Search results for: graceful ageing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 235

Search results for: graceful ageing

175 The Glycitin and 38 Combination Inhibit the UV-Induced Wrinkle Fomation in Human Primary Fibroblast

Authors: Manh Tin Ho, Phorl Sophors, Ga Young Seo, Young Mee Kim, Youngho Lim, Moonjae Cho

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UV radiation in sunlight is one of the most potential factor induced skin ageing and photocarcinogenesis. UV may induce the melanin production and wrinkle formation. Recently, the natural secondary compounds have been reported that had the beneficial protective effects from UV light. In this study, we investigated the effects of two different compounds, glycitin and 38, on human dermal fibroblast. We first only treated the 38 on melanocyte cell to test the proliferation inhibition of 38 on this cell line. Then, we induced the combination of glycitin and 38 on human dermal fibroblast in 48h and investigate the proliferation, collagen production and the metalloproteinase family expression. The 38 alone could inhibit the proliferation of melanocyte which indicated the reduction of melanin production. The combination of glycitin and 38 truly increased the fibroblast proliferation and even they could recover the UV-induced and H2O2-induced damaged fibroblast proliferation. The co-treatment also promoted the collagen IV expression significantly and accelerated the total collagen secretion. In addition, metalloproteinase (MMPs) family such as MMP1, MMP2, MMP7 was down-regulated in transcriptional level. In conclusion, the combination of glycitin and 38 has induced the fibroblast proliferation even when it was damaged by UV exposure and H2O2, whereas augmented collagen production and inhibited the MMPs caused the wrinkle formation and decreased the melanocyte proliferation, suggested an potential UV-protective therapy.

Keywords: UV radiation, wrinkle, ageing, glycitin, dermal fibroblast

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174 Use of Polymeric Materials in the Architectural Preservation

Authors: F. Z. Benabid, F. Zouai, A. Douibi, D. Benachour

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These Fluorinated polymers and polyacrylics have known a wide use in the field of historical monuments. PVDF provides a great easiness to processing, a good UV resistance and good chemical inertia. Although the quality of physical characteristics of the PMMA and its low price with a respect to PVDF, its deterioration against UV radiations limits its use as protector agent for the stones. On the other hand, PVDF/PMMA blend is a compromise of a great development in the field of architectural restoration, since it is the best method in term of quality and price to make new polymeric materials having enhanced properties. Films of different compositions based on the two polymers within an adequate solvent (DMF) were obtained to perform an exposition to artificial ageing and to the salted fog, a spectroscopic analysis (FTIR and UV) and optical analysis (refractive index). Based on its great interest in the field of building, a variety of standard tests has been elaborated for the first time at the central laboratory of ENAP (Souk-Ahras) in order to evaluate our blend performance. The obtained results have allowed observing the behavior of the different compositions of the blend under various tests. The addition of PVDF to PMMA enhances the properties of this last to know the exhibition to the natural and artificial ageing and to the saline fog. On the other hand, PMMA enhances the optical properties of the blend. Finally, 70/30 composition of the blend is in concordance with results of previous works and it is the adequate proportion for an eventual application.

Keywords: blend, PVDF, PMMA, preservation, historic monuments

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173 The Touch Sensation: Ageing and Gender Influences

