Search results for: elderly living alone

Authors: Ling Chen, Lanyan Peng

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In the new round of institutional reform of the State Council, Ministry of Culture and Ministry of Tourism were formed into a new department, Ministry of Culture and Tourism, which embodied the idea of the fusion development of cultural and tourism industries. At the same time, domestic tourists pay more attention to the tourism experience and tourism quality. The tourism patterns have been changed from the sightseeing mode of the individual scenic spot to the lifestyle mode of feeling the cultural atmosphere of the tourist destination. Therefore, this paper focuses on the tourism pattern based on lifestyle, studies the development status, content, and implementation measures of the tourism pattern. As the tourism pattern based on lifestyle integrating cultural and tourism industries in-depth, tourists can experience the living atmosphere, living conditions and living quality of the tourist destination, and deeply understand the urban cultural connotation during the trip. Suzhou has taken a series of measures to build up a tourism pattern based on lifestyle-'Suzhou life' tourism, including regional planning of tourism, integration of cultural resources, construction of urban atmosphere, and upgrading infrastructure. 'Suzhou life' tourism is based on the Suzhou food (cooked wheaten food, dim sum, specialty snacks), tourist attractions (Suzhou gardens, the ancient city) and characteristic recreational ways (appreciating Kun opera, enjoying Suzhou Pingtan, tea drinking). And the continuous integration of the three components above meet the spiritual, cultural needs of tourists and upgrade the tourism pattern based on lifestyle. Finally, the paper puts forward the tourism pattern planning suggestions.

Keywords: tourism pattern, lifestyle, integration of cultural and tourism industries, Suzhou life

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Authors: Christos E. Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Tamta Sirbilatze, Ifigenia Apostolou, Christina Kordali, Konstantina Panouria, Kostas Argyros, Georgios Mavras

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Malnutrition in hospitalized patients is related to increased morbidity and mortality. Purpose of our study was to assess nutritional status of hospitalized, elderly patients with various nutritional scores and to detect unfavorable prognostic factors, related to increased mortality and extended duration of admission. Methods: 150 patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). The following data were incorporated in analysis: Anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits and mediterranean diet (assessed by MedDiet score), cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were the mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Mann-Whitney two-sample statistics or t-test was used for group comparisons and Spearman or Pearson coefficients for testing correlation between variables. Results: Normal nutrition was assessed in 54/150 (36%), 92/150 (61.3%) and in 106/150 (70.7%) of patients, according to full MNA, MUST and sNAQ questionnaires respectively. Mortality rate was 20.7% (31/150 patients). The patients who died until 6 months after admission had lower BMI (24±4.4 vs 26±4.8, p=0.04) and albumin levels (2.9±0.7 vs 3.4±0.7, p=0.002), significantly lower full MNA (14.5±7.3 vs 20.7±6, p<0.0001) and short-form MNA scores (7.3±4.2 vs 10.5±3.4, p=0.0002) compared to non-dead one. In contrast, the aforementioned patients had higher MUST (2.5±1.8 vs 0.5±1.02, p=<0.0001) and sNAQ scores (2.9±2.4 vs 1.1±1.3, p<0.0001). Additionally, they showed significantly lower MedDiet (23.5±4.3 vs 31.1±5.6, p<0.0001) and IPAQ scores (37.2±156.2 vs 516.5±1241.7, p<0.0001) compared to remaining one. These patients had extended hospitalization [5 (0-13) days vs 0 (-1-3) days, p=0.001]. Patients who admitted due to cancer depicted higher mortality rate (10/13, 77%), compared to those who admitted due to infections (12/73, 18%), stroke (4/15, 27%) or other causes (4/49, 8%) (p<0.0001). Extension of hospitalization was negatively correlated to both full (Spearman r=-0.35, p<0.0001) and short-form MNA (Spearman r=-0.33, p<0.0001) and positively correlated to MUST (Spearman r=0.34, p<0.0001) and sNAQ (Spearman r=0.3, p=0.0002). Additionally, the extension was inversely related to MedDiet score (Spearman r=-0.35, p<0.0001), IPAQ score (Spearman r=-0.34, p<0.0001), albumin levels (Pearson r=-0.36, p<0.0001), Ht (Pearson r=-0.2, p=0.02) and Hb (Pearson r=-0.18, p=0.02). Conclusion: A great proportion of elderly, hospitalized patients are malnourished or at risk of malnutrition. All nutritional scores, physical activity and albumin are significantly related to mortality and increased hospitalization.

