals Online (AJOL)

Vulnerability of groundwater is a relative, non-measurable and dimensionless property which is based on the concept that some land areas are more vulnerable to groundwater contamination than others. Maps showing groundwater vulnerability assist with the identification of areas more susceptible to contamination than ...

Custodian for elderly with memory impairment in Sweden - a study of 260 physicians' statements to the court.

Science.gov (United States)

Björkstén, Karin S; Fälldin, Kerstin; Ulfvarson, Johanna

2014-08-26

In the modern world with new family structures, international migration and increased life expectancy, there is a growing need for legal ways of assisting elderly with impaired mental capacity to decide about their life and assets. There are few studies about the physician's role when a court appoints proxies for vulnerable elderly. Many doctors do not know how to assess mental capacity, and most lawyers and judges know little about medicine. Applications for a custodian sent to the Stockholm Chief Guardian' Office in Sweden were used. Physician's statements to the court for elderly with memory impairment were selected and 260 statements were scrutinized with regard to formal quality, the narrative content and the physician who wrote it. The quality of the statements varied from one sentence to excellent. Most statements were written by senior family practitioners or geriatricians. Seventeen % of the statements were handwritten and had more formal shortcomings than machine/computer written statements.The majority of patients needed massive help with daily life and economy. Median age was 84 years of age. MMSE score was given in 20% of the cases and varied from 6-27.A diagnosis of dementia was established in 57%. At the time of application, at least 48% were in a hospital or nursing home and at least 27% were in their private home. Only 5% were living with a spouse or a child. In 53% of the cases, the doctor knew the patient, but in 40% of the cases, the identity of the patient was not confirmed. The physician found that 54% were unable to understand the idea of getting a custodian, but out of those very vulnerable elderly, 20% had signed consent and 57% were considered able to be heard in court. There is a large variation in the quality of physicians' statements to the court concerning the mental capacity of elderly patients with cognitive impairment. Many statements have serious short-comings, and the system is not safe. There is a strong need for guide

Windows Server 2012 vulnerabilities and security

Directory of Open Access Journals (Sweden)

Gabriel R. López

2015-09-01

Full Text Available This investigation analyses the history of the vulnerabilities of the base system Windows Server 2012 highlighting the most critic vulnerabilities given every 4 months since its creation until the current date of the research. It was organized by the type of vulnerabilities based on the classification of the NIST. Next, given the official vulnerabilities of the system, the authors show how a critical vulnerability is treated by Microsoft in order to countermeasure the security flaw. Then, the authors present the recommended security approaches for Windows Server 2012, which focus on the baseline software given by Microsoft, update, patch and change management, hardening practices and the application of Active Directory Rights Management Services (AD RMS. AD RMS is considered as an important feature since it is able to protect the system even though it is compromised using access lists at a document level. Finally, the investigation of the state of the art related to the security of Windows Server 2012 shows an analysis of solutions given by third parties vendors, which offer security products to secure the base system objective of this study. The recommended solution given by the authors present the security vendor Symantec with its successful features and also characteristics that the authors considered that may have to be improved in future versions of the security solution.

Mining Bug Databases for Unidentified Software Vulnerabilities

Energy Technology Data Exchange (ETDEWEB)

Dumidu Wijayasekara; Milos Manic; Jason Wright; Miles McQueen

2012-06-01

Identifying software vulnerabilities is becoming more important as critical and sensitive systems increasingly rely on complex software systems. It has been suggested in previous work that some bugs are only identified as vulnerabilities long after the bug has been made public. These vulnerabilities are known as hidden impact vulnerabilities. This paper discusses the feasibility and necessity to mine common publicly available bug databases for vulnerabilities that are yet to be identified. We present bug database analysis of two well known and frequently used software packages, namely Linux kernel and MySQL. It is shown that for both Linux and MySQL, a significant portion of vulnerabilities that were discovered for the time period from January 2006 to April 2011 were hidden impact vulnerabilities. It is also shown that the percentage of hidden impact vulnerabilities has increased in the last two years, for both software packages. We then propose an improved hidden impact vulnerability identification methodology based on text mining bug databases, and conclude by discussing a few potential problems faced by such a classifier.

Determining Vulnerability Importance in Environmental Impact Assessment

International Nuclear Information System (INIS)

Toro, Javier; Duarte, Oscar; Requena, Ignacio; Zamorano, Montserrat

2012-01-01

The concept of vulnerability has been used to describe the susceptibility of physical, biotic, and social systems to harm or hazard. In this sense, it is a tool that reduces the uncertainties of Environmental Impact Assessment (EIA) since it does not depend exclusively on the value assessments of the evaluator, but rather is based on the environmental state indicators of the site where the projects or activities are being carried out. The concept of vulnerability thus reduces the possibility that evaluators will subjectively interpret results, and be influenced by outside interests and pressures during projects. However, up until now, EIA has been hindered by a lack of effective methods. This research study analyzes the concept of vulnerability, defines Vulnerability Importance and proposes its inclusion in qualitative EIA methodology. The method used to quantify Vulnerability Importance is based on a set of environmental factors and indicators that provide a comprehensive overview of the environmental state. The results obtained in Colombia highlight the usefulness and objectivity of this method since there is a direct relation between this value and the environmental state of the departments analyzed. - Research Highlights: ► The concept of vulnerability could be considered defining Vulnerability Importance included in qualitative EIA methodology. ► The use of the concept of environmental vulnerability could reduce the subjectivity of qualitative methods of EIA. ► A method to quantify the Vulnerability Importance proposed provides a comprehensive overview of the environmental state. ► Results in Colombia highlight the usefulness and objectivity of this method.

Fiscal crisis, social security reform and vulnerable population

Directory of Open Access Journals (Sweden)

Peinado Patricia

2014-01-01

Full Text Available The aging process we are witnessing in the majority of developed countries is raising financial sustainability problems in the pay-as-you-go pension system. The reforms designed to re-establish the financial equilibrium of pension systems may put one of the most important objectives of these systems at risk: to reduce the poverty rate among the elderly. This paper studies the effects that the reforms implemented in the Spanish pension system would have on the poverty rate of the retired population. The two main novelties presented are the following. First, the collective under study is focused on the most vulnerable workers. Second, the effects of the reforms are studied taking into account the labour market situation of the individuals in the years prior to retirement.

Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly

Directory of Open Access Journals (Sweden)

Jaul E

2014-05-01

Full Text Available Efraim Jaul Skilled Geriatric Nursing Department, Herzog Memorial Hospital, Affiliated to the Hebrew University Hadassah Medical School, Jerusalem, Israel Abstract: The occurrence of pressure ulcers (PUs is common and poses serious problems for the frail elderly, with implications for functional disability and reduced quality of life. PUs are preventable in a majority of cases. The increase in PU occurrence, however, appears regardless of higher awareness in prevention and improvement through utilization of pressure relieving devices. Multiple changes in the elderly body systems occur over time including aging, multiple chronic conditions, and functional impairment, potentially culminating in the final pathways of geriatric syndrome, unless awareness to the development of PUs is reversible and prevented. The assumption is that the development of PUs is based on multifactorial causes (extrinsic and intrinsic factors; thus, the optimal management for elderly patients requires a comprehensive approach in all medical settings (community, hospital, and at the long term care [LTC] level. Comprehensiveness signifies looking beyond the wounds, assisting the patient through both local (wound and systemic (medical condition treatment, using a strategy of prevention and supporting quality of life. Within the multidisciplinary involvement team approach, each professional discipline contributes its own task in coordination with other disciplines to address PU prevention, assessment, and treatment. The entire medical staff and the multidisciplinary team work together and communicate frequently in order to prevent, halt at an early stage, and provide healing in a timely fashion. Limiting the formation of PUs is facilitated through early identification, treating contributing causes, eliminating all unnecessary medications, instituting supportive interventions which include the family. Understanding the relationship between the formation of PUs and the

Health Related Quality of Life in Elderly of Nursing Homes, Medellin-Colombia, 2012

Directory of Open Access Journals (Sweden)

Jaiberth Antonio Cardona Arias

2014-05-01

Full Text Available Introduction: Elderly in Medellin present conditions of economic, social, environmental and gen-eral health vulnerability; in nursing homes shows further deterioration of health related quality of life (HRQOL. Objective: To compare the profile of HRQOL of adults over public and private nursing homes in Medellin. Materials and methods: Across-sectional correlational study in 220 elderly selected using probability sampling. WHOQOL-BREF was used and the clinical data of each individual. We assessed scale reliability using Cronbach’s alpha, internal consistency and discriminant validity using Pearson correlations, analyzes of HRQOL were based on summaries measures and frequencies, non-parametric and parametric tests and lineal regression. Results: We found 50 % hypertension, 23.6 % diabetes mellitus, dislipidemia 22.3 % and 15 % osteoporosis. The WHOQOL-BREF showed excellent reliability, internal consistency and discriminant validity, the best score was the psychological health and worst in social relationships. We found no differ¬ences in HRQOL by type of nursing home. The main factors related to HRQL were satisfaction with family support and participation in social groups. Conclusion: We identified some determinants of HRQOL, this demonstrated its multidimensionality; relevant information for further research and for the implementation of public health policies and clinical actions.

Mapping of coastal aquifer vulnerable zone in the south west coast of Kanyakumari, South India, using GIS-based DRASTIC model.

Science.gov (United States)

Kaliraj, S; Chandrasekar, N; Peter, T Simon; Selvakumar, S; Magesh, N S

2015-01-01

The south west coast of Kanyakumari district in Tamil Nadu, India, is significantly affected by seawater intrusion and diffusion of pollutants into the aquifers due to unregulated beach placer mining and other anthropogenic activities. The present study investigates the vulnerability of the coastal aquifers using Geographic Information System (GIS)-based DRASTIC model. The seven DRASTIC parameters have been analyzed using the statistical equation of this model to demarcate the vulnerable zones for aquifer contamination. The vulnerability index map is prepared from the weighted spatial parameters, and an accounting of total index value ranged from 85 to 213. Based on the categorization of vulnerability classes, the high vulnerable zones are found near the beach placer mining areas between Manavalakurichi and Kodimanal coastal stretches. The aquifers associated with settlements and agricultural lands in the middle-eastern part have experienced high vulnerability due to contaminated water bodies. Similarly, the coastal areas of Thengapattinam and Manakudi estuary and around the South Tamaraikulam have also been falling under high vulnerability condition due to backwater and saltpan. In general, the nearshore region except the placer mining zone and the backwater has a moderately vulnerable condition, and the vulnerability index values range from 149 to180. Significantly, the northern and northeastern uplands and some parts of deposition zones in the middle-south coast have been identified as low to no vulnerable conditions. They are structurally controlled by various geological features such as charnockite, garnet biotite gneiss and granites, and sand dunes, respectively. The aquifer vulnerability assessment has been cross-verified by geochemical indicators such as total dissolved solids (TDS), Cl(-), HCO₃(-), and Cl(-)/HCO₃(-) ratio. The high ranges of TDS (1,842--3,736 mg/l) and Cl(-) (1,412--2,112 mg/l) values are well correlated with the observed high

Exploring impacts of multi-year, community-based care programs for orphans and vulnerable children: a case study from Kenya.

Science.gov (United States)

Larson, Bruce A; Wambua, Nancy; Masila, Juliana; Wangai, Susan; Rohr, Julia; Brooks, Mohamad; Bryant, Malcolm

2013-01-01

The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006-2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n=500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n=300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n=700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18-22 year olds who were "children" during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities

Mental vulnerability, Helicobacter pylori, and incidence of hospital-diagnosed peptic ulcer over 28 years in a population-based cohort

DEFF Research Database (Denmark)

Levenstein, Susan; Jacobsen, Rikke Kart; Rosenstock, Steffen J

2017-01-01

Objective: To examine whether mental vulnerability, an enduring personality characteristic, predicts incident hospital-diagnosed ulcer over three decades. Materials and methods: A population-based cohort study enrolled 3365 subjects with no ulcer history, ages 30–60, in 1982–3. Mental vulnerabili......: A vulnerable personality raises risk for hospital-diagnosed peptic ulcer, in part because of an association with health risk behaviors. Its impact is seen in ‘idiopathic’ and Helicobacter pylori-associated ulcers, and in acute surgical cases.......Objective: To examine whether mental vulnerability, an enduring personality characteristic, predicts incident hospital-diagnosed ulcer over three decades. Materials and methods: A population-based cohort study enrolled 3365 subjects with no ulcer history, ages 30–60, in 1982–3. Mental vulnerability......, Helicobacter pylori IgG antibodies, socioeconomic status, and sleep duration were determined at baseline; non-steroidal antiinflammatory drug use, smoking, leisure time physical activity, and alcohol consumption both at baseline and in 1993–4. Hospital diagnoses of incident ulcer through 2011 were detected...

A novel method for designing and optimizing the layout of facilities in bathroom for the elderly in home-based rehabilitation.

Science.gov (United States)

Wang, Duojin; Wu, Jing; Lin, Qinglian

2018-05-01

The home-based rehabilitation of elderly patients improves their autonomy, independence and reintegration into society. Hence, a suitable environment plays an important role in rehabilitation, as do different assistance technologies. The majority of accidents at home involving elderly people occur in the bathroom. Therefore, the planning of the layout of facilities is important in this potentially dangerous area. This paper proposes an approach towards designing and optimizing the layout of facilities in the bathroom, based on logistical and nonlogistical relationships. A fuzzy-based analytical hierarchical process (fuzzy-AHP) is then proposed for a comprehensive evaluation of the alternatives for this layout plan. This approach was applied to the home of a 71 years old female patient, who was experiencing home-based rehabilitation. After the initial designing and optimizing of the layout of the facilities in her bathroom, a plan could then be created for her particular needs. The results of this research could then enable the home-based rehabilitation of elderly patients to be more effective. Value: This paper develops a new approach to design and optimize the layout of facilities in bathroom for the elderly. Implications for Rehabilitation Develop a new approach to design and optimize the layout of facilities in bathroom. Provide a mathematical and more scientific approach to home layout design for home-based rehabilitation. Provide new opportunities for research, for both the therapist and the patient to analyse the home facility layout.

Remote Sensing-based Models of Soil Vulnerability to Compaction and Erosion from Off-highway Vehicles

Science.gov (United States)

Villarreal, M. L.; Webb, R. H.; Norman, L.; Psillas, J.; Rosenberg, A.; Carmichael, S.; Petrakis, R.; Sparks, P.