Authors: A. Abdouni, C. Thieulin, M. Djaghloul, R. Vargiolu, H. Zahouani

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A decline in the main sensory modalities (vision, hearing, taste, and smell) is well reported to occur with advancing age, it is expected a similar change to occur with touch sensation and perception. In this study, we have focused on the touch sensations highlighting ageing and gender influences with in vivo systems. The touch process can be divided into two main phases: The first phase is the first contact between the finger and the object, during this contact, an adhesive force has been created which is the needed force to permit an initial movement of the finger. In the second phase, the finger mechanical properties with their surface topography play an important role in the obtained sensation. In order to understand the age and gender effects on the touch sense, we develop different ideas and systems for each phase. To better characterize the contact, the mechanical properties and the surface topography of human finger, in vivo studies on the pulp of 40 subjects (20 of each gender) of four age groups of 26±3, 35+-3, 45+-2 and 58±6 have been performed. To understand the first touch phase a classical indentation system has been adapted to measure the finger contact properties. The normal force load, the indentation speed, the contact time, the penetration depth and the indenter geometry have been optimized. The penetration depth of a glass indenter is recorded as a function of the applied normal force. Main assessed parameter is the adhesive force F_ad. For the second phase, first, an innovative approach is proposed to characterize the dynamic finger mechanical properties. A contactless indentation test inspired from the techniques used in ophthalmology has been used. The test principle is to blow an air blast to the finger and measure the caused deformation by a linear laser. The advantage of this test is the real observation of the skin free return without any outside influence. Main obtained parameters are the wave propagation speed and the Young's modulus E. Second, negative silicon replicas of subject’s fingerprint have been analyzed by a probe laser defocusing. A laser diode transmits a light beam on the surface to be measured, and the reflected signal is returned to a set of four photodiodes. This technology allows reconstructing three-dimensional images. In order to study the age and gender effects on the roughness properties, a multi-scale characterization of roughness has been realized by applying continuous wavelet transform. After determining the decomposition of the surface, the method consists of quantifying the arithmetic mean of surface topographic at each scale SMA. Significant differences of the main parameters are shown with ageing and gender. The comparison between men and women groups reveals that the adhesive force is higher for women. The results of mechanical properties show a Young’s modulus higher for women and also increasing with age. The roughness analysis shows a significant difference in function of age and gender.

Keywords: ageing, finger, gender, touch

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172 Effects of Copper Oxide Doping on Hydrothermal Ageing in Alumina Toughened Zirconia

Authors: Mohamed Abbas, Ramesh Singh

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This study investigates the hydrothermal aging behavior of undoped and copper oxide-doped alumina-toughened zirconia (ATZ). The ATZ ceramic composites underwent conventional sintering at temperatures ranging from 1250 to 1500°C with a holding time of 12 minutes. XRD analysis revealed a stable 100% tetragonal phase for conventionally sintered ATZ samples up to 1450°C, even after 100 hours of exposure. At 1500℃, XRD patterns of both undoped and doped ATZ samples showed no phase transformation after up to 3 hours of exposure to superheated steam. Extended exposure, however, resulted in phase transformation beyond 10 hours. CuO-doped ATZ samples initially exhibited lower monoclinic content, gradually increasing with aging. Undoped ATZ demonstrated better-aging resistance, maintaining ~40% monoclinic content after 100 hours. FESEM images post-aging revealed surface roughness changes due to the tetragonal-to-monoclinic phase transformation, with limited nucleation in the largest tetragonal grains. Fracture analysis exhibited macrocracks and microcracks on the transformed surface layer after aging. This study found that 0.2wt% CuO doping did not prevent the low-temperature degradation (LTD) phenomenon at elevated temperatures. Transformation zone depth (TZD) calculations supported the trend observed in the transformed monoclinic phase.

Keywords: alumina toughened zirconia, conventional sintering, copper oxide, hydrothermal ageing

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171 The Effects of Time and Cyclic Loading to the Axial Capacity for Offshore Pile in Shallow Gas

Authors: Christian H. Girsang, M. Razi B. Mansoor, Noorizal N. Huang

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An offshore platform was installed in 1977 at about 260km offshore West Malaysia at the water depth of 73.6m. Twelve (12) piles were installed with four (4) are skirt piles. The piles have 1.219m outside diameter and wall thickness of 31mm and were driven to 109m below seabed. Deterministic analyses of the pile capacity under axial loading were conducted using the current API (American Petroleum Institute) method and the four (4) CPT-based methods: the ICP (Imperial College Pile)-method, the NGI (Norwegian Geotechnical Institute)-Method, the UWA (University of Western Australia)-method and the Fugro-method. A statistical analysis of the model uncertainty associated with each pile capacity method was performed. There were two (2) piles analysed: Pile 1 and piles other than Pile 1, where Pile 1 is the pile that was most affected by shallow gas problems. Using the mean estimate of soil properties, the five (5) methods used for deterministic estimation of axial pile capacity in compression predict an axial capacity from 28 to 42MN for Pile 1 and 32 to 49MN for piles other than Pile 1. These values refer to the static capacity shortly after pile installation. They do not include the effects of cyclic loading during the design storm or time after installation on the axial pile capacity. On average, the axial pile capacity is expected to have increased by about 40% because of ageing since the installation of the platform in 1977. On the other hand, the cyclic loading effects during the design storm may reduce the axial capacity of the piles by around 25%. The study concluded that all piles have sufficient safety factor when the pile aging and cyclic loading effect are considered, as all safety factors are above 2.0 for maximum operating and storm loads.