Keywords: dietary habits, duration of admission, malnutrition, prognostic factors for mortality

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Medina Adulyarat

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Like many other countries, Thailand is experiencing an increase in its proportion of older adults. However, the political, social, and religious climates of the various regions of Thailand are very diverse and the life experiences of older Thai citizens can vary greatly by region. For more than a decade, the southernmost provinces, namely Yala, Pattani and Narathiwat, have experienced social and political unrest, often characterized by violence in the form of bombings and shootings, which has impacted the older adults residing in these regions. While, Muslims are considered a minority in Thailand, the majority of individuals in southernmost regions are Muslims, causing these regions to be different in terms of culture and beliefs. Using a phenomenological approach, this study examines older adults’ perceptions of successful aging within the context of violent social and political unrest. This research aims to 1) understand how older adults living in these areas perceive successful aging in relation to Rowe and Kahn’s successful ageing model, and 2) describe the experiences of older adults living in areas of violent social and political unrest. Data were collected using in-depth interviews with eight older adults living in the unrest area, composing of four males and four females aged between 55-75. Content analysis was used to investigate older adults’ perception of successful aging. Older adults living their life amidst the violence did not view the situation as a threat to their life for they viewed that they are not the targets of the unrest situation. Additionally, participants identified their religious beliefs and a strong sense of community belonging as coping strategies employed to deal with social and political unrest. Thus, according to them, the violence did not affect their perception of successful aging. While the participants’ perceptions of successful aging were generally consistent with aspects identified in the successful aging model proposed by Rowe and Kahn, a theme of “financial stability” emerged. The results can be divided into four interrelated themes, which are; 1) engaging with others; 2) religiosity; 3) financial stability; and 4) health. Understanding the older persons’ view of successful aging in vulnerable situations should add more depth and enhance the conceptualization of the successful aging concept.

Keywords: cultural gerontology, minority population, successful aging, unrest situation

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Authors: Andrea Vega-Tinoco, Ana I. Gil-Lacruz, Marta Gil-Lacruz

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The main objective of this research is to acknowledge whether civic participation affects the well-being of the elderly, thus being a key activity of active aging. It is also of interest to recognize any differences among genders, generational cohorts or country of residence. If a positive relationship is found between civic participation and well-being, the actions that promote this participation will benefit the quality of life of senior citizens. Otherwise, independent action must be taken in the improvement of social and human capital. The sample consists of approximately 50.000 individuals from the European Social Survey (2002-2016). Only individuals born before 1965 in 15 European countries were considered. The sample was distributed according to gender, year of birth, country, level of studies and ESS wave to form pseudo-panel data cohorts, leaving a total of 1.318 observations. The data were analyzed through a Cross-Lagged Model using Fixed-Effects. A bidirectional association is observed between the civic participation and well-being variables. However, participating in the past seems to have a higher impact on today’s health, happiness and life satisfaction than the other way around. Furthermore, 26% of the respondents expressed to be satisfied with their life, 27% to be happy and 57% to have good health. On the other hand, 49% have participated civically in the last year, being the most common activities: signing petitions, boycotting products and volunteer work in non-political organizations. A slight trend of BabyBoomers and men towards greater participation can be observed, as well as a higher impact of this participation on their well-being. In addition, international differences exhibit a stronger relation for Nordic, East European and Mediterranean countries. The given results support the hypothesis that civic participation is a promoter of well-being for the elderly. This paper positively highlights the activity of involving in political and non-political organizations, as well as wearing badges. At any rate, almost all forms of civic participation show a positive relationship with well-being and should therefore be promoted, although differences between countries must be taken into consideration.

Keywords: active aging, civic participation, Europe, well-being

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Authors: Gaya Bin Noon, Thoko Hanjahanja-Phiri, Laura Xavier Fadrique, Plinio Pelegrini Morita, Hélène Vaillancourt, Jennifer Teague, Tania Donovska

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Active Assisted Living (AAL) refers to systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for care recipients. As the population ages, there is a pressing need for non-intrusive, continuous, adaptable, and reliable health monitoring tools to support aging in place. AAL has great potential to support these efforts with the wide variety of solutions currently available, but insufficient efforts have been made to address concerns arising from the integration of AAL into care. The purpose of this research was to (1) explore the integration of AAL technologies and data into the clinical pathway, and (2) map data access and governance for AAL technology in order to develop standards for use by policy-makers, technology manufacturers, and developers of smart communities for seniors. This was done through four successive research phases: (1) literature search to explore existing work in this area and identify lessons learned; (2) modeling of the continuum of care; (3) adapting a framework for data governance into the AAL context; and (4) interviews with stakeholders to explore the applicability of previous work. Opportunities for standards found in these research phases included a need for greater consistency in language and technology requirements, better role definition regarding who can access and who is responsible for taking action based on the gathered data, and understanding of the privacy-utility tradeoff inherent in using AAL technologies in care settings.