2014-12-01

Intensive off-road vehicle use for immigration, smuggling, and security of the United States-Mexico border has prompted concerns about long-term human impacts on sensitive desert ecosystems. To help managers identify areas susceptible to soil erosion from vehicle disturbances, we developed a series of erosion potential models based on factors from the Revised Universal Soil Loss Equation (RUSLE), with particular focus on the management factor (P-factor) and vegetation cover (C-factor). To better express the vulnerability of soils to human disturbances, a soil compaction index (applied as the P-factor) was calculated as the difference in saturated hydrologic conductivity (Ks) between disturbed and undisturbed soils, which was then scaled up to remote sensing-based maps of vehicle tracks and digital soils maps. The C-factor was improved using a satellite-based vegetation index, which was better correlated with estimated ground cover (r2 = 0.77) than data derived from regional land cover maps (r2 = 0.06). RUSLE factors were normalized to give equal weight to all contributing factors, which provided more management-specific information on vulnerable areas where vehicle compaction of sensitive soils intersects with steep slopes and low vegetation cover. Resulting spatial data on vulnerability and erosion potential provide land managers with information to identify critically disturbed areas and potential restoration sites where off-road driving should be restricted to reduce further degradation.

Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation

OpenAIRE

Ko, Dae-Sik; Jung, Dae-In; Jeong, Mi-Ae

2014-01-01

[Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessi...

A metric-based assessment of flood risk and vulnerability of rural communities in the Lower Shire Valley, Malawi

Science.gov (United States)

Adeloye, A. J.; Mwale, F. D.; Dulanya, Z.

2015-06-01

In response to the increasing frequency and economic damages of natural disasters globally, disaster risk management has evolved to incorporate risk assessments that are multi-dimensional, integrated and metric-based. This is to support knowledge-based decision making and hence sustainable risk reduction. In Malawi and most of Sub-Saharan Africa (SSA), however, flood risk studies remain focussed on understanding causation, impacts, perceptions and coping and adaptation measures. Using the IPCC Framework, this study has quantified and profiled risk to flooding of rural, subsistent communities in the Lower Shire Valley, Malawi. Flood risk was obtained by integrating hazard and vulnerability. Flood hazard was characterised in terms of flood depth and inundation area obtained through hydraulic modelling in the valley with Lisflood-FP, while the vulnerability was indexed through analysis of exposure, susceptibility and capacity that were linked to social, economic, environmental and physical perspectives. Data on these were collected through structured interviews of the communities. The implementation of the entire analysis within GIS enabled the visualisation of spatial variability in flood risk in the valley. The results show predominantly medium levels in hazardousness, vulnerability and risk. The vulnerability is dominated by a high to very high susceptibility. Economic and physical capacities tend to be predominantly low but social capacity is significantly high, resulting in overall medium levels of capacity-induced vulnerability. Exposure manifests as medium. The vulnerability and risk showed marginal spatial variability. The paper concludes with recommendations on how these outcomes could inform policy interventions in the Valley.

Wavelet-based multiscale analysis of minimum toe clearance variability in the young and elderly during walking.

Science.gov (United States)

Khandoker, Ahsan H; Karmakar, Chandan K; Begg, Rezaul K; Palaniswami, Marimuthu

2007-01-01

As humans age or are influenced by pathology of the neuromuscular system, gait patterns are known to adjust, accommodating for reduced function in the balance control system. The aim of this study was to investigate the effectiveness of a wavelet based multiscale analysis of a gait variable [minimum toe clearance (MTC)] in deriving indexes for understanding age-related declines in gait performance and screening of balance impairments in the elderly. MTC during walking on a treadmill for 30 healthy young, 27 healthy elderly and 10 falls risk elderly subjects with a history of tripping falls were analyzed. The MTC signal from each subject was decomposed to eight detailed signals at different wavelet scales by using the discrete wavelet transform. The variances of detailed signals at scales 8 to 1 were calculated. The multiscale exponent (beta) was then estimated from the slope of the variance progression at successive scales. The variance at scale 5 was significantly (ppathological conditions. Early detection of gait pattern changes due to ageing and balance impairments using wavelet-based multiscale analysis might provide the opportunity to initiate preemptive measures to be undertaken to avoid injurious falls.

Customized chemotherapy based on epidermal growth factor receptor mutation status for elderly patients with advanced non-small-cell lung cancer: a phase II trial

International Nuclear Information System (INIS)

Fujita, Shiro; Mio, Tadashi; Katakami, Nobuyuki; Masago, Katsuhiro; Yoshioka, Hiroshige; Tomii, Keisuke; Kaneda, Toshihiko; Hirabayashi, Masataka; Kunimasa, Kei; Morizane, Toshio

2012-01-01

Elderly patients are more vulnerable to toxicity from chemotherapy. Activating epidermal growth factor receptor (EGFR) mutations in non-small-cell lung cancer (NSCLC) are associated with enhanced response to EGFR tyrosine-kinase inhibitors. We studied patients with advanced NSCLC for whom treatment was customized based on EGFR mutation status. We screened 57 chemotherapy-naïve patients with histologically or cytologically confirmed NSCLC, stage IIIB or IV, aged 70 years or older, and with an Eastern Cooperative Oncology Group performance status 0 or 1, for EGFR exon 19 codon 746–750 deletion and exon 21 L858R mutation. Twenty-two patients with EGFR mutations received gefitinib; 32 patients without mutations received vinorelbine or gemcitabine. The primary endpoint was the response rate. The response rate was 45.5% (95% confidence interval [CI]: 24.4%, 67.8%) in patients with EGFR mutations and 18.8% (95% CI: 7.2%, 36.4%) in patients without EGFR mutations. The median overall survival was 27.9 months (95%CI: 24.4 months, undeterminable months) in patients with EGFR mutations and 14.9 months (95%CI: 11.0 months, 22.4 months) in patients without EGFR mutations. In the gefitinib group, grade 3/4 hepatic dysfunction and dermatitis occurred in 23% and 5% of patients, respectively. In patients treated with vinorelbine or gemcitabine, the most common grade 3 or 4 adverse events were neutropenia (47%; four had febrile neutropenia), anemia (13%), and anorexia (9%). No treatment-related deaths occurred. Treatment customization based on EGFR mutation status deserves consideration, particularly for elderly patients who often cannot receive second-line chemotherapy due to poor organ function or comorbidities. This trial is registered at University hospital Medical Information Network-clinical trial registration (http://www.umin.ac.jp/ctr/index/htm) with the registration identification number C000000436

Cognitive Changes among Institutionalized Elderly People

Science.gov (United States)

Navarro, Jose I.; Menacho, Inmaculada; Alcalde, Concepcion; Marchena, Esperanza; Ruiz, Gonzalo; Aguilar, Manuel

2009-01-01

The efficiency of different cognitive training procedures in elderly people was studied. Two types of methods to train cognitive and memory functions were compared. One method was based on new technologies and the other one on pencil-and-paper activities. Thirty-six elderly institutionalized people aged 68-94 were trained. Quantitative and memory…

Comparison of elderly suicide rates among migrants in England and Wales with their country of origin.

Science.gov (United States)

Shah, Ajit; Lindesay, James; Dennis, Mick

2009-03-01

The black and minority ethnic (BME) elderly population size in England and Wales has progressively increased over the last three decades. Only two studies, both well over a decade old, have compared suicide rates in BME groups in England and Wales with those in their country of origin. A study comparing suicide rates among elderly migrants in England and Wales and in their country of origin using the latest available mortality data from the Office of National Statistics and the World Health Organization was conducted. There were wide variations in standardised mortality ratios for elderly suicides among migrants from different countries compared with those born in England and Wales and in their country of origin. There was convergence towards elderly suicide rates for England and Wales in some migrant groups in males in the age-bands 65-74 years and 75 + years, and in females in the age-band 75 + years. However, males aged 75 + years from most migrant groups had higher rates than those born in England and Wales. A more detailed analysis of suicide of older people from migrant groups is required to determine vulnerability and protective influences.

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.

Science.gov (United States)

Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

2018-01-01

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ 2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher ( P elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P elder abuse.

[Functional dependency and falls in elderly living in poverty in Mexico].

Science.gov (United States)

Manrique-Espinoza, Betty; Salinas-Rodríguez, Aarón; Moreno-Tamayo, Karla; Téllez-Rojo, Martha M

2011-01-01

To determine the prevalence of functional dependency (FD) on Mexican elderly living in extreme poverty conditions and to estimate the association between falls and FD. A survey was conducted with three stages for selection, stratified by type of locality (rural or urban) and nationally representative of the 2006 Oportunidades Program. The target population was composed of individuals 70 years of age and older who were beneficiaries of the Oportunidades Program. A total of 30.9% of the elderly presented FD. The gender stratified logistic regression model resulted in an odds ratio (OR) for women of 1.25 (I.C:1.13-1.39) for the association between the increase in the number of falls and FD and OR=1.12 (I.C:0.97-1.29) for men. Given the vulnerable conditions in which these older adults live, specific interventions need to be implemented to prevent falls in order to reduce the risk of functional dependency.

The elderly, the young and the pregnant traveler -- A retrospective data analysis from a large Swiss Travel Center with a special focus on malaria prophylaxis and yellow fever vaccination.

Science.gov (United States)

Jaeger, Veronika K; Tschudi, Nadine; Rüegg, Rolanda; Hatz, Christoph; Bühler, Silja

2015-01-01

Vulnerable individuals such as elderly, children/adolescents and pregnant/breastfeeding women increasingly travel overseas. We describe the travel and vaccination patterns of these groups at the largest Travel Clinic in Switzerland especially focusing on travel to yellow fever and malaria-endemic countries, and yellow fever vaccination (YFV) and malaria medications. An analysis of pre-travel visits between 2010 and 2012 at the Travel Clinic of the University of Zurich, was performed assessing differences between the elderly, young and middle-aged travelers as well as between pregnant/breastfeeding and other female travelers. Overall, the vulnerable groups did not differ from other travelers regarding their travel patterns. YFV was the most often administered vaccine to elderly travelers; half of them received it for the first time. More than 30% of children/adolescents received YFV, but no child below six months was vaccinated. 80% of young travelers and a similar percentage of pregnant women went to malaria-endemic regions. Twenty-five pregnant/breastfeeding women traveled to YF endemic areas. Travel patterns of vulnerable travelers are comparable to those of other travelers. In view of the limited data on malaria medications and precautions against YFV during pregnancy and at the extreme ages of life, giving travel advice to these groups is challenging. Copyright © 2015 Elsevier Ltd. All rights reserved.

My aging experiences no longer count, is there not a cause? : examining the impacts of senior citizen grants on wellbeing of the elderly in Kiboga District-Uganda

OpenAIRE

Nalwanga, Rebecca

2016-01-01

The current conversation is one of global citizenship, which binds together national and international actors in the field of development to work towards realizing a full set of rights for all global citizens. International donors in the Global North are now funding social assistance programmes targeting vulnerable groups such as the elderly in the Global South. Therefore, improving the living conditions of the elderly in addition to enhancing capabilities of older persons to enable them acti...

Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

NARCIS (Netherlands)

Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

2009-01-01

Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

Assessment of bullet effectiveness based on a human vulnerability model.

Science.gov (United States)

Liu, Susu; Xu, C; Wen, Y; Li, G; Zhou, J

2017-12-25

Penetrating wounds from explosively propelled fragments and bullets are the most common causes of combat injury. There is a requirement to assess the potential effectiveness of bullets penetrating human tissues in order to optimise preventive measures and wound trauma management. An advanced voxel model based on the Chinese Visible Human data was built. A digital human vulnerability model was established in combination with wound reconstruction and vulnerability assessment rules, in which wound penetration profiles were obtained by recreating the penetration of projectiles into ballistic gelatin. An effectiveness evaluation method of bullet penetration using the Abbreviated Injury Scale (AIS) was developed and solved using the Monte Carlo sampling method. The effectiveness of rifle bullets was demonstrated to increase with increasing velocity in the range of 300-700 m/s. When imparting the same energy, the effectiveness of the 5.56 mm bullet was higher than the 7.62 mm bullet in this model. The superimposition of simulant penetration profiles produced from ballistic gelatin simulant has been used to predict wound tracts in damaged tissues. The authors recognise that determining clinical effectiveness based on the AIS scores alone without verification of outcome by review of clinical hospital records means that this technique should be seen more as a manner of comparing the effectiveness of bullets than an injury prediction model. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Beyond exposure, sensitivity and adaptive capacity: A response based ecological framework to assess species climate change vulnerability

Science.gov (United States)

Fortini, Lucas B.; Schubert, Olivia

2017-01-01

As the impacts of global climate change on species are increasingly evident, there is a clear need to adapt conservation efforts worldwide. Species vulnerability assessments (VAs) are increasingly used to summarize all relevant information to determine a species’ potential vulnerability to climate change and are frequently the first step in informing climate adaptation efforts. VAs commonly integrate multiple sources of information by utilizing a framework that distinguishes factors relevant to species exposure, sensitivity, and adaptive capacity. However, this framework was originally developed for human systems, and its use to evaluate species vulnerability has serious practical and theoretical limitations. By instead defining vulnerability as the degree to which a species is unable to exhibit any of the responses necessary for persistence under climate change (i.e., toleration of projected changes, migration to new climate-compatible areas, enduring in microrefugia, and evolutionary adaptation), we can bring VAs into the realm of ecological science without applying borrowed abstract concepts that have consistently challenged species-centric research and management. This response-based framework to assess species vulnerability to climate change allows better integration of relevant ecological data and past research, yielding results with much clearer implications for conservation and research prioritization.

An Elderly Employment Model For The Thai Automotive Industry

Directory of Open Access Journals (Sweden)

Pornrat Sadangharn

2017-10-01

Full Text Available This research aims at studying an elderly employment model for the Thai automotive industry. Mixed methods with a sequential exploratory strategy were utilized. Grounded theory was employed by using in-depth interviews to investigate the characteristics of elderly employment in the Thai automotive industry. For this stage of the research, theoretical and purposive sampling was used to select 32 key informants from four groups of stakeholders: (1 elderly workers, (2 employers or human resource managers, (3 government officers, and (4 academics. The findings were then validated using a quantitative approach with structural equation modelling (SEM. A total of 308 elderly workers and human resource managers were surveyed regarding their opinion about elderly employment. Based on the survey, the elderly employment model in the Thai automotive industry, which is comprised of the approach to elderly employment, elderly employment preparation, and key success factors for elderly employment, was revealed to be a good fit. 

Assessment of urban vulnerability towards floods using an indicator-based approach – a case study for Santiago de Chile

Directory of Open Access Journals (Sweden)

A. Müller

2011-08-01

Full Text Available Regularly occurring flood events do have a history in Santiago de Chile, the capital city of Chile and study area for this research. The analysis of flood events, the resulting damage and its causes are crucial prerequisites for the development of risk prevention measures. The goal of this research is to empirically investigate the vulnerability towards floods in Santiago de Chile as one component of flood risk. The analysis and assessment of vulnerability is based on the application of a multi-scale (individual, household, municipal level set of indicators and the use of a broad range of data. The case-specific set of indicators developed in this study shows the relevant variables and their interrelations influencing the flood vulnerability in the study area. It provides a decision support tool for stakeholders and allows for monitoring and evaluating changes over time. The paper outlines how GIS, census, and remote sensing data as well as household surveys and expert interviews are used as an information base for the derivation of a vulnerability map for two municipalities located in the eastern part of Santiago de Chile. The generation of vulnerability maps representing the two different perspectives of local decision makers (experts and affected households is exemplified and discussed using the developed methodology.