Keywords: axial capacity, cyclic loading, pile ageing, shallow gas

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170 Offline High Voltage Diagnostic Test Findings on 15MVA Generator of Basochhu Hydropower Plant

Authors: Suprit Pradhan, Tshering Yangzom

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Even with availability of the modern day online insulation diagnostic technologies like partial discharge monitoring, the measurements like Dissipation Factor (tanδ), DC High Voltage Insulation Currents, Polarization Index (PI) and Insulation Resistance Measurements are still widely used as a diagnostic tools to assess the condition of stator insulation in hydro power plants. To evaluate the condition of stator winding insulation in one of the generators that have been operated since 1999, diagnostic tests were performed on the stator bars of 15 MVA generators of Basochhu Hydropower Plant. This paper presents diagnostic study done on the data gathered from the measurements which were performed in 2015 and 2016 as part of regular maintenance as since its commissioning no proper aging data were maintained. Measurement results of Dissipation Factor, DC High Potential tests and Polarization Index are discussed with regard to their effectiveness in assessing the ageing condition of the stator insulation. After a brief review of the theoretical background, the strengths of each diagnostic method in detecting symptoms of insulation deterioration are identified. The interesting results observed from Basochhu Hydropower Plant is taken into consideration to conclude that Polarization Index and DC High Voltage Insulation current measurements are best suited for the detection of humidity and contamination problems and Dissipation Factor measurement is a robust indicator of long-term ageing caused by oxidative degradation.

Keywords: dissipation Factor (tanδ), polarization Index (PI), DC High Voltage Insulation Current, insulation resistance (IR), Tan Delta Tip-Up, dielectric absorption ratio

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169 Improvement of Energy Efficiency and Cost Management for Household Refrigerators Under Different Climate Classes and Examination of Effect of VIP Ageing and Usage of Electronic Expansion Valve Technology

Authors: Yesim Guzel, Mert Akbiyik

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Energy consumption (EC) and costs due to the usage of refrigerators are increasing continuously. This creates a disadvantage not only on the budget of customers but also to global warming. This study aims to decrease EC and cost due to refrigerator EC all around the world. Research about the effect of climate classes on industrial cabinets, supermarket refrigerators or room air conditioning systems can be found in open literature; however, to the best of authors' knowledge, there is no study that includes the effect of climate classes, vacuum insulation panels (VIP) and polyurethane (PU) aging, and electronic expansion valve (EEV) technology for home refrigerators. For this purpose, 4 configurations are examined for household refrigerators for ST (subtropical) and T (tropical) climates. The aging of VIP and PU and the annual interest rate of electricity cost (%5) are considered to obtain more accurate results in calculations. Heat gain (Q), EC, and CO₂ emission are calculated. Config. 1, 2, 3 and 4 are with NO VIP, FULL VIP, NO VIP+ EEV, and FULL VIP+EEV, respectively. As a result, it is observed that Q for Config. 1 and 2 increase as Temp increases. Moreover, from ST to T climates, for all the configurations, EC increases. Additionally, the payback period (t) is based on reference cabinet Config. 1 is calculated. It is considered that annual electricity cost as constant for every climate. When ts are compared with Config. 1 for both climates, it is seen that the minimum t of 2 years is Config. 3. This study shows not only is EEV a better alternative option than VIPs. Hence, EEVs are way cheaper than VIPs and have shorter t, but it also allows us to compare Ec, Q, CO₂ emissions, and cost.