Keywords: active assisted living, aging in place, internet of things, standards

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Authors: Young-Eun Jang, Mi-Hye Ma, Yemi Kim

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As the elderly population increases, the number of patients complaining of dry mouth is also increasing. Elderly people often use mouthwash to prevent periodontal disease. Mouthwash and saliva substitutes with low pH were reported to be able to cause enamel erosion. To the best of our knowledge, there have been no studies showing the effect of mouthwash on patients using saliva substitutes. Therefore, the purpose of this study was to evaluate the effect of the use of mouthwash in combination with saliva substitutes on tooth erosion using a quantitative light-induced fluorescence-digital (QLF-D) system. A total of 96 bovine specimens were embedded in putty blocks and randomly allocated to the following groups with n = 12 each: Group 1, application of mouthwash; Group 2, application of saliva substitutes; Group 3, application of saliva substitutes in combination with mouthwash; and control group, application of saline. The bovine samples were eroded using a demineralization solution and then saliva substitutes and mouthwash were applied according to the groups for 2 weeks. For saliva substitutes, three different products were used; Oasis (Oasis Consumer Health, Cleveland, OH, USA), Xeromia solution (Osstem Pharma Co., Seoul, Korea), and Drymund gel (Dong-A Pharma Co., Seoul, Korea). The pH values of the saliva substitutes were determined using a pH meter. Loss of enamel and root dentin was measured using the QLF-D system immediately after demineralization on the 3rd, 7th, and 14th days. The data were analyzed using repeated measures ANOVA followed by Tukey’s post hoc tests (p < 0.05). Mineral loss in enamel and root dentin was detected when mouthwash and saliva substitutes were used alone, respectively (p < 0.05). Also, when mouthwash was used with saliva substitutes, the mineral loss was observed in enamel and root dentin (p < 0.05). The use of Xeromia and Drymund gel increased mineral loss of enamel significantly compared to the use of Oasis (p < 0.05). However, when Drymund gel and Xeromia were used in combination with mouthwash, mineral loss of enamel was significantly reduced compared to when they were used alone (p < 0.05). The pH values of Drymund gel, Xeromia, Oasis, and mouthwash were 5.5, 5.52, 6.2, and 6.37, respectively. Based on these results, it can be concluded that the use of mouthwash with a higher pH value than that of saliva substitutes could help patients suffering from xerostomia avoid the risk of dental erosion.

Keywords: saliva substitute, mouthwash, tooth erosion, dry mouth

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Authors: N. Casado-Sanz, B. Guirao

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The population aged 65 and over is projected to double in the coming decades. Due to this increase, driver population is expected to grow and in the near future, all countries will be faced with population aging of varying intensity and in unique time frames. This is the greatest challenge facing industrialized nations and due to this fact, the study of the relationships of dependency between population aging and road safety is becoming increasingly relevant. Although the deterioration of driving skills in the elderly has been analyzed in depth, to our knowledge few research studies have focused on the road infrastructure and the mobility of this particular group of users. In Spain, crosstown roads have one of the highest fatality rates. These rural routes have a higher percentage of elderly people who are more dependent on driving due to the absence or limitations of urban public transportation. Analysing road safety in these routes is very complex because of the variety of the features, the dispersion of the data and the complete lack of related literature. The objective of this paper is to identify key factors that cause traffic accidents. The individuals under study were the accidents with killed or seriously injured in Spanish crosstown roads during the period 2006-2015. Latent cluster analysis was applied as a preliminary tool for segmentation of accidents, considering population aging as the main input among other socioeconomic indicators. Subsequently, a linear regression analysis was carried out to estimate the degree of dependence between the accident rate and the variables that define each group. The results show that segmenting the data is very interesting and provides further information. Additionally, the results revealed the clear influence of the aging variable in the clusters obtained. Other variables related to infrastructure and mobility levels, such as the crosstown roads layout and the traffic intensity aimed to be one of the key factors in the causality of road accidents.

Keywords: cluster analysis, population ageing, rural roads, road safety

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Authors: Sarah Faulkner, Patrick Faulkner, Caroline Ellison

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Improved mental and physical health, community connection, and increased life satisfaction has been strongly associated with bike riding for those with and without a disability. However, much evidence suggests that people living with a disability face increased barriers to engaging in cycling compared to members of the general population. People with an intellectual disability often live more sedentary and socially isolated lives that negatively impact their mental and physical health, as well as life satisfaction. This paper is based on preliminary findings from a three-year intervention cycling project funded by the South Australian Government. The cycling project was developed in partnership with community stakeholders that provided weekly instruction, training, and support to individuals living with intellectual disabilities to increase their capacity in cycling. This project aimed to support people living with intellectual disabilities to foster and facilitate improved physical and mental health, confidence, and independence and enhance social networking through their engagement in community cycling. The program applied principles of social role valorisation (SRV) theory as its guiding framework. Preliminary data collected is based on qualitative interviews with over 50 program participants, results from two participant wellness questionnaires, as well as a perceptually regulated exercise test administered throughout the project implementation. Preliminary findings are further supplemented with ethnographic analyses by the researchers who took a phenology of life experience approach. Preliminary findings of the program suggest a variety of social motivations behind participants' desire to learn cycling that acknowledges previous barriers to engagement and cycling’s role to address feelings of loneliness and social isolation. Meaningful health benefits can be achieved as demonstrated by increases in predicted V02 max measures, suggesting that physical intervention can not only improve physical health outcomes but also provide a variety of other social benefits. Initial engagement in the project has demonstrated an increase in participants' sense of confidence, well-being, and physical fitness. Implementation of the project in partnership with a variety of community stakeholders has identified a number of critical factors and processes necessary for future service replication, sustainability, and success. Findings from this intervention study contribute to the development of a knowledge base on how best to support individuals living with an intellectual disability to partake in bike riding and increase positive outcomes associated with their capacity building, social interaction, increased physical activity, physical health, and mental well-being. The initial findings of this study provide critical academic insights into the social and physical benefits of cycling for people living with a disability, as well as practical advice for future human service applications.