Return Migration among Elderly, Chronically Ill Bosnian Refugees

DEFF Research Database (Denmark)

Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

2015-01-01

Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...... Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show...

Capitalized design of smart medicine box for elderly person based on quality function deployment (QFD)

Science.gov (United States)

Lestari, Brina Cindy; Dewi, Dyah Santhi; Widodo, Rusminto Tjatur

2017-11-01

The elderly who has a particular disease need to take some medicines in everyday with correct dosages and appropriate by time schedules. However, the elderly frequently forget to take medicines because of their memory weakened. Consequently, the product innovation of elderly healthcare is required for helping elderly takes some medicine more easily. This research aims to develop a smart medicine box by applying quality function deployment method. The first step is identifying elderly requirements through an ethnographic approach by interviewing thirty-two of elderly people as respondents. Then, the second step is translated elderly requirements to technical parameter for designing a smart medicine box. The smart box design is focused on two main requirements which have highest importance rating including alarm reminder for taking medicine and automatic medicine box. Finally, the prototype design has been created and tested by using usability method. The result shown that 90% from ten respondents have positive respond on the feature of smart medicine box. The voice of alarm reminder smart medicine box is easy to understand by elderly people for taking medicines.

Vulnerability assessment in a participatory approach to design and implement community based adaptation to drought in the Peruvian Andes

Science.gov (United States)

Lasage, Ralph; Muis, Sanne; Sardella, Carolina; van Drunen, Michiel; Verburg, Peter; Aerts, Jeroen

2015-04-01

The livelihoods of people in the Andes are expected to be affected by climate change due to their dependence on glacier meltwater during the growing season. The observed decrease in glacier volume over the last few decades is likely to accelerate during the current century, which will affect water availability in the region. This paper presents the implementation of an approach for the participatory development of community-based adaptation measures to cope with the projected impacts of climate change, which was implemented jointly by the local community and by a team consisting of an NGO, Peruvian ministry of environment, research organisations and a private sector organisation. It bases participatory design on physical measurements, modelling and a vulnerability analysis. Vulnerability to drought is made operational for households in a catchment of the Ocoña river basin in Peru. On the basis of a household survey we explore how a vulnerability index (impacts divided by the households' perceived adaptive capacity) can be used to assess the distribution of vulnerability over households in a sub catchment. The socio-economic factors water entitlement, area of irrigated land, income and education are all significantly correlate with this vulnerability to drought. The index proved to be appropriate for communicating about vulnerability to climate change and its determining factors with different stakeholders. The water system research showed that the main source of spring water is local rainwater, and that water use efficiency in farming is low. The adaptation measures that were jointly selected by the communities and the project team aimed to increase water availability close to farmland, and increase water use efficiency, and these will help to reduce the communities vulnerability to drought.

Placental miR-340 mediates vulnerability to activity based anorexia in mice.

Science.gov (United States)

Schroeder, Mariana; Jakovcevski, Mira; Polacheck, Tamar; Drori, Yonat; Luoni, Alessia; Röh, Simone; Zaugg, Jonas; Ben-Dor, Shifra; Albrecht, Christiane; Chen, Alon

2018-04-23

Anorexia nervosa (AN) is a devastating eating disorder characterized by self-starvation that mainly affects women. Its etiology is unknown, which impedes successful treatment options leading to a limited chance of full recovery. Here, we show that gestation is a vulnerable window that can influence the predisposition to AN. By screening placental microRNA expression of naive and prenatally stressed (PNS) fetuses and assessing vulnerability to activity-based anorexia (ABA), we identify miR-340 as a sexually dimorphic regulator involved in prenatal programming of ABA. PNS caused gene-body hypermethylation of placental miR-340, which is associated with reduced miR-340 expression and increased protein levels of several target transcripts, GR, Cry2 and H3F3b. MiR-340 is linked to the expression of several nutrient transporters both in mice and human placentas. Using placenta-specific lentiviral transgenes and embryo transfer, we demonstrate the key role miR-340 plays in the mechanism involved in early life programming of ABA.

Value-based design for the elderly : An application in the field of mobility aids

NARCIS (Netherlands)

Boerema, Simone Theresa; van Velsen, Lex Stefan; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

2016-01-01

In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility

An Educational Intervention for Police and Firefighters for Elders at Risk: Limits of Education Alone as a Strategy for Behavior Change

Science.gov (United States)

Nusbaum, N. J.; Mistretta, M.; Wegner, J.

2007-01-01

As part of a research project aimed at the health care needs of the vulnerable community-dwelling elderly, an educational intervention was delivered to police and firefighters in worksite settings. A single educational intervention proved insufficient to produce lasting attitudinal and behavioral change as measured by follow-up surveys 3 and 6…

Research and application of ARP protocol vulnerability attack and defense technology based on trusted network

Science.gov (United States)

Xi, Huixing

2017-03-01

With the continuous development of network technology and the rapid spread of the Internet, computer networks have been around the world every corner. However, the network attacks frequently occur. The ARP protocol vulnerability is one of the most common vulnerabilities in the TCP / IP four-layer architecture. The network protocol vulnerabilities can lead to the intrusion and attack of the information system, and disable or disable the normal defense function of the system [1]. At present, ARP spoofing Trojans spread widely in the LAN, the network security to run a huge hidden danger, is the primary threat to LAN security. In this paper, the author summarizes the research status and the key technologies involved in ARP protocol, analyzes the formation mechanism of ARP protocol vulnerability, and analyzes the feasibility of the attack technique. Based on the summary of the common defensive methods, the advantages and disadvantages of each defense method. At the same time, the current defense method is improved, and the advantage of the improved defense algorithm is given. At the end of this paper, the appropriate test method is selected and the test environment is set up. Experiment and test are carried out for each proposed improved defense algorithm.

Intelligent monitoring system of bedridden elderly

Science.gov (United States)

Dong, Rue Shao; Tanaka, Motohiro; Ushijima, Miki; Ishimatsu, Takakazu

2005-12-01

In this paper we propose a system to detect physical behavior of the elderly under bedridden status. This system is used to prevent those elderly from falling down and being wounded. Basic idea of our approach is to measure the body movements of the elderly using the acceleration sensor. Based on the data measured, dangerous actions of the elderly are extracted and warning signals to the caseworkers are generated via wireless signals. A feature of the system is that the senor part is compactly assembled as a wearable unit. Another feature of the system is that the system adopts a simplified wireless network system. Due to the network capability the system can monitor physical movements of multi-patients. Applicability of the system is now being examined at hospitals.

Participation of the elderly after vision loss

NARCIS (Netherlands)

Alma, M.A.; Mei, van der S.F.; Melis-Dankers, B.J.M.; Tilburg, van T.G.; Groothoff, J.W.; Suurmeijer, T.P.B.M.

2011-01-01

Purpose. To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. Method. This cross-sectional study included visually impaired elderly persons (≥55 years; n=173) who were referred to a low-vision rehabilitation centre.

Psychiatric morbidity, quality of life, and perceived social support among elderly population: a community-based study

Directory of Open Access Journals (Sweden)

Pallavi Kwan

2016-01-01

Full Text Available Background: The growth in the elderly population means an inevitable increase in general physical health, psychobiological and mental health-related problems. Aim of the study: The present study aims to examine psychiatric morbidity, quality of life, and perceived social support among elderly population. Research design: A cross-sectional community-based study was conducted. People in age group of 60 years and above, who were permanent members of their respective households of Ranga Pukri Para and Dekargaon village in Tezpur, Sonitpur district of Assam, were the sample for the present study. One thousand four hundred and ninety adult populations had been identified as sample frame from the electorate list. One hundred and four people of age 60 years and above had been identified from the list for the study purpose. Random sampling method was used for selection of the sample. Semi-structured socio-demographic datasheet, General Health Questionnaire-12 (GHQ-12, CAGE questionnaire, Multidimensional Scale of Perceived Social Support, and World Health Organization Quality of Life (WHOQOL-BREF scale were administered to the respondents. Results: Based on the GHQ-12 score, it was found that 24% of the respondents showed an indication of mental health problems and from the CAGE score, it indicated that 13% of the respondents were found to be misusing or was in dependence in alcohol. The result from the present study indicated that elderly population was getting more family social support, followed by friends and from significant others. The result indicated that the mean score was low in the domain of social relationships. Environment domain was high followed by physical health and psychological domains of WHOQOL-BREF. Conclusion: In the elderly population, overall health can be influenced by multiple factors, including a person’s physical, psychological, behavioural, and social factors. The mental health professionals can provide resources, services

Hippotherapy: quality of life for the elderly on the horse

Directory of Open Access Journals (Sweden)

Lia Mara Wibelinger

2011-09-01

Full Text Available Hippotherapy is a technique of rehabilitation and education that uses horse riding and equestrian activities to provide physical benefits to the practitioner, psychological, educational and social. This activity requires the participation of the entire body, the practitioner working in a global horse being used as a therapeutic method that will help develop equilibrium, muscle tone, muscle strength, body awareness, improvement of motor coordination, attention, self-confidence, self-esteem and quality of life. Hippotherapy in the elderly will use the horse as a therapeutic agent in treating various pathologies providing welfare and thus improved quality of life, and a pleasurable treatment, because it runs away from offices and indoor environments. Moreover, threedimensional movement, rhythmic rocking horse and will stimulate the vestibular system, the improvement of consciousness space-time, concentration, equilibrium and consolidation of security gravitational leaving the elderly less vulnerable to falls and related disabilities. Therefore, this article literature review aimed to determine the effects and show the importance of the practice of hippotherapy in order to obtain better quality of life and longevity.

Groundwater vulnerability mapping of Qatar aquifers

Science.gov (United States)

Baalousha, Husam Musa

2016-12-01

Qatar is one of the most arid countries in the world with limited water resources. With little rainfall and no surface water, groundwater is the only natural source of fresh water in the country. Whilst the country relies mainly on desalination of seawater to secure water supply, groundwater has extensively been used for irrigation over the last three decades, which caused adverse environmental impact. Vulnerability assessment is a widely used tool for groundwater protection and land-use management. Aquifers in Qatar are carbonate with lots of fractures, depressions and cavities. Karst aquifers are generally more vulnerable to contamination than other aquifers as any anthropogenic-sourced contaminant, especially above a highly fractured zone, can infiltrate quickly into the aquifer and spread over a wide area. The vulnerability assessment method presented in this study is based on two approaches: DRASTIC and EPIK, within the framework of Geographical Information System (GIS). Results of this study show that DRASTIC vulnerability method suits Qatar hydrogeological settings more than EPIK. The produced vulnerability map using DRASTIC shows coastal and karst areas have the highest vulnerability class. The southern part of the country is located in the low vulnerability class due to occurrence of shale formation within aquifer media, which averts downward movement of contaminants.

Assessment of well vulnerability for groundwater source protection based on a solute transport model: a case study from Jilin City, northeast China

Science.gov (United States)

Huan, Huan; Wang, Jinsheng; Lai, Desheng; Teng, Yanguo; Zhai, Yuanzheng

2015-05-01

Well vulnerability assessment is essential for groundwater source protection. A quantitative approach to assess well vulnerability in a well capture zone is presented, based on forward solute transport modeling. This method was applied to three groundwater source areas (Jiuzhan, Hadawan and Songyuanhada) in Jilin City, northeast China. The ratio of the maximum contaminant concentration at the well to the released concentration at the contamination source ( c max/ c 0) was determined as the well vulnerability indicator. The results indicated that well vulnerability was higher close to the pumping well. The well vulnerability in each groundwater source area was low. Compared with the other two source areas, the cone of depression at Jiuzhan resulted in higher spatial variability of c max/ c 0 and lower minimum c max/ c 0 by three orders of magnitude. Furthermore, a sensitivity analysis indicated that the denitrification rate in the aquifer was the most sensitive with respect to well vulnerability. A process to derive a NO3-N concentration at the pumping well is presented, based on determining the maximum nitrate loading limit to satisfy China's drinking-water quality standards. Finally, the advantages, disadvantages and prospects for improving the precision of this well vulnerability assessment approach are discussed.

Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

DEFF Research Database (Denmark)

Oerkild, Bodil; Frederiksen, Marianne; Hansen, Jorgen Fischer

2011-01-01

BACKGROUND: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have...... investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. METHODS: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients = 65 years with coronary heart disease. RESULTS: seventy-five patients...... in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect...

Vulnerability of families with children with intestinal stomas

Directory of Open Access Journals (Sweden)

Clara Ferraz Lazarini Zacarin

2014-06-01

Full Text Available Intestinal stomas cause transformations in the body and create specific and continuous needs for care that imply in hospitalization and surgeries. In this context, we applied the concept of family vulnerability in order to identify the vulnerability of the family living with a child who has intestinal stoma. It is a qualitative study which interviewed the mothers of children with this chronic condition. We used narrative analysis based on the concept of family vulnerability. The results display that the family has gone through previous noteworthy experiences associated with the child’s condition. The family cares for the child on their own and seeks ways to control the situation and regain autonomy, hoping for stoma reversal. Based on the concept of vulnerability, we observed that these families can be considered vulnerable, for they experience threats to their autonomy, but are moved by the hope of reversal and intestinal tract reconstruction. doi: 10.5216/ree.v16i2.26639.

A Depth Video Sensor-Based Life-Logging Human Activity Recognition System for Elderly Care in Smart Indoor Environments

Directory of Open Access Journals (Sweden)

Ahmad Jalal

2014-07-01

Full Text Available Recent advancements in depth video sensors technologies have made human activity recognition (HAR realizable for elderly monitoring applications. Although conventional HAR utilizes RGB video sensors, HAR could be greatly improved with depth video sensors which produce depth or distance information. In this paper, a depth-based life logging HAR system is designed to recognize the daily activities of elderly people and turn these environments into an intelligent living space. Initially, a depth imaging sensor is used to capture depth silhouettes. Based on these silhouettes, human skeletons with joint information are produced which are further used for activity recognition and generating their life logs. The life-logging system is divided into two processes. Firstly, the training system includes data collection using a depth camera, feature extraction and training for each activity via Hidden Markov Models. Secondly, after training, the recognition engine starts to recognize the learned activities and produces life logs. The system was evaluated using life logging features against principal component and independent component features and achieved satisfactory recognition rates against the conventional approaches. Experiments conducted on the smart indoor activity datasets and the MSRDailyActivity3D dataset show promising results. The proposed system is directly applicable to any elderly monitoring system, such as monitoring healthcare problems for elderly people, or examining the indoor activities of people at home, office or hospital.

A depth video sensor-based life-logging human activity recognition system for elderly care in smart indoor environments.