Keywords: energy, thermodynamics, ageing, VIP, polyurethane, expansion valve, EEV, PU, climate, refrigerating, cooling, efficiency

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168 Oi̇l Absorption Behavior and Its Effect on Charpy Impact Test of Glass Reinforced Polyester Composites Used in the Manufacture of Naval Ship Hulls

Authors: Bouhafara Djaber, Menail Younes, Mesrafet Farouk, Aissaoui Mohammed Islem

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This article presents results of experimental investigations of the durability of (GFRP) composite exposed to typical environments of marine industries applications,The use of fiber-glass reinforced polyester composites in marine applications such as Hulls of voyage boats and hulls of small vessels for the military navy , this type of composite is becoming attractive because of their reduced weight and improved corrosion resistance. However,a deep understating of oil ageing effect on composite structures is essential to ensure long-term performance and durability. in this work evaluate the effect of oil ageing on absorptıon behavıor and ımpact properties of glass/polyester composites manufactured with two types of fiber fabrics (fibreglass mat and fiberglass woven roving) and isophthalic polyester resin. The specimens obtained from commercial (GFRP) profiles made of unsaturated polyester resin were subjected to immersion in (i) marine oil for boats and (ii) salt water at ambient temperature for up to 1 month. The effects of such exposure conditions on this types of profile we analysed in what concerns their (i) mass change,(ii) mechanical response in impact, namely on the mechanical response – oil immersion caused a higher level of degradation, compared with salt water immersion;fracture surface examination by scanning electron microscopy revealed delamination, fiber debonding and resin crumbling due to oil effect.

Keywords: Marine Engine Oil, Absorption, Polyester, Glass Fibre

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167 Undoped and Fluorine Doped Zinc Oxide (ZnO:F) Thin Films Deposited by Ultrasonic Chemical Spray: Effect of the Solution on the Electrical and Optical Properties

Authors: E. Chávez-Vargas, M. de la L. Olvera-Amador, A. Jimenez-Gonzalez, A. Maldonado

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Undoped and fluorine doped zinc oxide (ZnO) thin films were deposited on sodocalcic glass substrates by the ultrasonic chemical spray technique. As the main goal is the manufacturing of transparent electrodes, the effects of both the solution composition and the substrate temperature on both the electrical and optical properties of ZnO thin films were studied. As a matter of fact, the effect of fluorine concentration ([F]/[F+Zn] at. %), solvent composition (acetic acid, water, methanol ratios) and ageing time, regarding solution composition, were varied. In addition, the substrate temperature and the deposition time, regarding the chemical spray technique, were also varied. Structural studies confirm the deposition of polycrystalline, hexagonal, wurtzite type, ZnO. The results show that the increase of ([F]/[F+Zn] at. %) ratio in the solution, decreases the sheet resistance, RS, of the ZnO:F films, reaching a minimum, in the order of 1.6 Ωcm, at 60 at. %; further increase in the ([F]/[F+Zn]) ratio increases the RS of the films. The same trend occurs with the variation in substrate temperature, as a minimum RS of ZnO:F thin films was encountered when deposited at TS= 450 °C. ZnO:F thin films deposited with aged solution show a significant decrease in the RS in the order of 100 ΩS. The transmittance of the films was also favorable affected by the solvent ratio and, more significantly, by the ageing of the solution. The whole evaluation of optical and electrical characteristics of the ZnO:F thin films deposited under different conditions, was done under Haacke’s figure of Merit in order to have a clear and quantitative trend as transparent conductors application.

Keywords: zinc oxide, ZnO:F, TCO, Haacke’s figure of Merit

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166 Social Ties and the Prevalence of Single Chronic Morbidity and Multimorbidity among the Elderly Population in Selected States of India

Authors: Sree Sanyal

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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.