Keywords: cycling, disability, social inclusion, capacity building

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Authors: Shyam Sunder Gupta

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GOD is the infinite source of knowledge and from time to time, as per the need of mankind, keeps revealing a portion of HIS knowledge as” Words” through chosen messengers. In the course of time, ” Words” get converted into scripture. This process of conversion happens after a long gap of time and with the involvement of a large number of persons; and unintentionally scientific and other types of errors get into scriptures; otherwise scriptures are in reality, truly scientific. Description of Chronology of life in the womb (Fetal Development), Five types of rotations of celestial bodies, Speed of the Sun, Rotation of Universe, Multiple verses, Spherical shape of the earth, Measurement of time, Classification of species by nature of birth, Evolution process of non-living matter and living species, etc., most convincing prove that scriptures are truly scientific. In fact, there are many facts for which, till date, science has not found answers, but are available in scriptures; like source of Singularity from which the Big Bang took place and the Universe was created, the Infinite number of Universes, the most fundamental particle, Param-anu( God particle), fundamental of measurement of time and many more.

Keywords: Big Bang, God Particle, Scientific, Scriptures, Singularity, Universe

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Authors: Vinko Vidučić, Tanja Brešan Ančić, Marijana Tomelić Ćurlin

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Prior to quantifying the variables of the information model for using school terminology in Croatia's region of Dalmatia from 1884 to 2014, the most relevant model variables had to be determined: historical circumstances, standard of living, education system, linguistic situation, and media. The research findings show that there was no significant transfer of the 1884 school terms into 1949 usage; likewise, the 1949 school terms were not widely used in 2014. On the other hand, the research revealed that the meaning of school terms changed over the decades. The quantification of the variables will serve as the groundwork for creating an information model for using school terminology in Dalmatia from 1884 to 2014 and for defining direct growth rates in further research.

Keywords: education system, historical circumstances, linguistic situation, media, school terminology, standard of living

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Authors: Ahuva Even-Zohar

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Context: Families living in poverty often struggle with poor financial management and accumulating debts. Social workers play a crucial role in assisting these families, but they typically receive no formal training in financial management. Research Aim: The aim of this study was to assess the impact of a voluntary organization called Paamonim on social work students' attitudes toward providing material support and assistance in financial management to families living in poverty. Additionally, the study aimed to evaluate the students' perception of the workshop's contribution and their actual use of the tools acquired during the training. Methodology: The study involved 134 social work students, with 55 in a regular program and 79 in a retraining program. The first stage of the study involved the students receiving an explanation of the research, ensuring confidentiality, and signing informed consent. The students completed two questionnaires: The Student Attitudes Questionnaire and a sociodemographic questionnaire. In the second stage, three months after the workshop, the students completed the questionnaires again, along with a feedback questionnaire. Findings: The study found that there were no significant differences in the students' attitudes toward providing material support and proper financial management to families living in poverty before and after the workshop. However, their attitudes remained positive, at a medium level or higher. The students reported that the workshop provided them with tools to assist families in poverty, and they used these tools to some extent in their practical training. They found the workshop interesting and acknowledged its importance in raising awareness about budget management and enriching their knowledge of money management. The students acknowledged the workshop's effectiveness but mentioned that it was too short. Theoretical Importance: This study highlights the importance of developing programs to help families living in poverty manage their household finances. The workshop enriched the students' knowledge and skills, which are vital for their role as social workers working with families in poverty to rehabilitate their financial situations. Data Collection and Analysis Procedures: The students completed self-report questionnaires before and after the workshop, providing insights into their attitudes and perception about the role of social workers in providing material support for families living in poverty and helping them manage their household finances. Statistical analysis was conducted to compare the students' attitudes pre and post-workshop, and a feedback questionnaire assessed the students' perception of the contribution of the workshop. Question Addressed: This study addressed the question of whether a workshop on financial management can positively impact social work students' attitudes and skills in assisting families living in poverty with their household finances. Conclusion: Despite being short and consisting of only one session, the workshop proved to be valuable in enriching the students' knowledge and providing them with important tools for their role as social workers. The students reported positive attitudes toward providing material support and financial assistance to families in need. The practical recommendation is to continue offering such workshops as part of the social work curriculum to further enhance students' abilities to help families manage their finances effectively.