Science.gov (United States)

Jalal, Ahmad; Kamal, Shaharyar; Kim, Daijin

2014-07-02

Recent advancements in depth video sensors technologies have made human activity recognition (HAR) realizable for elderly monitoring applications. Although conventional HAR utilizes RGB video sensors, HAR could be greatly improved with depth video sensors which produce depth or distance information. In this paper, a depth-based life logging HAR system is designed to recognize the daily activities of elderly people and turn these environments into an intelligent living space. Initially, a depth imaging sensor is used to capture depth silhouettes. Based on these silhouettes, human skeletons with joint information are produced which are further used for activity recognition and generating their life logs. The life-logging system is divided into two processes. Firstly, the training system includes data collection using a depth camera, feature extraction and training for each activity via Hidden Markov Models. Secondly, after training, the recognition engine starts to recognize the learned activities and produces life logs. The system was evaluated using life logging features against principal component and independent component features and achieved satisfactory recognition rates against the conventional approaches. Experiments conducted on the smart indoor activity datasets and the MSRDailyActivity3D dataset show promising results. The proposed system is directly applicable to any elderly monitoring system, such as monitoring healthcare problems for elderly people, or examining the indoor activities of people at home, office or hospital.

Comparison of oral health status and daily nutrient intake between elders who live alone and elders who live with family: Based on the Korean National Health and Nutrition Examination Survey (KNHANES VI) (2013-2015).

Science.gov (United States)

Kim, Eun-Jeong; Jin, Bo-Hyoung

2018-06-01

To compare the nutritional factors and oral status of elders living alone and elders living with their families in Korea. Numerous studies have found that the presence of fewer remaining teeth is associated with decreased nutrient intake; however, there is no study comparing the nutritional status and oral status of elders living alone with that of elders living with family based on a nationally representative sample. A sample of 2904 individuals who participated in the sixth Korean National Health and Nutrition Examination Survey was reviewed (65-84 years of age). Living status was defined according to the participants' self-reported questionnaire, and a nutrient intake questionnaire was designed as an open questionnaire and used during the face-to-face interviews. The number of existing teeth was used to determine oral status. A complex-sample general linear analysis and multivariate logistic regression analysis were used to evaluate the association between the number of teeth and nutrient intake among elders living with family and elders living alone after adjusting for confounders. Elders living alone were significantly older and tended to have the following characteristics: women, lower household income, lower educational level, poor perceived health status, non-smokers, non-drinkers and lack of physical activity. Elders living alone had a poorer perceived oral health status, had not received an oral examination in the past year, had chewing problems and had fewer existing teeth (P oral health and nutrient intake status. Participants who had many existing teeth had higher nutrient intake than the participants who had fewer existing teeth. For healthy lives at old age, family support or additional social support for elders living alone should be considered. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Vulnerability

NARCIS (Netherlands)

Issa, Sahar; van der Molen, Irna; Stel, Nora

2015-01-01

This chapter reviews the literature on vulnerability. Together with Chapter 3, that offers a literature review specifically focused on resilience, it lays the conceptual foundations for the empirical chapters in this edited volume. Vulnerability symbolizes the susceptibility of a certain system to

Nuclear material production cycle vulnerability analysis

International Nuclear Information System (INIS)

Bott, T.F.

1996-01-01

This paper discusses a method for rapidly and systematically identifying vulnerable equipment in a nuclear material or similar production process and ranking that equipment according to its attractiveness to a malevolent attacker. A multistep approach was used in the analysis. First, the entire production cycle was modeled as a flow diagram. This flow diagram was analyzed using graph theoretical methods to identify processes in the production cycle and their locations. Models of processes that were judged to be particularly vulnerable based on the cycle analysis then were developed in greater detail to identify equipment in that process that is vulnerable to intentional damage

Development, validity, and reliability of a food frequency questionnaire for antioxidants in elderly Iranian people.

Science.gov (United States)

Malekahmadi, Mahsa; Naeini, Amirmansour Alavi; Shab-Bidar, Sakineh; Feizi, Awat; Djazayery, Abolghasem

2016-01-01

The food frequency questionnaire (FFQ), as a way to assess the dietary intake in comparison with other methods, is easier to analyze and takes less time and is less costly. Our aim in this study was to develop and validate an FFQ for estimating the intakes of selected antioxidants in elderly Iranian people. A total of 185 elderly people were randomly selected. Three-day food records were completed by the subjects and collected every 2 months and dietary intake levels of zinc, selenium, carotenes and vitamins C and E were estimated. Based on the food records data, geographic location, and age, an FFQ was designed to estimate antioxidant intakes during 1 year. In addition, for controlling energy intake, 2-day food records were also collected with the food frequency questionnaire. To assess the reliability, 40 individuals were asked to complete the FFQ twice with an interval of 3 months in between. Intraclass correlation coefficient (ICC) between the two FFQs for antioxidant C, antioxidant E, carotene, selenium, and zinc were 0.62, 0.47, 0.51, 0.54, and 0.58, respectively ( P food records, after controlling energy for vitamin C, vitamin E, carotene, selenium, and zinc, were 0.46, 0.48, 0.38, 0.55, and 0.47 respectively ( P < 0.001). According to the results of this study, considering the fact that the FFQ was designed for the elderly and the special conditions (patience, memory, etc.) and vulnerability of this age group, the questionnaire is relatively valid and reliable to use.

Plasma incorporation, apparent retroconversion and β-oxidation of 13C-docosahexaenoic acid in the elderly

Directory of Open Access Journals (Sweden)

Brenna J Thomas

2011-01-01

Full Text Available Abstract Background Higher fish or higher docosahexaenoic acid (DHA intake normally correlates positively with higher plasma DHA level, but recent evidence suggests that the positive relationship between intake and plasma levels of DHA is less clear in the elderly. Methods We compared the metabolism of 13C-DHA in six healthy elderly (mean - 77 y old and six young adults (mean - 27 y old. All participants were given a single oral dose of 50 mg of uniformly labelled 13C-DHA. Tracer incorporation into fatty acids of plasma triglycerides, free fatty acids, cholesteryl esters and phospholipids, as well as apparent retroconversion and β-oxidation of 13C-DHA were evaluated 4 h, 24 h, 7d and 28d later. Results Plasma incorporation and β-oxidation of 13C-DHA reached a maximum within 4 h in both groups, but 13C-DHA was transiently higher in all plasma lipids of the elderly 4 h to 28d later. At 4 h post-dose, 13C-DHA β-oxidation was 1.9 times higher in the elderly, but over 7d, cumulative β-oxidation of 13C-DHA was not different in the two groups (35% in the elderly and 38% in the young. Apparent retroconversion of 13C-DHA was well below 10% of 13C-DHA recovered in plasma at all time points, and was 2.1 times higher in the elderly 24 h and 7d after tracer intake. Conclusions We conclude that 13C-DHA metabolism changes significantly during healthy aging. Since DHA is a potentially important molecule in neuro-protection, these changes may be relevant to the higher vulnerability of the elderly to cognitive decline.

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

Science.gov (United States)

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

Structural vulnerability in transmission systems: Cases of Colombia and Spain

International Nuclear Information System (INIS)

Correa, Gabriel J.; Yusta, José M.

2014-01-01

Highlights: • Vulnerability analysis of transmission electric systems in Colombia and Spain. • Based on scale-free graph statistic indexes. • Evaluating both current conditions and expansion plans of infrastructures. • Comparison of random error and deliberate attack tolerance evaluation. - Abstract: In this paper the authors apply methodological strategies for the structural vulnerability assessment in high voltage power networks based upon the combination of power flow models and scale-free graph statistic indexes. Thus, it is possible to study risk scenarios based on events that may trigger cascading failures within a power system. The usefulness of graph theory techniques has been validated on previous works of the authors, and may be applied in analysis of the vulnerability of different power electric networks. A case study for vulnerability analysis is carried out through methodologies that allow comparison on random error and deliberate attack tolerance evaluation in transmission electric systems from countries like Colombia and Spain. Such vulnerability assessment methodology takes into account the current conditions of the power networks (base case), as well as the impact of expansion plans into infrastructures as defined by their governments. Consequently, the authors show the advantage on the use of graph theory based techniques for vulnerability analysis of electrical power systems

Assessment of vulnerability zones for ground water pollution using GIS-DRASTIC-EC model: A field-based approach

Science.gov (United States)

Anantha Rao, D.; Naik, Pradeep K.; Jain, Sunil K.; Vinod Kumar, K.; Dhanamjaya Rao, E. N.

2018-06-01

Assessment of groundwater vulnerability to pollution is an essential pre-requisite for better planning of an area. We present the groundwater vulnerability assessment in parts of the Yamuna Nagar District, Haryana State, India in an area of about 800 km2, considered to be a freshwater zone in the foothills of the Siwalik Hill Ranges. Such areas in the Lower Himalayas form good groundwater recharge zones, and should always be free from contamination. But, the administration has been trying to promote industrialization along these foothill zones without actually assessing the environmental consequences such activities may invite in the future. GIS-DRASTIC model has been used with field based data inputs for studying the vulnerability assessment. But, we find that inclusion electrical conductivity (EC) as a model parameter makes it more robust. Therefore, we rename it as GIS-DRASTIC-EC model. The model identifies three vulnerability zones such as low, moderate and high with an areal extent of 5%, 80% and 15%, respectively. On the basis of major chemical parameters alone, the groundwater in the foothill zones apparently looks safe, but analysis with the help of GIS-DRASTIC-EC model gives a better perspective of the groundwater quality in terms of identifying the vulnerable areas.

Management of epilepsy in elderly

Directory of Open Access Journals (Sweden)

Harsono Harsono

2003-03-01

Full Text Available Management of epilepsy in elderly requires understanding the unique biochemical and pharmacological characteristics of these patients. Management decisions must be based on accurate classification of seizures or epilepsy syndromes, a thorough neurological assessment to define etiology, and a comprehensive assessment of the patient’s health and living situation. Concomitant illnesses such as neurological, psychiatric, metabolic, or cardiac disorders will require individualization of plans and instructions. Specific problems of treatment of epilepsy in the elderly compared to childhood patients are as follows: distinctive range of causes of epilepsy, distinctive differential diagnosis, concurrent pathologies unrelated to epilepsy, pharmacokinetic and pharmacodynamic differences, and distinctive psychosocial effects. (Med J Indones 2003; 12: 40-7 Keywords:  epilepsy, elderly, management, concomitant illness, pharmacokinetic

Kidney transplantation in the elderly.

Science.gov (United States)

Singh, Neeraj; Nori, Uday; Pesavento, Todd

2009-08-01

Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

Increased gait unsteadiness in community-dwelling elderly fallers

Science.gov (United States)

Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

1997-01-01

OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

Reliability and Validity of a Novel Internet-Based Battery to Assess Mood and Cognitive Function in the Elderly.

Science.gov (United States)

Myers, Candice A; Keller, Jeffrey N; Allen, H Raymond; Brouillette, Robert M; Foil, Heather; Davis, Allison B; Greenway, Frank L; Johnson, William D; Martin, Corby K

2016-10-18

Dementia is a chronic condition in the elderly and depression is often a concurrent symptom. As populations continue to age, accessible and useful tools to screen for cognitive function and its associated symptoms in elderly populations are needed. The aim of this study was to test the reliability and validity of a new internet-based assessment battery for screening mood and cognitive function in an elderly population. Specifically, the Helping Hand Technology (HHT) assessments for depression (HHT-D) and global cognitive function (HHT-G) were evaluated in a sample of 57 elderly participants (22 male, 35 female) aged 59-85 years. The study sample was categorized into three groups: 1) dementia (n = 8; Mini-Mental State Exam (MMSE) score 10-24), 2) mild cognitive impairment (n = 24; MMSE score 25-28), and 3) control (n = 25; MMSE score 29-30). Test-retest reliability (Pearson correlation coefficient, r) and internal consistency reliability (Cronbach's alpha, α) of the HHT-D and HHT-G were assessed. Validity of the HHT-D and HHT-G was tested via comparison (Pearson r) to commonly used pencil-and-paper based assessments: HHT-D versus the Geriatric Depression Scale (GDS) and HHT-G versus the MMSE. Good test-retest (r = 0.80; p validity of the HHT-D was obtained (r = 0.60 between the HHT-D and GDS; p Validity of the HHT-G was supported (r = 0.71 between the HHT-G and MMSE; p valid computerized assessments to screen for depression and cognitive status, respectively, in an elderly sample.

Elder Abuse and Help-Seeking Behavior in Elderly Chinese.

Science.gov (United States)

Yan, Elsie

2015-09-01

Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. © The Author(s) 2014.

Applicability of vulnerability maps

International Nuclear Information System (INIS)

Andersen, L.J.; Gosk, E.

1989-01-01

A number of aspects to vulnerability maps are discussed: the vulnerability concept, mapping purposes, possible users, and applicability of vulnerability maps. Problems associated with general-type vulnerability mapping, including large-scale maps, universal pollutant, and universal pollution scenario are also discussed. An alternative approach to vulnerability assessment - specific vulnerability mapping for limited areas, specific pollutant, and predefined pollution scenario - is suggested. A simplification of the vulnerability concept is proposed in order to make vulnerability mapping more objective and by this means more comparable. An extension of the vulnerability concept to the rest of the hydrogeological cycle (lakes, rivers, and the sea) is proposed. Some recommendations regarding future activities are given

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

Science.gov (United States)

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder.

Science.gov (United States)

Delphi, Maryam; Lotfi, M-Yones; Moossavi, Abdollah; Bakhshi, Enayatollah; Banimostafa, Maryam

2017-09-01

Previous studies have shown that interaural-time-difference (ITD) training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV). We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months' follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001). The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months' follow-up (P=0.212). The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder.

Handgrip strength and physical activity in frail elderly

Directory of Open Access Journals (Sweden)

Maria Helena Lenardt

2016-02-01

Full Text Available Abstract OBJECTIVE To investigate the association between handgrip strength (HS and physical activity in physical frailty elderly. METHOD Cross-sectional quantitative study with a sample of 203 elderly calculated based on the population estimated proportion. Tests were applied to detect cognitive impairment and assessment of physical frailty. Descriptive statistics and multivariate analysis by binary logistic regression were used, and also Student's t-test and Fisher's exact test. RESULTS A total of 99 (64.3% elderly showed decreased handgrip strength and 90 (58.4% elderly presented decrease in physical activity levels. There was a statistically significant difference between these two components (p=0.019, in which elderly who have decreased HS have lower levels of physical activity. For low levels of physical activity and decreased HS, there was no evidence of significant difference in the probability of the classification as frail elderly (p<0.001. CONCLUSION The components handgrip strength and physical activity are associated with the frail elderly. The joint presence of low levels of physical activity and decreased handgrip strength leads to a significantly higher probability of the elderly to be categorized as frailty.