Keywords: morbidity, multi-morbidity, prevalence, social ties

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165 Music Education in Aged Care: Positive Ageing through Instrumental Music Learning

Authors: Ellina Zipman

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This research investigates the place of music education in aged care facilities through the implementation of a program of regular piano lessons for residents. Using a qualitative case study methodology, the research explores aged care residents’ experiences in learning to play the piano. Since the aged care homes are unlikely places for formal learning and since older adults, especially in residential care, are not considered likely candidates for learning, this research opens the door for innovative and transformative thinking about where and to whom educational programs can be delivered. By addressing the educational needs of residents in aged care facilities, this research fills the gap in the literature. The research took place in Australia in two of Melbourne’s residential aged care facilities, engaging two residents (a nonagenarian female and an octogenarian male) to participate in 12-months weekly individual piano lessons. The data was collected through video recording of lessons, observations, interviews, emails, and a reflective journal. Data analysis was done using Nvivo and hard copy analysis with identifications of themes. The case studies revealed that passion for music was a major driver in participants’ motivation to engage in a long-term piano lessons program. This participation led to experiences of positive emotions, positive attitude, successes and challenges, the exercise of control, maintaining and building new relationships, improved self-confidence through autonomy and independent skills development, and discovering new identities through finding a new purpose and new roles in life. Speaking through participants’ voices, this research project demonstrates the importance of music education for older adults and hopes to influence transformation in the residential aged care sector.

Keywords: adult music education, quality of life, passion, positive ageing, wellbeing

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164 Illustrative Effects of Social Capital on Perceived Health Status and Quality of Life among Older Adult in India: Evidence from WHO-Study on Global AGEing and Adults Health India

Authors: Himansu, Bedanga Talukdar

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The aim of present study is to investigate the prevalence of various health outcomes and quality of life and analyzes the moderating role of social capital on health outcomes (i.e., self-rated good health (SRH), depression, functional health and quality of life) among elderly in India. Using WHO Study on Global AGEing and adults health (SAGE) data, with sample of 6559 elderly between 50 and above (Mage=61.81, SD=9.00) age were selected for analysis. Multivariate analysis accessed the prevalence of SRH, depression, functional limitation and quality of life among older adults. Logistic regression evaluates the effect of social capital along with other co-founders on SRH, depression, and functional limitation, whereas linear regression evaluates the effect of social capital with other co-founders on quality of life (QoL) among elderly. Empirical results reveal that (74%) of respondents were married, (70%) having low social action, (46%) medium sociability, (45%) low trust-solidarity, (58%) high safety, (65%) medium civic engagement and 37% reported medium psychological resources. The multivariate analysis, explains (SRH) is associated with age, female, having education, higher social action great trust, safety and greater psychological resources. Depression among elderly is greatly related to age, sex, education and higher wealth, higher sociability, having psychological resources. QoL is negatively associated with age, sex, being Muslim, whereas positive associated with higher education, currently married, civic engagement, having wealth, social action, trust and solidarity, safeness, and strong psychological resources.

Keywords: depressive symptom, functional limitation, older adults, quality of life, self rated health, social capital

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163 Dielectric Response Analysis Measurement for Diagnostic Oil-Paper Insulation System on Aged Inter Bus Transformer 3x10 MVA

Authors: Eki Farlen, Akas

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Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.

Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor

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162 Psychological Stress and Accelerated Aging in SCI Patients - A Longitudinal Pilot Feasibility Study

Authors: Simona Capossela, Ramona Schaniel, Singer Franziska, Aquino Fournier Catharine, Daniel Stekhoven, Jivko Stoyanov

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A spinal cord injury (SCI) is a traumatic life event that often results in ageing associated health conditions such as muscle mass decline, adipose tissue increase, decline in immune function, frailty, systemic chronic inflammation, and psychological distress and depression. Psychological, oxidative, and metabolic stressors may facilitate accelerated ageing in the SCI population with reduced life expectancy. Research designs using biomarkers of aging and stress are needed to elucidate the role of psychological distress in accelerated aging. The aim of this project is a feasibility pilot study to observe changes in stress biomarkers and correlate them with aging markers in SCI patients during their first rehabilitation (longitudinal cohort study). Biological samples were collected in the SwiSCI (Swiss Spinal Cord Injury Cohort Study) Biobank in Nottwil at 4 weeks±12 days after the injury (T1) and at the end of the first rehabilitation (discharge, T4). The "distress thermometer" is used as a selfassessment tool for psychological distress. Stress biomarkers, as cortisol and protein carbonyl content (PCC), and markers of cellular aging, such as telomere lengths, will be measured. 2 Preliminary results showed that SCI patients (N= 129) are still generally distressed at end of rehabilitation, however we found a statistically significant (p< 0.001) median decrease in distress from 6 (T1) to 5 (T4) during the rehabilitation. In addition, an explorative transcriptomics will be conducted on N=50 SCI patients to compare groups of persons with SCI who have different trajectories of selfreported distress at the beginning and end of the first rehabilitation after the trauma. We identified 4 groups: very high chronic stress (stress thermometer values above 7 at T1 and T4; n=14); transient stress (high to low; n=14), low stress (values below 5 at T1 and T4; n=14), increasing stress (low to high; n=8). The study will attempt to identify and address issues that may occur in relation to the design and conceptualization of future study on stress and aging in the SCI population.