Keywords: financial literacy, poverty, social work students, workshop

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Authors: W. Chatan, W. Promprom

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Phu Langka National Park is located in Nakhon Phanom Province, the Northeast of Thailand. It contains about 50 km2 of one mountain and three types of forest including deciduous dipterocarp, mixed deciduous and dry evergreen forests. It was interesting area because of that there were some local ethnic groups living around the national park and most people use plants in this area for their life. The objective of this research is to preliminary survey of the use of medicinal plants from this area by local ethnic groups living around the national park. Colour photographs of each species were prepared. In addition, ecology, distribution in the study area, utilization and vernacular names were provided. The result showed that sixteen species of medicinal plant species were found and most plants were used for digestive system and wound. The voucher specimens were deposited in the Forest Herbarium, Department of National Parks, Wildlife and Plant Conservation (BKF), Thailand.

Keywords: diversity, ethnobotany, ethnophamacology, taxonomy, utilization

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Authors: Naqvi Shraddha Rathi

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During the aging process, physical frailty may develop. A more sedentary lifestyle, a reduction in metabolic cell mass and, consequently, lower energy expenditure and dietary intake are important contributors to the progression of frailty. A decline in intake is in turn associated with the risk of developing a suboptimal nutritional state or multiple micro nutrient deficiencies.The tantalizing potential of nanotechnology is to fabricate and combine nano scale approaches and building blocks to make useful tools and, ultimately, interventions for medical science, including nutritional science, at the scale of ∼1–100 nm.

Keywords: aging, cells frailty, micronutrients, biochemical reactivity

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: Victor Counted

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Staying true to self is complicated. In most cases, we might not fully come to terms with this realities. Just like any journey, a self-discovery experience with the ‘self’, is like a rollercoaster ride. The researcher attempts to engage the reader in an empirical study on authenticity tendencies of African Christian Millennials. Hence, attempting the all-important question: What does it actually mean to be true to self for the African youth? A comprehensive, yet an unfinished business that applies the authenticity theory in its exploratory navigations to uncover the “lived world” of the participants who were part of this study. Using a mixed methods approach, the researcher will exhaustively give account to the authenticity tendencies and experiences of the respondents in the study by providing the reader with a unique narrative for understanding what it means to be true to oneself in Africa. At the quantitative study, the participants recorded higher scores on the Authenticity Scale (AS) authentic living, while showing a significant correlation within the subscales. Hypotheses were tested at the quantitative phase, which statistically supported gender and church affiliation as possible predictors for the authenticity orientations of the participants, while being a Christian native and race/ethnicity were not impact factors statistically. The results helped the researcher to develop the objectives behind the qualitative study, where only fifteen AS-authentic living participants were interviewed to understand why they scored high on authentic living, in order to understand what it means to be authentic. The hallmark of the qualitative case study exploration was the common coping mechanism of splitting adopted by the respondents to deal with their self-crisis as they tried to remain authentic to self, whilst self-regulating and self-investing the self to discover ‘self’. Specifically, the researcher observed the concurrent utilization of some kind of the religious-self by the respondents to regulate their self crisis, as they relate with self fragmenting through different splitting stages in hope for some kind of redemption. It was an explanation that led to the conclusion that being authentic is the new pieces. Authenticity is in fragments. This proposition led the researcher to introduce a hermeneutical support-system that will enable future researchers engage more critically and responsibly with their “living human documents” in order to inspire timely solutions that resolve the concerns of authenticity and wellbeing among Millennials in Africa.

Keywords: authenticity, self, identity, self-fragmentation, weak self integration, postmodern self, splitting

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Authors: Zurina Mahadi, Hukil Sino

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United Nations resolved 2030 Sustainable Development Goals (SDGs) in 2015 to complete what Millennium Development Goals did not achieve. Accommodating 17 goals and 169 targets, Sustainable Development Goals are designated to be achieved over the next 15 years. A survey was conducted in July 2019 among the undergraduate students of a public university in Selangor, Malaysia, to learn their selection over Sustainable Development Goals, which they think is the most critical in the Malaysian scenario. This study adopted a qualitative approach, and data is gathered from a single instruction questionnaire administered to a purposive sample of participants. 13 goals were selected by the participants which are Goal 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 13, 16 and 17 while none has selected Goal 7, 9, 14 and 15 which are ‘Affordable and Clean Energy’; ‘Industry, Innovation and Infrastructure’; ‘Life Below Water’ and ‘Life On Land’ respectively. The selected goals are then ranked according to the number of participants who chose that particular goal. Goal 8 is found to be at the highest position of the ranking while Goal 5, 6, 10, and 13 accommodating the lowest position. Goal 8, which is ‘Decent Work and Economic Growth’ is chosen by 13 participants as the most critical goal in Malaysia while Goal 5,6 10, and 13, which are ‘Gender Equality’; ‘Clean Water and Sanitation’; ‘Reduced Inequalities’ and ‘Climate Action’ respectively, are chosen by only one participant each. Issues highlighted by the participants are themed into 10 themes, which are job availability, cost of living, well-being, corruption, education, environment, gender, development planning, consumption, and partnership. The theme of the cost of living has the highest number of issues, followed by the theme of job availability and the environment. The theme of gender has the least number of issues, followed by the theme of corruption and development planning. In principle, these findings, therefore, conclude that from a public university students’ point of view, the most critical sustainable development goal is decent work and economic growth while the most concerning issue is the cost of living. The implications of these findings are students’ knowledge towards the current issues of development, and their views of future sustainable development are considerably high. This study, therefore, suggests their views be inculcated into local, sustainable development frameworks to increase the inclusiveness of the young generation as they are the future SDGs stakeholders.