Social vulnerability to climate-induced natural disasters

DEFF Research Database (Denmark)

Rubin, Olivier

2014-01-01

This paper conducts an analysis of the socioeconomic determinants of Vietnam's cross-provincial variations in natural disaster vulnerability. The purpose is twofold: (i) to capture disaggregated vulnerability variations normally obscured by national statistics, thereby providing more nuanced...... insights into Vietnam's vulnerability to natural disasters; and (ii) to take advantage of the fact that the overall political system and key institutional structures to a large extent are constant across Vietnam's provinces, which makes the analysis a novel addition to the many disaster studies based...

["Good intentions are not enough": analysis of a health policy for the elderly in Senegal].

Science.gov (United States)

Mbaye, Elhadji Mamadou; Ridde, Valery; Kâ, Ousseynou

2013-01-01

In 2006, the Senegalese government introduced the "Plan Sésame", an unprecedented policy in West Africa aimed at reducing social vulnerability among the elderly (i.e. people aged over 60 years). This paper examines the process of implementation of the "Plan Sdsame': Using a qualitative approach, the study was based on a unique case study authorized by the Senegalese Ministry of Health. Three methods were used: i) individual interviews (n = 19), ii) discussion groups (n = 24), and iii) documentary study. Despite its social objective, the "Plan Sésame" was ultimately limited to free health care. However, even the health component of the plan has suffered from under funding. Political obstacles, inadequate accompanying measures and short staffing have resulted in late reimbursements at a local level, thus limiting the implementation of the plan. While both health professionals and elderly people are in favor of free healthcare, they are also critical of the implementation issues surrounding the "Plan Sésame": Although it appears to be a viable solution, these issues may spell the end of the plan. The task of designing solid technical foundations and developing appropriate accompanying measures should not be overlooked because of the limited interest of international partners in the "Plan Sésame" the national dimension of the plan and its electoral importance.

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Directory of Open Access Journals (Sweden)

Yanrong Zhao

2017-03-01

Full Text Available This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05–1.68; urban resident basic medical insurance (URBMI vs. urban employee basic medical insurance (UEBMI (OR = 1.96, 95% CI, 1.46–2.61; and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50–0.90 for RMB 1001–3000; OR = 0.59, 95% CI, 0.39–0.90 for RMB 3001–5000. Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09–17.27. Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income.

Modelling farm vulnerability to flooding: A step toward vulnerability mitigation policies appraisal

Science.gov (United States)

Brémond, P.; Abrami, G.; Blanc, C.; Grelot, F.

2009-04-01

are needed to implement the model and to collect them, specifically using the focus group method; Based on the conceptual model, to program a mathematical model which will be used to simulate damage (direct and indirect) on farm due to flood. This last objective should enable us to appraise policy to mitigate vulnerability which is planned to be implemented on Rhône River at the individual and regional scale. Finally, we discuss the possibility to use the UML modelling to develop a multi-agent system approach which could be interesting to take into account ties between farmers (solidarity, loan of equipment) or systemic effects due to the damage incurred by economic partners (loss of market share). Keywords vulnerability, UML modelling, farming systems, flood, mitigation policy, economic valuation

Topological Vulnerability Evaluation Model Based on Fractal Dimension of Complex Networks.

Directory of Open Access Journals (Sweden)

Li Gou

Full Text Available With an increasing emphasis on network security, much more attentions have been attracted to the vulnerability of complex networks. In this paper, the fractal dimension, which can reflect space-filling capacity of networks, is redefined as the origin moment of the edge betweenness to obtain a more reasonable evaluation of vulnerability. The proposed model combining multiple evaluation indexes not only overcomes the shortage of average edge betweenness's failing to evaluate vulnerability of some special networks, but also characterizes the topological structure and highlights the space-filling capacity of networks. The applications to six US airline networks illustrate the practicality and effectiveness of our proposed method, and the comparisons with three other commonly used methods further validate the superiority of our proposed method.

The Elder Problem

Directory of Open Access Journals (Sweden)

John W. Elder

2017-03-01

Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

Modelling the changing cumulative vulnerability to climate-related hazards for river basin management using a GIS-based multicriteria decision approach

Science.gov (United States)

Hung, Hung-Chih; Wu, Ju-Yu; Hung, Chih-Hsuan

2017-04-01

1. Background Asia-Pacific region is one of the most vulnerable areas of the world to climate-related hazards and extremes due to rapid urbanization and over-development in hazard-prone areas. It is thus increasingly recognized that the management of land use and reduction of hazard risk are inextricably linked. This is especially critical from the perspective of integrated river basin management. A range of studies has targeted existing vulnerability assessments. However, limited attention has been paid to the cumulative effects of multiple vulnerable factors and their dynamics faced by local communities. This study proposes a novel methodology to access the changing cumulative vulnerability to climate-related hazards, and to examine the relationship between the attraction factors relevant to the general process of urbanization and vulnerability variability with a focus on a river basin management unit. 2. Methods and data The methods applied in this study include three steps. First, using Intergovernmental Panel on Climate Change's (IPCC) approach, a Cumulative Vulnerability Assessment Framework (CVAF) is built with a goal to characterize and compare the vulnerability to climate-related hazards within river basin regions based on a composition of multiple indicators. We organize these indicator metrics into three categories: (1) hazard exposure; (2) socioeconomic sensitivity, and (3) adaptive capacity. Second, the CVAF is applied by combining a geographical information system (GIS)-based spatial statistics technique with a multicriteria decision analysis (MCDA) to assess and map the changing cumulative vulnerability, comparing conditions in 1996 and 2006 in Danshui River Basin, Taiwan. Third, to examine the affecting factors of vulnerability changing, we develop a Vulnerability Changing Model (VCM) using four attraction factors to reflect how the process of urban developments leads to vulnerability changing. The factors are transport networks, land uses

Vulnerability and resilience of competing land-based livelihoods in south eastern Zimbabwe

NARCIS (Netherlands)

Murungweni, C.

2011-01-01

Key words: vulnerability; resilience; livelihood; drought; Great Limpopo Transfrontier Conservation Area; south eastern Zimbabwe.

Vulnerability and resilience have emerged as powerful analytical concepts in the study of socio-ecological systems. In this research these concepts are used

Elder Abuse and Neglect in Israel: A Comparison between the General Elderly Population and Elderly New Immigrants

Science.gov (United States)

Iecovich, Esther

2005-01-01

The present study investigated differences between the general elderly population and elderly new immigrants from former Soviet Union countries in regard to the incidence of elder abuse and neglect, victims' characteristics, and perpetrators' characteristics. In addition, the study sought to examine predictors of various types of abuse and…

Elder Abuse: Systematic Review and Implications for Practice.

Science.gov (United States)

Dong, Xin Qi

2015-06-01

This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

Management of depression in the elderly.

Science.gov (United States)

Williams, G O

1989-06-01

Primary care physicians have a vital role to play in identifying depression in their elderly patients. Diagnosis may be difficult, because symptoms are atypical and frequently include psychomotor agitation, somatic symptoms, and complaints of memory loss. Patients with medical illnesses, such as cancer, postmyocardial infarction, stroke, Parkinson's disease, and early Alzheimer's disease are particularly vulnerable to depression. Drugs that may cause depressive symptoms are digitalis at toxic levels, beta-blockers, centrally acting antihypertensives, immunosuppressants, and nonsteroidal anti-inflammatory agents. Cyclic antidepressants are the drugs of first choice. Selection depends on the patient's physical health and current medications and the side effect profile of the drug. Side effects are more pronounced in old age because of drug accumulation owing to slowed clearance. Troublesome side effects are anticholinergic effects, orthostatic hypotension, sedation, cardiotoxicity, and weight gain. The most useful antidepressants for geriatric patients are the secondary amines, desipramine and nortriptyline. The second-generation drug trazodone has the advantage of causing the least anticholinergic effects, but it is very sedating. Before treatment, the patient should have an electrocardiogram, liver function tests, tonometry, sitting and standing blood pressures, evaluation of urinary symptoms for outflow obstruction, review of current medications, and estimation of suicide risk. Cyclic antidepressants are contraindicated during recovery from myocardial infarction, in heart disease when there is severe impairment of myocardial performance, in seizure disorders, and in the presence of glaucoma or a large prostate. Drug interactions that may cause trouble can occur with epinephrine, MAO inhibitors, thyroid hormone, cimetidine, and centrally acting antihypertensives. Dosage should start low, increasing usually by 25 mg every 4 to 5 days until a therapeutic level is

Robots in Elderly Care

Directory of Open Access Journals (Sweden)

Alessandro Vercelli

2018-03-01

Full Text Available Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general perspective, robotics has the power to completely reshape the landscape of healthcare both in its structure and its operation. In fact, the long-term sustainability of healthcare systems could be addressed by automation powered by digital health technologies, such as artificial intelligence, 3D-printing or robotics. The latter could take over monotonous work from healthcare workers, which would allow them to focus more on patients and to have lesser workload. Robots might be used in elder care with several different aims. (i Robots may act as caregivers, i.e. assist the elderly, (ii they can provide remainders and instructions for activities of daily life and safety, and/or assist their carers in daily tasks; (iii they can help monitor their behaviour and health; and (iv provide companionship, including entertainment and hobbies, reminiscence and social contact. The use of Robots with human subjects/patients raise several sensitive questions. First of all, robots may represent information hubs, and can collect an incredible amount of data about the subjects and their environment. In fact, they record habits such as sleeping, exercising, third persons entering in the house, appointments. Communications may be continuously recorded. Moreover, by connecting with medical devices, they can store medical data. On one hand, this represents a very powerful tool to collect information about the single subject (precision medicine, about disease (thus eventually finding

Mining Spatiotemporal Patterns of the Elder's Daily Movement

Science.gov (United States)

Chen, C. R.; Chen, C. F.; Liu, M. E.; Tsai, S. J.; Son, N. T.; Kinh, L. V.

2016-06-01

With rapid developments in wearable device technology, a vast amount of spatiotemporal data, such as people's movement and physical activities, are generated. Information derived from the data reveals important knowledge that can contribute a long-term care and psychological assessment of the elders' living condition especially in long-term care institutions. This study aims to develop a method to investigate the spatial-temporal movement patterns of the elders with their outdoor trajectory information. To achieve the goal, GPS based location data of the elderly subjects from long-term care institutions are collected and analysed with geographic information system (GIS). A GIS statistical model is developed to mine the elderly subjects' spatiotemporal patterns with the location data and represent their daily movement pattern at particular time. The proposed method first finds the meaningful trajectory and extracts the frequent patterns from the time-stamp location data. Then, a density-based clustering method is used to identify the major moving range and the gather/stay hotspot in both spatial and temporal dimensions. The preliminary results indicate that the major moving area of the elderly people encompasses their dorm and has a short moving distance who often stay in the same site. Subjects' outdoor appearance are corresponded to their life routine. The results can be useful for understanding elders' social network construction, risky area identification and medical care monitoring.

Depression in elderly: A review of Indian research

Directory of Open Access Journals (Sweden)

Sandeep Grover

2015-01-01

Full Text Available To review the existing literature on depression among elderly arising from India. Search was carried out using PubMed, Google Scholar, Google, and Medknow search engines to identify the relevant studies. Most of the literatures that are available are in terms of prevalence of depression. Community-based studies involving 70 to 7,150 elderly subjects report prevalence rate varying from 8.9% to 62.16%. Clinic-based studies involving 50 to 5,260 participants report prevalence rates ranging from 42.4% to 72%. Studies have reported depression to be more common among females. Other demographic factors that have been associated with depression among elderly include being unmarried, divorced or widowed elderly, residing in rural locality, being illiterate, increasing age, lower socioeconomic status, and unemployment. Depression has also been shown to be associated with various psychosocial factors, lifestyle and dietary factors, and presence of chronic physical illness. There are limited data on various therapeutic interventions. Available data suggest usefulness of pranayam, cognitive behavior therapy, and electroconvulsive therapy. The review of data suggests that prevalence of depression among elderly in India is high. However, there is lack of data on symptom profile and limited data is available on various therapeutic interventions for the management of depression in elderly from India. There is urgent need to conduct large multicentric studies to fill this void in research.

Crimes against the elderly in Italy, 2007-2014.

Science.gov (United States)

Terranova, Claudio; Bevilacqua, Greta; Zen, Margherita; Montisci, Massimo

2017-08-01

Crimes against the elderly have physical, psychological, and economic consequences. Approaches for mitigating them must be based on comprehensive knowledge of the phenomenon. This study analyses crimes against the elderly in Italy during the period 2007-2014 from an epidemiological viewpoint. Data on violent and non-violent crimes derived from the Italian Institute of Statistics were analysed in relation to trends, gender and age by linear regression, T-test, and calculation of the odds ratio with a 95% confidence interval. Results show that the elderly are at higher risk of being victimized in two types of crime, violent (residential robbery) and non-violent (pick-pocketing and purse-snatching) compared with other age groups during the period considered. A statistically significant increase in residential robbery and pick-pocketing was also observed. The rate of homicide against the elderly was stable during the study period, in contrast with reduced rates in other age groups. These results may be explained by risk factors increasing the profiles of elderly individuals as potential victims, such as frailty, cognitive impairment, and social isolation. Further studies analysing the characteristics of victims are required. Based on the results presented here, appropriate preventive strategies should be planned to reduce crimes against the elderly. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Goat-based aid programme in Central Java: An effective intervention for the poor and vulnerable?

NARCIS (Netherlands)

Budisatria, I.G.S.; Udo, H.M.J.

2013-01-01

This study evaluated a goat-based aid programme developed to facilitate the recovery of vulnerable people in an earthquake affected area in Central Java, Indonesia. Farmers, organised in farmers’ groups, received a package of one male and four female goats. In total, 72 farmers from 6 farmers’

Impact of road traffic accidents on the elderly.

Science.gov (United States)

Etehad, H; Yousefzadeh-Chabok, Sh; Davoudi-Kiakalaye, A; Moghadam Dehnadi, A; Hemati, H; Mohtasham-Amiri, Z

2015-01-01

Older adults are a vulnerable road user group with high mortality and morbidity in road crash. The aim of this study was to show pattern of road traffic injuries in this special aging group. In a cross sectional study, pre-hospital emergency system reports, hospital and police records of all motor vehicle collisions injured above 60 years old who were admitted to Pour-Sina hospital from April 2011 to March 2012 were studied. Demographic data, characteristic of road traffic incidents and in-hospital medical profiles were derived. Data were analyzed with SPSS ver. 18. Differences between demographic and injuries situation were calculated by chi square test. A p-value of road accident injured. Mean age of them was 70.9 ± 6.7 years. Most of them were male (74.7%). 40.5% were pedestrians, 22.1% were car occupants and 19.1% were motorcyclists.76.7% had multiple trauma. Head and neck were the most prevalent regions of injured. Total in-hospital mortality rate was 10.1% that was higher in old elderly pedestrians and motorcyclists in comparison to young elderly (16.1% vs. 7.9%) and other type of victims (ρroad accident injured. Mean age of them was 70.9 ± 6.7 years. Most of them were male (74.7%). 40.5% were pedestrians, 22.1% were car occupants and 19.1% were motorcyclists.76.7% had multiple trauma. Head and neck were the most prevalent regions of injured. Total in-hospital mortality rate was 10.1% that was higher in old elderly pedestrians and motorcyclists in comparison to young elderly (16.1% vs. 7.9%) and other type of victims (ρroad traffic injuries in this group especially in pedestrians should be taken into consideration and strategies aimed at the road-user safety including periodic medical examination and improvement of road structure and facilities. Copyright © 2015. Published by Elsevier Ireland Ltd.