Keywords: stress, aging, spinal cord injury, biomarkers

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161 Psychosocial Development: The Study of Adaptation and Development and Post-Retirement Satisfaction in Ageing Australians

Authors: Sahar El-Achkar, Mizan Ahmad

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Poor adaptation of developmental milestones over the lifespan can significantly impact emotional experiences and Satisfaction with Life (SWL) post-retirement. Thus, it is important to understand how adaptive behaviour over the life course can predict emotional experiences. Broadly emotional experiences are either Positive Affect (PA) or Negative Affect (NA). This study sought to explore the impact of successful adaptation of developmental milestones throughout one’s life on emotional experiences and satisfaction with life following retirement. A cross-sectional self-report survey was completed by 132 Australian retirees between the ages 55 and 70 years. Three hierarchical regression models were fitted, controlling for age and gender, to predict PA, NA, and SWL. The full model predicting PA was statistically significant overall, F (8, 121) = 17.97, p < .001, account for 57% of the variability in PA. Industry/Inferiority were significantly predictive of PA. The full model predicting NA was statistically significant overall, F (8, 121) = 12.00, p < .001, accounting for 51% of the variability in NA. Age and Trust/Mistrust were significantly predictive of NA. The full model predicting NA was statistically significant overall, F (8, 121) = 12.00, p < .001, accounting for 51% of the variability in NA. Age and Trust/Mistrust were significantly predictive of NA. The full model predicting SWL, F (8, 121) = 11.05, p < .001, accounting for 45% of the variability in SWL. Trust/Mistrust and Ego Integrity/Despair were significantly predictive of SWL. A sense of industry post-retirement is important in generating PA. These results highlight that individuals presenting with adaptation and identity issues are likely to present with adjustment challenges and unpleasant emotional experiences post-retirement. This supports the importance of identifying and understanding the benefits of successful adaptation and development throughout the lifespan and its significance for the self-concept. Most importantly, the quality of lives of many may be improved, and the future risk of continued poor emotional experiences and SWL post-retirement may be mitigated. Specifically, the clinical implications of these findings are that they support the promotion of successful adaption over the life course and healthy ageing.

Keywords: adaptation, development, negative affect, positive affect, retirement, satisfaction with life

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160 Analysis of the Role of Population Ageing on Crosstown Roads' Traffic Accidents Using Latent Class Clustering

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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159 The Study of Using Mon Dance in Pathum Thani Province’s Tradition

Authors: Dusittorn Ngamying

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This investigation of Mon Dance is focused on using in Pathum Thani Province’s tradition and has the following objectives: 1) to study the background of Mon dance in Pathum Thani Province; 2) to study Mon dance in Pathum Thani Province; 3) to study of using Mon Dance in Pathum Thani province’s tradition. This qualitative research was conducted in Pathum Thani provinces (the central of Thailand). Data was collected from a documentary study and field data by means of observation, interview and group discussion. Workshops were also held with a total of 100 attendees, comprised of 20 key informants, 40 casual informants and 40 general informants. Data was validated using a triangulation technique and findings are presented using descriptive analysis. The results of the studied showed that the historical background of Mon dance in Pathum Thani Province initiated during the war evacuation from Martaban (south of Burma) to settle down in Sam Khok, Pathum Thani Province in Ayutthaya period to Rattanakosin. The study found that Mon dance typically consists of 12 dancing process. The melodies have 12 songs. Piphat Mon (Mon traditional music ensemble) was used in the performance. The costume was dressed on Mon traditional. The performers were 6-12 women and depending on the employer’s demands. Length of the performance varied from the duration of music orchestration. Rituals and Customs were paying homage to teachers before the performance. The offerings were composed of flowers, incense sticks, candles, money gifts which were well arranged on a tray with pedestal, and also liquors, tobaccos and pure water for asking propitiousness. To using Mon Dance in Pathum Thani Province’s tradition, was found that it commonly performed in the funeral ceremonial tradition at present because the physical postures of the performance were graceful and exquisite as approved conservative. In addition, the value since the ancient time had believed that Mon Dance was the sacred thing considered as the dignity glorification especially for funeral ceremonies of the priest or royal hierarchy classes. However, Mon dance was continued to use in the traditions associated with Mon people activities in Pathum Thani Province, for instance, customary welcome for honor guest and Songkran Festival.