Keywords: cost of living, inclusiveness, job availability, sustainable development goals

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Authors: Meera Prajapati

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Technological innovation is important for economic and spatial rejuvenation. Innovation districts from the last decades around university towns offer interesting examples. Planning directs the interplay between economic and urban development in these innovation districts that appear in particular regions with economic benefits as a result of incentives to attract multinational industries in innovation centres, research parks, universities, bio incubator assets, etc. The inclination of the OECED towards developing entrepreneurship and innovation to harness a boost in growth requires sustainable living conditions. This research aims to understand ‘how innovation or knowledge centres affected development policies and helped cities to become a high-tech region?’ Therefore, the economic policies of cities are investigated as well as the location logic of centres and their intertwining with supporting services (health, education, living environment, etc.). Case studies (Eindhoven (The Netherlands) and Ho Chi Minh City (Viet Nam)) position Pune (India) in terms of the planning components of innovation.

Keywords: innovation districts, high-tech regions, smart cities, urban planning and policies

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Authors: Jason M. Hegenauer, Nicholas Fucci

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In the late 1990s, a major deinstitutionalization movement of elderly patients took place, since which, the design of long-term care facilities has not been adequately analyzed in the United States. Over the course of the last 25 years, major innovations in construction methods, technology, and medicine have been developed, drastically changing the landscape of healthcare architecture. In light of recent events, and the expected increase in elderly populations with the aging of the baby-boomer generation, it is evident that reconsideration of these facilities is essential for the proper care of aging populations. The global response has been effective in stifling this pandemic; however, widespread disease still poses an imminent threat to the human race. Having witnessed the devastation Covid-19 has reaped throughout nursing homes and long-term care facilities, it is evident that the current strategies for protecting our most vulnerable populations are not enough. Light renovation of existing facilities and previously overlooked considerations for new construction projects can drastically lower the risk at nursing homes and long-term care facilities. A reconfigured entry sequence supplements several of the features which have been long-standing essentials of the design of these facilities. This research focuses on several aspects identified as needing improvement, including indoor environment quality, security measures incorporated into healthcare architecture and design, and architectural mitigation strategies for sick building syndrome. The results of this study have been compiled as 'best practices' for the design of future healthcare construction projects focused on the health, safety, and quality of life of the residents of these facilities. These design strategies, which can easily be implemented through renovation of existing facilities and new construction projects, minimize risk of infection and spread of disease while allowing routine functions to continue with minimal impact, should the need for future lockdowns arise. Through the current lockdown procedures, which were implemented during the Covid-19 pandemic, isolation of residents has caused great unrest and worry for family members and friends as they are cut off from their loved ones. At this time, data is still being reported, leaving infection and death rates inconclusive; however, recent projections in some states list long-term care facility deaths as high as 60% of all deaths in the state. The population of these facilities consists of residents who are elderly, immunocompromised, and have underlying chronic medical conditions. According to the Centers for Disease Control, these populations are particularly susceptible to infection and serious illness. The obligation to protect our most vulnerable population cannot be overlooked, and the harsh measures recently taken as a response to the Covid-19 pandemic prove that the design strategies currently utilized for doing so are inadequate.

Keywords: building security, healthcare architecture and design, indoor environment quality, new construction, sick building syndrome, renovation

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Authors: Flavia Magliacani

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The urbanization of the last decades and its resulting urban growth entail problems both for environmental and economic sustainability. From this perspective, sustainable settlement development requires a horizontal decrease in the existing urban structure in order to enhance its greater concentration. Hence, new stratifications of the city fabric and architectural strategies ensuring high-density settlement models are possible solutions. However, although increasing housing density is necessary, it is not sufficient. Guaranteeing the quality of living is, indeed, equally essential. In order to meet this objective, many other factors come to light, namely the relationship between private and public spaces, the proximity to services, the accessibility of public transport, the local lifestyle habits, and the social needs. Therefore, how to safeguard both quality and density in human habitats? The present paper attempts to answer the previous main research question by addressing several sub-questions: Which architectural types meet the dual need for urban density and housing quality? Which project criteria should be taken into consideration by good design practices? What principles are desirable for future planning? The research will analyse different architectural responses adopted in four European cities: Paris, Lion, Rotterdam, and Amsterdam. In particular, it will develop a qualitative and comparative study of two specific architectural solutions which integrate housing density and quality living. On the one hand, the so-called 'self-contained city' model, on the other hand, the French 'Habitat Dense Individualisé' one. The structure of the paper will be as follows: the first part will develop a qualitative evaluation of some case studies, emblematic examples of the two above said architectural models. The second part will focus on the comparison among the chosen case studies. Finally, some conclusions will be drawn. The methodological approach, therefore, combines qualitative and comparative research. Parameters will be defined in order to highlight potential and criticality of each model in light of an interdisciplinary view. In conclusion, the present paper aims at shading light on design approaches which ensure a right balance between density and quality of the urban living in contemporary European cities.