Prevalence of undetected cognitive impairment and depression in residents of an elderly care home.

Science.gov (United States)

Al-Jawad, M; Rashid, A K; Narayan, K A

2007-12-01

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Aging and Identity: Meanings of Elderly Women

Directory of Open Access Journals (Sweden)

Irani Iracema de Lima Argimon

2012-06-01

Full Text Available This paper presents the results of a survey that focus on reflections on the construction of identity in elderly women. Interviews were conducted by semi-structured form with six elderly women and the data were analyzed based on the Comprehensive Review of Phenomenological Base. Not reduce the subject to biological, genetic, social allows us to develop these projects and achievements in this time of life where the experience can lead to a better well-being and quality of life.

Indicator-based model to assess vulnerability to landslides in urban areas. Case study of Husi city (Eastern Romania)

Science.gov (United States)

Grozavu, Adrian; Ciprian Margarint, Mihai; Catalin Stanga, Iulian

2013-04-01

In the last three or four decades, vulnerability evolved from physical fragility meanings to a more complex concept, being a key element of risk assessment. In landslide risk assessment, there are a large series of studies regarding landslide hazard, but far fewer researches focusing on vulnerability measurement. Furthermore, there is still no unitary understanding on the methodological framework, neither any internationally agreed standard for landslide vulnerability measurements. The omnipresent common element is the existence of elements at risk, but while some approaches are limited to exposure, other focus on the degree of losses (human injuries, material damages and monetary losses, structural dysfunctions etc.). These losses are differently assessed using both absolute and relative values on qualitative or quantitative scales and they are differently integrated to provide a final vulnerability value. This study aims to assess vulnerability to landslides at local level using an indicator-based model applied to urban areas and tested for Husi town (Eastern Romania). The study region is characterized by permeable and impermeable alternating sedimentary rocks, monoclinal geological structure and hilly relief with impressive cuestas, continental temperate climate, and precipitation of about 500 mm/year, rising to 700 m and even more in some rainy years. The town is a middle size one (25000 inhabitants) and it had an ascending evolution in the last centuries, followed by an increasing human pressure on lands. Methodologically, the first step was to assess the landslide susceptibility and to identify in this way those regions within which any asset would be exposed to landslide hazards. Landslide susceptibility was assessed using the logistic regression approach, taking into account several quantitative and qualitative factors (elements of geology, morphometry, rainfall, land use etc.). The spatial background consisted in the Digital Elevation Model and all derived

Engaging Elderly People in Telemedicine Through Gamification.

Science.gov (United States)

de Vette, Frederiek; Tabak, Monique; Dekker-van Weering, Marit; Vollenbroek-Hutten, Miriam

2015-12-18

Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great connectivity between these taxonomies

Metabolic syndrome in Iranian elderly

Directory of Open Access Journals (Sweden)

Nizal Sarrafzadegan

2012-01-01

Full Text Available BACKGROUND: This study aimed to compare Iranian elderly with the youth and middle aged population in terms of the prevalence of metabolic syndrome and its components in Iranian elderly METHODS: This cross-sectional study was conducted using the information from the third phase of Isfahan Healthy Heart Program. Male and female residents of Isfahan who aged over 19 years were selected by multistage cluster random sampling. A questionnaire including demographic characteristics, health status, medical history, medications used, as well as waist circumference, weight, height and systolic and diastolic blood pressures was completed for all participants. Fasting blood samples were obtained from all subjects and examined for fasting blood sugar and lipid profile. RESULTS: The prevalence of metabolic syndrome in individuals aged over 60 years was significantly higher than those under 60 (49.5% vs. 17.5%, respectively; P < 0.001. It was also more prevalent among elderly females than in males (59.2% vs. 39.8%, respectively; P < 0.005. Some anthropometric measures such as height, body mass index, abdominal circumference, waist-hip ratio, and waist to height ratio were significantly different in men and women below 60 years in comparison with those over 60 years (P < 0.05. Moreover, there were significant differences in most studied parameters between the elderly and non-elderly women (P < 0.001. Based on the findings of this study, the risk factors for cardiovascular diseases were significantly more prevalent in men and women over 60 years. T-test and Mann-Whitney were used for quantitative data and the square-chi test is performed for qualitative data.    CONCLUSION: This study showed that metabolic syndrome has a relatively high prevalence in Iranian elderly people (especially in women. Therefore, early diagnosis and management of the complication are recommended among this high-risk group. Keywords: Metabolic Syndrome, Elderly, Iran

Minimizing Air Pollution Exposure: A Practical Policy to Protect Vulnerable Older Adults from Death and Disability.

Science.gov (United States)

Woodward, Nick; Levine, Morgan

2016-02-01

Air pollution causes an estimated 200,000 deaths per year in the United States alone. Older adults are at greater risk of mortality caused by air pollution. Here we quantify the number of older adult facilities in Los Angeles County that are exposed to high levels of traffic derived air pollution, and propose policy solutions to reduce pollution exposure to this vulnerable subgroup. Distances between 20,362 intersections and 858 elder care facilities were estimated, and roads or highways within 500 of facilities were used to estimate traffic volume exposure. Of the 858 facilities, 54 were located near at least one major roadway, defined as a traffic volume over 100,000 cars/day. These 54 facilities house approximately 6,000 older adults. Following standards established for schools, we recommend legislation mandating the placement of new elder care facilities a minimum of 500 feet from major roadways in order to reduce unnecessary mortality risk from pollution exposure.

Study and Comparison of Different Aspects Healthy Lifestyle of the Elderly People Residing in Nursing Homes, Isfahan, Iran

Directory of Open Access Journals (Sweden)

Hossein Shahnazi

2016-01-01

Conclusion: Regarding the study results, it is suggested that health policymakers make appropriate plans to promote elderly lifestyle in nursing homes. With regard to seclusion and loneliness of old people, using strategies to alleviate stress and depression and also prevention of its physical and mental effects, seems to be absolutely needed. It can be a step toward promotion of health status of this vulnerable group.

THE METHOD FOR IDENTIFYING THE MOST VULNERABLE AREAS CAUSED BY EXOGENOUS PROCESSES UNDER ARIDIFICATION/HUMIDIFICATION (BASED ON GIS AND RS

Directory of Open Access Journals (Sweden)

D. A. Chupina

2017-01-01

Full Text Available The paper presents the method of identifying the most vulnerable territories under exogenous processes caused by aridification/humidification. It is based on the assumption that some forms and types of relief increase resistance of terrestrial ecosystems to external influences, while other kinds of relief make them vulnerable. The relationship between landscape and moistening (ground and climatic is of great importance to plains which have groundwater close to the surface. We have used morphometric analysis to divide the territory into hydromorphic and automorphic landscapes. Hydromorphic territories are those that are affected by additional surface moistening and groundwater, while automorphic landscapes are less dependent on groundwater under normal atmospheric moisture. The territory is ranked according to the degree of vulnerability by expert evaluation method. The developed approach is based entirely on using GIS software (ArcGIS 10.2.1 and processing the DEM SRTM. As a result, two models of vulnerability of natural terrestrial ecosystems to exogenic processes on Baraba Plain (Western Siberia have been created for both aridification and humidification cases. The opportunity to estimate the vulnerability is the novel feature for these models of terrestrial ecosystems, in both regional and local scales. The results obtained confirm the existing ideas about the discrete mosaic character of changes in spatial landscape patterns in the area under consideration. For the southern part of Western Siberia where farming is risky the assessment of the potential degree of vulnerability for ecosystems under conditions of increasing climate aridity and extremes is relevant.

The effect of loneliness on malnutrition in elderly population.

Science.gov (United States)

Ramic, Enisa; Pranjic, Nurka; Batic-Mujanovic, Olivera; Karic, Enisa; Alibasic, Esad; Alic, Alma

2011-01-01

The clinical and epidemiological data show that proper nutrition plays an important role in maintaining health and combating the danger of developing some chronic diseases in the elderly population. Nutrition is an important factor in many physiological and pathological changes that accompany the aging process. More than 50% of elderly patients are suffering from malnutrition which is information that concerns. Due to various factors, older people are potentially vulnerable groups at risk of malnutrition. Loneliness, isolation from society and neglect of parents by children is a big problem to many people in old age. To determine differences in nutritional status of elderly people living alone compared to those who live in family surroundings. The study was conducted in the municipality of Tuzla in 2009-2010, in outpatient family medicine Simin Han. The survey covered a total of 200 elderly subjects (age >65 years). Subject group consisted of 45% of people living alone, and 55% control group consisted of elderly patients who live in traditional family surroundings. Questionnaires used in this study are General geriatric assessment questionnaire and Mini nutritional status. The average age (+/- SD) was 75.4 +/- 6.2 years in subject group, while the same in the control group was 74.9 +/- 5.6 years. In subject group significantly more patients are on the verge of poverty. There are significant differences in the classification of financial status, according to the groups (p = 0.043). Members of subject groups have significantly lower BMI categories (p = 0.03) compared with the control group. In our study, people who live alone are at increased risk of malnutrition (p = 0030), have reduced the number of daily meals, significantly lower daily intake of protein, fruits and vegetables in the diet in relation to persons living in a family environment. Significantly more patients with loss of appetite live alone. According to the existence of self-reported food problems

Abnormal Gait Behavior Detection for Elderly Based on Enhanced Wigner-Ville Analysis and Cloud Incremental SVM Learning

Directory of Open Access Journals (Sweden)

Jian Luo

2016-01-01

Full Text Available A cloud based health care system is proposed in this paper for the elderly by providing abnormal gait behavior detection, classification, online diagnosis, and remote aid service. Intelligent mobile terminals with triaxial acceleration sensor embedded are used to capture the movement and ambulation information of elderly. The collected signals are first enhanced by a Kalman filter. And the magnitude of signal vector features is then extracted and decomposed into a linear combination of enhanced Gabor atoms. The Wigner-Ville analysis method is introduced and the problem is studied by joint time-frequency analysis. In order to solve the large-scale abnormal behavior data lacking problem in training process, a cloud based incremental SVM (CI-SVM learning method is proposed. The original abnormal behavior data are first used to get the initial SVM classifier. And the larger abnormal behavior data of elderly collected by mobile devices are then gathered in cloud platform to conduct incremental training and get the new SVM classifier. By the CI-SVM learning method, the knowledge of SVM classifier could be accumulated due to the dynamic incremental learning. Experimental results demonstrate that the proposed method is feasible and can be applied to aged care, emergency aid, and related fields.

GIS based Hydrogeological Vulnerability Mapping of Groundwater Resources in Jerash Area-Jordan

Energy Technology Data Exchange (ETDEWEB)

Hammouri, N [Department of Earth and Environmental Sciences, Faculty of Natural Resources and Environment, Hashemite University, Zarqa (Jordan); El-Naqa, A [Department of Water Management and Environment, Faculty of Natural Resources and Environment, Hashemite University, Zarqa (Jordan)

2008-04-15

This paper presents groundwater vulnerability mapping for Jerash area, north Jordan generated using EPIK and DRASTIC models. These models have been implemented using GIS to delineate groundwater protection zones and to suggest a protection plan to improve groundwater quality of the major springs and wells. Most of the groundwater resources in the study area are polluted and bacteria and nitrate levels are high. Different sources of groundwater pollution have been identified. Domestic wastewater is considered as a major source of pollution. Urban runoff, fertilizers from agricultural return flows and solid waste disposal appear to be secondary sources. The most relevant vulnerability class of EPIK map is very high which accounts for about 41 % of the total area. While in the DRASTIC vulnerability map, areas with high vulnerability were only about 23 % of the total area. There is a good correlation between vulnerability maps obtained from both models with microbiological and chemical pollution evidences. There is also a good agreement between the areas classified as highly vulnerable and those that have high levels of pollution. [Spanish] El estudio de vulnerabilidad de aguas subterraneas en la region de Yerash, Jordania fue obtenido mediante las metodologias de EPIK y DRASTIC. Se uso GIS para mapear las zonas protegidas y para sugerir un plan de proteccion para mejorar la calidad del agua subterranea en los principales manantiales y pozos. Los niveles de contaminacion bacteriana y de nitratos son elevados. El efluente domestico es la fuente mas importante de contaminacion; vienen en segundo lugar la precipitacion en zonas urbanas, los fertilizantes agricolas y los desechos solidos. En el mapa de EPIK, la vulnerabilidad extrema abarca hasta 41% del area total; en cambio, en el mapa de DRASTIC las areas de alta vulnerabilidad ocupan solo un 23% del area. La correlacion de los datos de contaminacion microbiana y quimica con ambos mapas der vulnerabilidad es buena

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder

Directory of Open Access Journals (Sweden)

Maryam Delphi

2017-09-01

Full Text Available Background: Previous studies have shown that interaural-time-difference (ITD training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV. We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. Methods: The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months’ follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. Results: Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001. The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months’ follow-up (P=0.212. Conclusion: The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder.

Spatial variation of vulnerability in geographic areas of North Lebanon

NARCIS (Netherlands)

Issa, Sahar; van der Molen, I.; Nader, M.R.; Lovett, Jonathan Cranidge

2014-01-01

This paper examines the spatial variation in vulnerability between different geographical areas of the northern coastal region of Lebanon within the context of armed conflict. The study is based on the ‘vulnerability of space’ approach and will be positioned in the academic debate on vulnerability

Elderly road collision injury outcomes associated with seat positions and seatbelt use in a rapidly aging society-A case study in South Korea.