Keywords: density, future design, housing quality, human habitat

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Authors: Tania Sharmin

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Energy use, overheating and thermal discomfort in low-income tropical housing remains an under-researched area. This research attempts to explore these aspects in the Loving Community, a housing colony created for former leprosy patients and their families in Ahmedabad in India. The living conditions in these households and working practices of the inhabitants in terms of how the building and its internal and external spaces are used, will be explored through interviews and monitoring which will be based on a household survey and a focus group discussion (FGD). The findings from the study will provide a unique and in-depth account of how the relocation of the affected households to the new, flood-resistant and architecturally-designed buildings may have affected the dwellers’ household routines (health and well-being, comfort, satisfaction and working practices) and overall living conditions compared to those living in poorly-designed, existing low-income housings. The new houses were built under an innovative building project supported by De Montfort University Leicester (DMU)’s Square Mile India project. A comparison of newly-built and existing building typologies will reveal how building design can affect people’s use of space and energy use. The findings will be helpful to design healthier, energy efficient and socially acceptable low-income housing in future, thus addressing United Nation’s sustainable development goals on three aspects: 3 (health and well-being), 7 (energy) and 11 (safe, resilient and sustainable human settlements). This will further facilitate knowledge exchange between policy makers, developers, designers and occupants focused on strategies to increase stakeholders’ participation in the design process.

Keywords: thermal comfort, energy use, low-income housing, tropical climate

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Authors: Ram Sharan Mehta, Naveen Kumar Pandey, Binod Kumar Deo

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Quality of Life (QOL) is an important component in the evaluation of the well-being of People Living with AIDS (PLWA). This study assessed the effectiveness of education intervention programme in improving the QOL of PLWA on ART attaining the ART-clinics at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. A pre-experimental research design was used to conduct the study among the PLWA on ART at BPKIHS from June to August 2013 involving 60 PLWA on pre-test randomly. The mean age of the respondents was 36.70 ± 9.92, and majority of them (80%) were of age group of 25-50 years and Male (56.7%). After education intervention programme there is significant change in the QOL in all the four domains i.e. Physical (p=0.008), Psychological (p=0.019), Social (p=0.046) and Environmental (p=0.032) using student t-test at 0.05 level of significance. There is significant (p= 0.016) difference in the mean QOL scores of pre-test and post-test. High QOL scores in post-test after education intervention programme may reflective of the effectiveness of planned education interventions programme.

Keywords: telephone, AIDS, health service, Nepal

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Authors: Michael Ajide Oyinloye

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The natural environment is made up of air, water and soil. The release of emission of industrial waste into anyone of the components of the environment causes pollution. Industrial pollution significantly threatens the inherent right of people, to the enjoyment of a safe and secure environment. The aim of this paper is to assess the effect of environmental pollution and health risks of residents living near Ewekoro Cement factory. The research made use of IKONOS imagery for Geographical Information System (GIS) to buffer and extract buildings that are less than 1 km to the plant, within 1 km to 5 km and above 5 km to the factory. Also, a questionnaire was used to elicit information on the socio-economic factors, the effect of environmental pollution on residents and measures adopted to control industrial pollution on the residents. Findings show that most buildings that between less than 1 km and 1 km to 5 km to the factory have high health risk in the study area. The study recommended total relocation for the residents of the study area to reduce risk health problems.

Keywords: environmental pollution, health risk, GIS, satellite imagery, ewekoro

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Authors: Zhou Yuwei

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This study used the multidimensional rating scale for disruptive behaviour in preschool children (parent version) to assess changes in the disruptive behaviour (tantrums, disobedience, aggression, and low level of concern for others) of 200 young children in Nanjing, Jiangsu Province, China, before and after living at home during the new crown epidemic, and five additional teachers of young children were selected to conduct interviews on the performance and changes in their disruptive behaviour at school. The following conclusions were drawn from the questionnaires and interviews: (1) 49% of the children showed a decrease in disruptive behaviour compared to the pre-epidemic period; (2) boys were more disruptive than girls due to individual factors; (3) children with a decrease in disruptive behaviour were more likely to have democratic and authoritative parenting styles due to parental education and upbringing; and the higher the level of parental education, the greater the decrease in disruptive behaviour. (4) For parents who worked outside the home during the epidemic and who did not work, disruptive behaviour scores were higher for their children. Meanwhile, disruptive behaviour was more pronounced the longer the child used electronic devices. The longer the parent-child interaction, the less disruptive behaviour was evident.