Directory of Open Access Journals (Sweden)

Yuna Noh

Full Text Available Aging has long been regarded as one of the most critical factors affecting crash injury outcomes. In South Korea, where the elderly population is projected to reach 35.9% by 2050, the implications of an increasing number of elderly vehicle users on road safety are evident. In this research, the confounding effect of occupant age in a vehicle in terms of seat position and seatbelt use was investigated. In addition, elderly occupants were divided into a younger-old group aged between 65 and 74 years and an older-old group aged 75 years and older in an effort to assess whether the conventional elderly age standard of 65 years should be reconsidered.A multinomial logit framework was adopted to predict two-level injury severity using collision data between 2008 and 2015. Predictor variables included gender, age group, seat position, seatbelt, road type, road slope, road surface, road line, and type of vehicle. Five models, a base model with no interactions and four interaction models which were combinations of age group, seatbelt use and seat position, were devised and evaluated.With no interacting term, age was the most prominent predictor. Elderly occupants were most likely to suffer from severe injury without a seatbelt in all seat positions, and the use of a seatbelt reduced this likelihood the most in the elderly group as well. Front passenger seats had the highest risk to elderly occupants, while the driver seat was statistically insignificant. When the elderly group was divided into the younger-old group and the older-old group, the older-olds were found to be much more vulnerable compared to the younger-olds. In particular, older drivers were five times more likely to suffer a severe injury without a seatbelt.The degree of injury severity of elderly occupants was reduced the most with the use of a seatbelt, demonstrating the importance of using seat restraints. The sharp increase in the risk of injury of the older-old group suggests that the

Elderly road collision injury outcomes associated with seat positions and seatbelt use in a rapidly aging society-A case study in South Korea.

Science.gov (United States)

Noh, Yuna; Yoon, Yoonjin

2017-01-01

Aging has long been regarded as one of the most critical factors affecting crash injury outcomes. In South Korea, where the elderly population is projected to reach 35.9% by 2050, the implications of an increasing number of elderly vehicle users on road safety are evident. In this research, the confounding effect of occupant age in a vehicle in terms of seat position and seatbelt use was investigated. In addition, elderly occupants were divided into a younger-old group aged between 65 and 74 years and an older-old group aged 75 years and older in an effort to assess whether the conventional elderly age standard of 65 years should be reconsidered. A multinomial logit framework was adopted to predict two-level injury severity using collision data between 2008 and 2015. Predictor variables included gender, age group, seat position, seatbelt, road type, road slope, road surface, road line, and type of vehicle. Five models, a base model with no interactions and four interaction models which were combinations of age group, seatbelt use and seat position, were devised and evaluated. With no interacting term, age was the most prominent predictor. Elderly occupants were most likely to suffer from severe injury without a seatbelt in all seat positions, and the use of a seatbelt reduced this likelihood the most in the elderly group as well. Front passenger seats had the highest risk to elderly occupants, while the driver seat was statistically insignificant. When the elderly group was divided into the younger-old group and the older-old group, the older-olds were found to be much more vulnerable compared to the younger-olds. In particular, older drivers were five times more likely to suffer a severe injury without a seatbelt. The degree of injury severity of elderly occupants was reduced the most with the use of a seatbelt, demonstrating the importance of using seat restraints. The sharp increase in the risk of injury of the older-old group suggests that the age standard of

The Effect of Care Plan Application Based on Roy’s Adaptation Model on The Spiritual Well-Being of Elderly People in Urmia Nursing Homes

Directory of Open Access Journals (Sweden)

Esmaiel Maghsoodi

2016-11-01

Full Text Available Wth the growing elderly population and the incidence of complications and problems associated with this period, the need to make a positive adaptation during this important period of life, is considerable. In this regard, this is possible to use the nursing theory and particular, Roy's adaptation model to creation work positive with make the incompatible and unhealthy behaviors to compatible and healthy behaviors and also improve their SWB as one if the overall health. The present study was determine the effects of the health careplan based on Roy's adaptation model on the Spiritual Well-Being of elderly people In Urmia nursing homes, have been done. In this study, 60persons of elderly, which had conditions related to this study, had been selected and randomly divided into control group (30 persons and intervention group (30 persons, were selected. Tools for Collecting data was SWB questionnaire, which was completed in post and pre – test. The care plan was designed according to conclusions from investigation and knowing Roy's adaptation model and applicated in intervention group, in 2 sessions teaching for elderly and 4 individual sessions , in order to manipulate focal stimulants in during 1.5 month and a month later was followed. The analysis of data were done by SPSS software and by using the descriptive and inferential statistics. The results indicate that overall mean scores below the scale dual SWB and average of SWB, after a study of 2 groups is statistically significant (P< 0.001.Also the average of scores in elderly SWB in the intervention group after care plan, was increased which, according to T-test, this increase is significant(P< 0.001. Caring plan which based on self concept mode of Roy's adaptation model,have positive influence in promoting the SWB of the elderly. Therefor, it's suggested, health caring providers and nurses by strengthen the adaptation in the elderly based on the theories of nursing and caring plan, increase

VULNERABILITY OF COMPANIES

Directory of Open Access Journals (Sweden)

ARMEAN ANDREEA

2013-06-01

Full Text Available In present, the study of vulnerability of companies is increasing in every field due to the unstable economic environment influences. The object of this research is to define and identify vulnerabilities of companies and the establishment of evaluation methods at their level. This article emphasizes the importance and usefulness of one of the best known model in this way, from our point of view, namely Băileşteanu, Negrila Pattern. This pattern covers both external factors and internal ones, that increase vulnerabilities of companies, and fit the companies in which the state of vulnerability are (vitality, viability, vulnerability, high vulnerability, difficulty and high difficulty, with a matrix. The result of the research is that any company belonging to any field, can be analyzed using this model, and assigned to one of the conditions defined within.

Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies.

Science.gov (United States)

Pillemer, Karl; Burnes, David; Riffin, Catherine; Lachs, Mark S

2016-04-01

Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention. This article provides a scoping review of key issues in the field from an international perspective. By drawing primarily on population-based studies, this scoping review provided a more valid and reliable synthesis of current knowledge about prevalence and risk factors than has been available. Despite the lack of scientifically rigorous intervention research on elder abuse, the review also identified 5 promising strategies for prevention. The findings highlight a growing consensus across studies regarding the extent and causes of elder mistreatment, as well as the urgent need for efforts to make elder mistreatment prevention programs more effective and evidence based. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mini-Mental State Examination in Elderly Chinese: A Population-Based Normative Study.

Science.gov (United States)

Li, Hanzhi; Jia, Jianping; Yang, Zhiqiang

2016-05-07

Chinese nationwide norms of the Mini-Mental State Examination (MMSE) have not been established despite its wide use. To obtain norms for the MMSE based on age, gender, education, and rural or urban residences and to determine the optimal cut-off points of the MMSE in elderly Chinese. A cross-sectional study was conducted in Chinese community residents aged 65 years or over selected by cluster random sampling. The MMSE was administered to 9,629 subjects (7,110 cognitively normal, 2,024 with mild cognitive impairment, and 495 with dementia). The demographic influences on MMSE scores were investigated and the norms were established considering those factors. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off points. Years of education (standardized β= 0.399), rural residence (standardized β= -0.261), age (standardized β= -0.198), and being female (standardized β= -0.101) had significant effects on MMSE scores (p < 0.001). Accordingly, we presented the demographic-stratified normative data for the MMSE. The optimal cut-off points for dementia screening were 16/17 for illiterate (sensitivity 87.6% and specificity 80.8%), 19/20 for individuals with 1-6 years of education (sensitivity 93.6% and specificity 92.7%), and 23/24 for individuals with 7 or more years of education (sensitivity 94.3% and specificity 94.3%). We provide the age-, gender-, education-, and residence-specific reference norms for the MMSE derived from an investigation of a large-scale, multicenter, nationwide representative Chinese elderly population. It could be of great improvement for the use of the MMSE in dementia screening in Chinese elderly population.

Earlier and greater hand pre-shaping in the elderly: a study based on kinematic analysis of reaching movements to grasp objects.

Science.gov (United States)

Tamaru, Yoshiki; Naito, Yasuo; Nishikawa, Takashi

2017-11-01

Elderly people are less able to manipulate objects skilfully than young adults. Although previous studies have examined age-related deterioration of hand movements with a focus on the phase after grasping objects, the changes in the reaching phase have not been studied thus far. We aimed to examine whether changes in hand shape patterns during the reaching phase of grasping movements differ between young adults and the elderly. Ten healthy elderly adults and 10 healthy young adults were examined using the Simple Test for Evaluating Hand Functions and kinetic analysis of hand pre-shaping reach-to-grasp tasks. The results were then compared between the two groups. For kinetic analysis, we measured the time of peak tangential velocity of the wrist and the inter-fingertip distance (the distance between the tips of the thumb and index finger) at different time points. The results showed that the elderly group's performance on the Simple Test for Evaluating Hand Functions was significantly lower than that of the young adult group, irrespective of whether the dominant or non-dominant hand was used, indicating deterioration of hand movement in the elderly. The peak tangential velocity of the wrist in either hand appeared significantly earlier in the elderly group than in the young adult group. The elderly group also showed larger inter-fingertip distances with arch-like fingertip trajectories compared to the young adult group for all object sizes. To perform accurate prehension, elderly people have an earlier peak tangential velocity point than young adults. This allows for a longer adjustment time for reaching and grasping movements and for reducing errors in object prehension by opening the hand and fingers wider. Elderly individuals gradually modify their strategy based on previous successes and failures during daily living to compensate for their decline in dexterity and operational capabilities. © 2017 Japanese Psychogeriatric Society.

The SAVI Vulnerability Analysis Software Package

International Nuclear Information System (INIS)

Mc Aniff, R.J.; Paulus, W.K.; Key, B.; Simpkins, B.

1987-01-01

SAVI (Systematic Analysis of Vulnerability to Intrusion) is a new PC-based software package for modeling Physical Protection Systems (PPS). SAVI utilizes a path analysis approach based on the Adversary Sequence Diagram (ASD) methodology. A highly interactive interface allows the user to accurately model complex facilities, maintain a library of these models on disk, and calculate the most vulnerable paths through any facility. Recommendations are provided to help the user choose facility upgrades which should reduce identified path vulnerabilities. Pop-up windows throughout SAVI are used for the input and display of information. A menu at the top of the screen presents all options to the user. These options are further explained on a message line directly below the menu. A diagram on the screen graphically represents the current protection system model. All input is checked for errors, and data are presented in a logical and clear manner. Print utilities provide the user with hard copies of all information and calculated results

The complexities of elder abuse.

Science.gov (United States)

Roberto, Karen A

2016-01-01

Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Assessment of agricultural drought vulnerability in the Philippines using remote sensing and GIS-based techniques

International Nuclear Information System (INIS)

Macapagal, Marco D.; Olivares, Resi O.; Perez, Gay Jane P.

2015-01-01

Drought is a recurrent extreme climate event that can cause crop damage and yield loss, thereby inflicting negative socioeconomic impacts all over the world. According to several climate studies, drought events may be more frequent and more severe as global warming progresses. As an agricultural country, the Philippines is highly susceptible to adverse impacts of drought using remotely sensed information and geographic processing techniques. An agricultural drought vulnerability map identifying croplands that are least vulnerable, moderately vulnerable, and most vulnerable to crop water-related stress, was developed. Vulnerability factors, including land use system, irrigation support. Available soil-water holding capacity, as well as satellite-derived evapotranspiration and rainfall, were taken into consideration in classifying and mapping agricultural drought vulnerability at a national level. (author)

Increasing Android Security using a Lightweight OVAL-based Vulnerability Assessment Framework

OpenAIRE

Barrère , Martín; Hurel , Gaëtan; Badonnel , Rémi; Festor , Olivier

2012-01-01

International audience; Mobile computing devices and the services offered by them are utilized by millions of users on a daily basis. However, they operate in hostile environments getting exposed to a wide variety of threats. Accordingly, vulnerability management mechanisms are highly required. We present in this paper a novel approach for increasing the security of mobile devices by efficiently detecting vulnerable configurations. In that context, we propose a modeling for performing vulnera...

No evidence for an open vessel effect in centrifuge-based vulnerability curves of a long-vesselled liana (Vitis vinifera).

Science.gov (United States)

Jacobsen, Anna L; Pratt, R Brandon

2012-06-01

Vulnerability to cavitation curves are used to estimate xylem cavitation resistance and can be constructed using multiple techniques. It was recently suggested that a technique that relies on centrifugal force to generate negative xylem pressures may be susceptible to an open vessel artifact in long-vesselled species. Here, we used custom centrifuge rotors to measure different sample lengths of 1-yr-old stems of grapevine to examine the influence of open vessels on vulnerability curves, thus testing the hypothesized open vessel artifact. These curves were compared with a dehydration-based vulnerability curve. Although samples differed significantly in the number of open vessels, there was no difference in the vulnerability to cavitation measured on 0.14- and 0.271-m-long samples of Vitis vinifera. Dehydration and centrifuge-based curves showed a similar pattern of declining xylem-specific hydraulic conductivity (K(s)) with declining water potential. The percentage loss in hydraulic conductivity (PLC) differed between dehydration and centrifuge curves and it was determined that grapevine is susceptible to errors in estimating maximum K(s) during dehydration because of the development of vessel blockages. Our results from a long-vesselled liana do not support the open vessel artifact hypothesis. © 2012 The Authors. New Phytologist © 2012 New Phytologist Trust.

Value-based design for the elderly: An application in the field of mobility aids.

Science.gov (United States)

Boerema, Simone T; van Velsen, Lex; Vollenbroek-Hutten, Miriam M R; Hermens, Hermie J

2017-01-01

In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility aids that address real needs and thus, lead to high acceptance. We elicited values, facilitators, and barriers of mobility of older adults via ten in-depth interviews. Next, we held co-creation sessions, resulting in several designs of innovative mobility aids, which were evaluated for acceptance via nine in-depth interviews. The interviews resulted in a myriad of key values, such as "independence from family" and "doing their own groceries." Design sessions resulted in three designs for a wheeled walker. Their acceptance was rather low. Current mobility device users were more eager to accept the designs than non-users. The value-based approach offers designers a close look into the lives of the elderly, thereby opening up a wide range of innovation possibilities that better fit their actual needs. Product service systems seem to be a promising focus for targeting human needs in mobility device design.

Spatial-temporal eco-environmental vulnerability assessment and its influential factors based on Landsat data

Science.gov (United States)

Anh, N. K.; Liou, Y. A.; Ming-Hsu, L.

2016-12-01

Regional land use/land cover (LULC) changes lead to various changes in ecological processes and, in turn, alter regional micro-climate. To understand eco-environmental responses to LULC changes, eco-environmental evaluation is thus required with aims to identify vulnerable regions and influential factors, so that practical measures for environmental protection and management may be proposed. The Thua Thien - Hue Province has been experiencing urbanization at a rapid rate in both population and physical size. The urban land, agricultural land, and aquaculture activities have been invasively into natural space and caused eco-environment deterioration by land desertification, soil erosion, shrinking forest resources,…etc. In this study, an assessment framework that is composed by 11 variables with 9 of them constructed from Landsat time series is proposed to serve as basis to examine eco-environmental vulnerability in the Thua Thien - Hue Province in years 1989, 2003, and 2014. An eco-environmental vulnerability map is assorted into six vulnerability levels consisting of potential, slight, light, medium, heavy, and very heavy vulnerabilities. Result shows that there is an increasing trend in eco-environmental vulnerability in general with expected evolving distributions in heavy and very heavy vulnerability levels, which mainly lying on developed land, bare land, semi bare land, agricultural land, and poor and recovery forests. In contrast, there is a significant decline in potential vulnerability level. The contributing factors of an upward trend in medium, heavy, and very heavy levels include: (i) a large natural forest converted to plantation forest and agriculture land; and (ii) significant expansion of developed land leading to difference in thermal signatures in urban areas as compared with those of the surrounding areas. It is concluded that anthropogenic processes with transformation on LULC has amplified the vulnerability of eco-environment in the study

Profile of Hospitalized Elderly Patients Treated for Falling

Directory of Open Access Journals (Sweden)

Yu-Ling Hsiao

2012-03-01

Conclusion: This study utilized actual nationwide data to provide a profile of elderly patients treated for falling in Taiwan. Based on the results of this study, fall prevention should especially target the female elderly, and should be given more emphasis during the winter season, in terms of clinical and policy applications.

Inside the Black Box: The Case Review Process of an Elder Abuse Forensic Center.

Science.gov (United States)

Navarro, Adria E; Wysong, Julia; DeLiema, Marguerite; Schwartz, Elizabeth L; Nichol, Michael B; Wilber, Kathleen H

2016-08-01

Preliminary evidence suggests that elder abuse forensic centers improve victim welfare by increasing necessary prosecutions and conservatorships and reducing the recurrence of protective service referrals. Center team members gather information and make decisions designed to protect clients and their assets, yet the collective process of how these case reviews are conducted remains unexamined. The purpose of this study is to present a model describing the interprofessional approach of investigation and response to financial exploitation (FE), a frequent and complex type of abuse of vulnerable adults. To develop an understanding of the case review process at the Los Angeles County Elder Abuse Forensic Center (Center), a quasi-Delphi field study approach was used involving direct observations of meetings, surveying team members, and review from the Center's Advisory Council. The goal of this iterative analysis was to understand the case review process for suspected FE in Los Angeles County. A process map of key forensic center elements was developed that may be useful for replication in other settings. The process map includes: (a) multidisciplinary data collection, (b) key decisions for consideration, and (c) strategic actions utilized by an interprofessional team focused on elder justice. Elder justice relies on a complex system of providers. Elder abuse forensic centers provide a process designed to efficiently address client safety, client welfare, and protection of assets. Study findings provide a process map that may help other communities replicate an established multidisciplinary team, one experienced with justice system outcomes designed to protect FE victims. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Coastal vulnerability: climate change and natural hazards perspectives

Science.gov (United States)

Romieu, E.; Vinchon, C.

2009-04-01

Introduction Studying coastal zones as a territorial concept (Integrated coastal zone management) is an essential issue for managers, as they have to consider many different topics (natural hazards, resources management, tourism, climate change…). The recent approach in terms of "coastal vulnerability" studies (since the 90's) is the main tool used nowadays to help them in evaluating impacts of natural hazards on coastal zones, specially considering climate change. This present communication aims to highlight the difficulties in integrating this concept in risk analysis as it is usually practiced in natural hazards sciences. 1) Coastal vulnerability as a recent issue The concept of coastal vulnerability mainly appears in the International panel on climate change works of 1992 (IPCC. 2001), where it is presented as essential for climate change adaptation. The concept has been defined by a common methodology which proposes the assessment of seven indicators, in regards to a sea level rise of 1m in 2100: people affected, people at risk, capital value at loss, land at loss, wetland at loss, potential adaptation costs, people at risk assuming this adaptation. Many national assessments have been implemented (Nicholls, et al. 1995) and a global assessment was proposed for three indicators (Nicholls, et al. 1999). The DINAS-Coast project reuses this methodology to produce the DIVA-tool for coastal managers (Vafeidis, et al. 2004). Besides, many other methodologies for national or regional coastal vulnerability assessments have been developed (review by (UNFCCC. 2008). The use of aggregated vulnerability indicators (including geomorphology, hydrodynamics, climate change…) is widespread: the USGS coastal vulnerability index is used worldwide and was completed by a social vulnerability index (Boruff, et al. 2005). Those index-based methods propose a vulnerability mapping which visualise indicators of erosion, submersion and/or socio economic sensibility in coastal zones

Áreas vulnerables en el centro de Madrid

Directory of Open Access Journals (Sweden)

Agustín Hernández Aja

2007-07-01

This document shows an vulnerability analysis of the central area of Madrid taken it as the field of APE-00.01. Its objective is to delimit “vulnerable areas” so there can be evaluated the opportunities for interve trough them and then define the best tools in detriment of their vulnerability reasons. To determinate those areas we have developed a sociodemographic analysis where we have found those units of population with vulnerable values. Once determinated, we have synthetize them to define them as easy drafts that makes understandable the work area for later on establish a vulnerable areas catalogue with spatial homogeneity and significant size. The basic nucleus of the análisis has been the sociodemographic fact, based on homogeneus data sources for all the area so they could be referenced to specific spacial areas. In each case has been advised other possible indicators of vulnerability including a signifier selection of thrm on the fifth chapter.

Statistics of software vulnerability detection in certification testing

Science.gov (United States)

Barabanov, A. V.; Markov, A. S.; Tsirlov, V. L.

2018-05-01

The paper discusses practical aspects of introduction of the methods to detect software vulnerability in the day-to-day activities of the accredited testing laboratory. It presents the approval results of the vulnerability detection methods as part of the study of the open source software and the software that is a test object of the certification tests under information security requirements, including software for communication networks. Results of the study showing the allocation of identified vulnerabilities by types of attacks, country of origin, programming languages used in the development, methods for detecting vulnerability, etc. are given. The experience of foreign information security certification systems related to the detection of certified software vulnerabilities is analyzed. The main conclusion based on the study is the need to implement practices for developing secure software in the development life cycle processes. The conclusions and recommendations for the testing laboratories on the implementation of the vulnerability analysis methods are laid down.

Determining shallow aquifer vulnerability by the DRASTIC model ...

Indian Academy of Sciences (India)

Shallow aquifer vulnerability has been assessed using GIS-based DRASTIC model by incorporating the major geological and hydrogeological factors that affect and control the groundwater contamination in a granitic terrain. It provides a relative indication of aquifer vulnerability to the contamination. Further, it has been ...

Elderly homicide in Chicago: a research note.

Science.gov (United States)

Fazel, Seena; Bond, Mieko; Gulati, Gautam; O'Donnell, Ian

2007-01-01

There is a body of knowledge about elderly crime victims, but we know little about the characteristics of elderly perpetrators, especially of homicide. The few studies that have been published are based on small samples and are somewhat dated. In an examination of homicides committed in Chicago over a 31-year period, we compared cases involving perpetrators aged over 60 years (n = 443) with those involving younger perpetrators (n = 24,066). There were a number of significant differences. Elderly killers were more likely to be White and to commit suicide afterwards. Their victims were more likely to be spouses, females, and aged over 60 years. Inter-racial homicide was more common for younger offenders. The low number of homicides involving the elderly is explained by reference to routine activity theory. Copyright 2007 John Wiley & Sons, Ltd.

Assessment of water intake from food and beverages by elderly in Poland

Science.gov (United States)

Drywień, Małgorzata E; Galon, Katarzyna

Fluid intake in elderly is more important than in younger individuals, because compromised homeostatic mechanisms such as loss of the thirst sensation can result in dehydration. The aim of the present study was the assessment of water intake from food and beverages by free-living elderly in Poland. The study was conducted on 138 volunteers (women and men) at the age of 60 to 90, recruited from Warsaw and Płock Universities of the Third Age and different informal groups from the same cities. Food and beverages consumption data were collected using the method of records for 3 days, including two weekdays and one week-end day, in the period April – June 2012. Average values of total water intake in the present study indicated that women meets of the European Food Safety Agency recommendations (2000 mL/day), but men did not (less about 200 mL/day than the recommended 2500 mL/day). Taking into account the criterion of water per energy intake (mL/kcal) 51% of women and 75% of men did not meet the recommendation. Continuation of the careers and/or participation in Universities of the Third Age contributed to less intake of water from beverages, what in turn affected the total water intake. The elderly leading an active life (working, studying) may be a risk group vulnerable to dehydration, so monitoring is needed.

The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

Science.gov (United States)

Carlson, Elisabeth; Bengtsson, Mariette

2014-04-01

The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. © 2013.

Quantitative assessment of key parameters in qualitative vulnerability methods applied in karst systems based on an integrated numerical modelling approach

Science.gov (United States)

Doummar, Joanna; Kassem, Assaad

2017-04-01

In the framework of a three-year PEER (USAID/NSF) funded project, flow in a Karst system in Lebanon (Assal) dominated by snow and semi arid conditions was simulated and successfully calibrated using an integrated numerical model (MIKE-She 2016) based on high resolution input data and detailed catchment characterization. Point source infiltration and fast flow pathways were simulated by a bypass function and a high conductive lens respectively. The approach consisted of identifying all the factors used in qualitative vulnerability methods (COP, EPIK, PI, DRASTIC, GOD) applied in karst systems and to assess their influence on recharge signals in the different hydrological karst compartments (Atmosphere, Unsaturated zone and Saturated zone) based on the integrated numerical model. These parameters are usually attributed different weights according to their estimated impact on Groundwater vulnerability. The aim of this work is to quantify the importance of each of these parameters and outline parameters that are not accounted for in standard methods, but that might play a role in the vulnerability of a system. The spatial distribution of the detailed evapotranspiration, infiltration, and recharge signals from atmosphere to unsaturated zone to saturated zone was compared and contrasted among different surface settings and under varying flow conditions (e.g., in varying slopes, land cover, precipitation intensity, and soil properties as well point source infiltration). Furthermore a sensitivity analysis of individual or coupled major parameters allows quantifying their impact on recharge and indirectly on vulnerability. The preliminary analysis yields a new methodology that accounts for most of the factors influencing vulnerability while refining the weights attributed to each one of them, based on a quantitative approach.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: cross-national study

Science.gov (United States)

Shah, Ajit

2010-01-01

Abstract: Background: A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. Methods: A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. Results: The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). Conclusions: The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. PMID:21483194

Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

Science.gov (United States)

Evandrou, Maria; Falkingham, Jane C; Qin, Min; Vlachantoni, Athina

2017-10-22

This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources. The study uses a cross-sectional survey design. The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011. Secondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately. The overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (pwealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households. Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas.

Science.gov (United States)

Gao, Langli; Jiang, Jiaojiao; Yang, Ming; Hao, Qiukui; Luo, Li; Dong, Birong

2015-11-01

To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia. A cross-sectional study. Urban and rural communities in western China. A total of 887 community-dwelling elderly adults aged 60 years or older. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively. A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia. Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The gut mycobiome of elderly danes

DEFF Research Database (Denmark)

Bin Ahmad, Hajar Fauzan; Castro Mejia, Josue Leonardo; Kot, Witold

mycobiome on health and disease in elderly remain sparsely investigated. Consequently, the aim of this study was to characterise the feacal mycobiota in relation to host health parameters.Feacal samples from 99 healthy individuals ranging from 65 to 81 years old were collected, and fungal composition...... categories associated with the clinical features among individuals.The elderly gut is home to three main phyla Ascomycota, Basidiomycota and Zygomycota, with genera Penicillium, Candida, and Aspergillus being particularly common. Based on HbA1c-levels, the individuals could be clustered into 3 groups, High...... glucose level.Collectively, these findings suggest that the presences of specific gut mycobiome member is associated with glycemic behaviours among the healthy individuals of the elderly Danes population....

The Study of Physical Activity AmongElderly of Karaj City and its Relationship with Some the Demographic Factors

Directory of Open Access Journals (Sweden)

M. Asadi Shavaki

2016-11-01

Full Text Available Backgrounds and Objective:Physical activity is one of the important and effective factors associated with the human health. The elderly are among the most vulnerable groups in many diseases and disorders that exercise can prevent of many of these diseases. The aims of this study is to determine the level of physical activity among elderly of Karaj city and its relationship with some the demographic factors. Materials and Method: This cross-sectional study was conducted in the first half of 2014 and in health centers of Karaj city, Iran. The study population were people older than 60 years (n=286 who referred to these centers. A short physical activity questionnaire (IPAQ was used to collect data. Data were analyzed by SPSS and the descriptive and analytical tests.  Results: The age mean of elderly was 67/37 ± 6/5 years. The majority of them (52/4% were woman & (54/2 % were in families with 4-6 members. About physical activity level in participant finding show that 50/5% were in low level, 43/1% intermediate and 6/4% were in high level. A significant relationship was between gender & job in elderly with level of physical activity (P<0/05.  Conclusion: According to the results it seems that for encourage and remove the barriers of doing physical activity in elderly, basic plans must be done at the macro level of management. So it is suggested that more researches and interventions about barriers of doing physical activity be done in elderly of Karaj city.  

Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study.

Science.gov (United States)

Vilppula, Anitta; Kaukinen, Katri; Luostarinen, Liisa; Krekelä, Ilkka; Patrikainen, Heikki; Valve, Raisa; Mäki, Markku; Collin, Pekka

2009-06-29

Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002-2005 was 0.23%, giving an annual incidence of 0.08% in this population. The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

Science.gov (United States)

Dong, XinQi; Simon, Melissa A.

2013-01-01

Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

Vulnerability Assessment of Mangrove Habitat to the Variables of the Oceanography Using CVI Method (Coastal Vulnerability Index) in Trimulyo Mangrove Area, Genuk District, Semarang

Science.gov (United States)

Ahmad, Rifandi Raditya; Fuad, Muhammad

2018-02-01

Some functions of mangrove areas in coastal ecosystems as a green belt, because mangrove serves as a protector of the beach from the sea waves, as a good habitat for coastal biota and for nutrition supply. Decreased condition or degradation of mangrove habitat caused by several oceanographic factors. Mangrove habitats have some specific characteristics such as salinity, tides, and muddy substrates. Considering the role of mangrove area is very important, it is necessary to study about the potential of mangrove habitat so that the habitat level of mangrove habitat in the east coast of Semarang city is known. The purpose of this research is to obtain an index and condition of habitat of mangrove habitat at location of research based on tidal, salinity, substrate type, coastline change. Observation by using purposive method and calculation of habitat index value of mangrove habitat using CVI (Coastal Vulnerability Index) method with scores divided into 3 groups namely low, medium and high. The results showed that there is a zone of research belonging to the medium vulnerability category with the most influential variables is because there is abrasion that sweeps the mangrove substrate. Trimulyo mangrove habitat has high vulnerable variable of tidal frequency, then based on value variable Salinity is categorized as low vulnerability, whereas for mangrove habitat vulnerability based on variable type of substrate belong to low and medium vulnerability category. The CVI values of mangrove habitats divided into zones 1; 2; and 3 were found to varying values of 1.54; 3.79; 1.09, it indicates that there is a zone with the vulnerability of mangrove habitat at the study site belonging to low and medium vulnerability category.