Keywords: disruptive behaviour, home life, children, COVID-19

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Authors: Jeong-Min Son, Jeong-Hee Eum, Jin-Kyu Min, Uk-Je Sung, Ju-Eun Kim

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While various environmental problems are severe due to climate change, especially in cities where population and development are concentrated, urban thermal environment problems such as heat waves and tropical nights are particularly worsening. Accordingly, the Korean government provides basic data related to the urban thermal environment to support each local government in effectively establishing policies to cope with heat waves. However, the basic data related to the thermal environment provided by the government has limitations in establishing a regional thermal adaptation plan with a minimum unit of cities, counties, and districts. In addition, the urban heat environment perceived by people differs in each region and space. Therefore, it is necessary to prepare practical measures that can be used to establish regional-based policies for heat wave adaptation by identifying people’s heat perception in the entire city. This study aims to develop a mobile phone application (APP) to gather people’s thermal sensation information and create Korea’s first thermal map based on this information. In addition, through this APP, citizens directly propose thermal adaptation policies, and urban planners and policymakers accept citizens' opinions, so this study provides a tool to solve local thermal environment problems. To achieve this purpose, first, the composition and contents of the app were discussed by examining various existing apps and cases for citizen participation and collection of heat information. In addition, factors affecting human thermal comfort, such as spatial, meteorological, and demographic factors, were investigated to construct the APP system. Based on these results, the basic version of the APP was developed. Second, the living lab methodology was adopted to gather people’s heat perception using the developed app to conduct overall evaluation and feedback of people on the APP. The people participating in the living lab were selected as those living in Daegu Metropolitan City, which is located in South Korea and annually records high temperatures. The user interface was improved through the living lab to make the app easier to use and the thermal map was modified. This study expects to establish high-resolution thermal maps for effective policies and measures and to solve local thermal environmental problems using the APP. The collected information can be used to evaluate spatial, meteorological, and demographic characteristics that affect the perceived heat of citizens. In addition, it is expected that the research can be expanded by gathering thermal information perceived by citizens of foreign cities as well as other cities in South Korea through the APP developed in this study.

Keywords: mobile application, living lab, thermal map, climate change adaptation

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Authors: Sheraz Akhtar

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In recent years, a massive influx of refugees into developing countries has placed significant constraints on the host government’s capacities to provide social services, including education, to all. As a result, the refugee communities often find themselves deprived of their rights to education in these host countries, particularly for those who to live outside camps in urban locations. While previous research has examined the educational experiences of refugees who have resettled in developed nations, there remains a dearth of research on the educational experiences of urban refugees in developing nations. This study examines this issue through a case study of Pakistani Christian refugees living in urban settings in Thailand. Using a combination of observations within community learning centres set up by international non-government organisations (INGOs) working with these communities, and interviews with young Pakistani Christian refugees and their families, the research aims to give greater voice to the Pakistani Christian refugee community living in Thailand, and better understand their educational aspirations.

Keywords: Education, Developing Countries , INGOs, Urban Refugees

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Authors: Gemma Postil, Claire Zanin, Michael Halpin, Caroline Ritter

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Illness experience research typically focuses on people that are living with a medical condition; however, the broad consequences of the COVID-19 pandemic are impacting those without the virus itself, as many experienced extensive lockdowns, social isolation, and distress. Drawing on conceptual work in the illness experience literature, we argue that policy and social changes tied to COVID-19 produce biographical disruptions. In this sense, we argue that the COVID-19 pandemic produces illness experience without illness, as the pandemic comprehensively impacts health and biography. This paper draws on 30 in-depth interviews with young adults living in Prince Edward Island (PEI), which were conducted as part of a larger project to understand how young adults navigate compliance with the COVID-19 pandemic. We then inductively analyzed the interviews with a constructivist grounded theory approach. Specifically, we demonstrate that young adults living in PEI during the COVID-19 pandemic experienced biographical disruptions throughout the pandemic despite not contracting the virus. First, we detail how some participants experience biographical acceleration, with the pandemic accelerating relationships, home buying, and career planning. Second, we demonstrate biographical stagnation, wherein participants report being unable to pursue major life milestones. Lastly, we describe biographical regression, wherein participants feel they are losing ground during the pandemic and are actively falling behind their peers. These findings provide the novel application of illness experience concepts to the context of the COVID-19 pandemic, contribute to work on illness experience and ambiguity, and extend Bury’s conceptualization of biographical disruption. In conclusion, we demonstrate that young adults experienced the biographical disruption expected from having COVID-19 without having an illness, highlighting the depth to which the pandemic affected young adults.

Keywords: illness experience, lived experience, biographical disruption, COVID-19, young adults

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

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Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

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Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

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