Keywords: Mon dance, Pathum Tani Province, tradition, triangulation technique

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158 Comparative Ante-Mortem Studies through Electrochemical Impedance Spectroscopy, Differential Voltage Analysis and Incremental Capacity Analysis on Lithium Ion Batteries

Authors: Ana Maria Igual-Munoz, Juan Gilabert, Marta Garcia, Alfredo Quijano-Lopez

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Nowadays, several lithium-ion battery technologies are being commercialized. These chemistries present different properties that make them more suitable for different purposes. However, comparative studies showing the advantages and disadvantages of different chemistries are incomplete or scarce. Different non-destructive techniques are currently being employed to detect how ageing affects the active materials of lithium-ion batteries (LIBs). For instance, electrochemical impedance spectroscopy (EIS) is one of the most employed ones. This technique allows the user to identify the variations on the different resistances present in LIBs. On the other hand, differential voltage analysis (DVA) has shown to be a powerful technique to detect the processes affecting the different capacities present in LIBs. This technique shows variations in the state of health (SOH) and the capacities for one or both electrodes depending on their chemistry. Finally, incremental capacity analysis (ICA) is a widely known technique for being capable of detecting phase equilibria. It reminds of the commonly used cyclic voltamperometry, as it allows detecting some reactions taking place in the electrodes. In these studies, a set of ageing procedures have been applied to commercial batteries of different chemistries (NCA, NMC, and LFP). Afterwards, results of EIS, DVA, and ICA have been used to correlate them with the processes affecting each cell. Ciclability, overpotential, and temperature cycling studies envisage how the charge-discharge rates, cut-off voltage, and operation temperatures affect each chemistry. These studies will serve battery pack manufacturers, as for common battery users, as they will determine the different conditions affecting cells for each of the chemistry. Taking this into account, each cell could be adjusted to the final purpose of the battery application. Last but not least, all the degradation parameters observed are focused to be integrated into degradation models in the future. This fact will allow the implementation of the widely known digital twins to the degradation in LIBs.

Keywords: lithium ion batteries, non-destructive analysis, different chemistries, ante-mortem studies, ICA, DVA, EIS

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157 The Role of Mass Sport Guidance in the Health Service Industry of China

Authors: Qiu Jian-Rong, Li Qing-Hui, Zhan Dong, Zhang Lei

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Facing the problem of the demand of economic restructuring and risk of social economy stagnation due to the ageing of population, the Health Service Industry will play a very important role in the structure of industry in the future. During the process, the orient of Chinese sports medicine as well as the joint with preventive medicine, and the integration with data bank and cloud computing will be involved.

Keywords: China, the health service industry, mass sport, data bank

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156 Evolutions of Structural Properties of Native Phospho Casein (NPC) Powder during Storage

Authors: Sarah Nasser, Anne Moreau, Alain Hedoux, Romain Jeantet, Guillaume Delaplace

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Background: Spray dryed powders containing some caseins are commonly produced in dairy industry. It is widely admitted that the structure of casein evolves during powder storage, inducing a loss of solubility. However few studies evaluate accurately the destabilization mechanisms at molecular and mesoscopic level, in particular for Native Phospho Casein powder (NPC). Consequently, at the state of the art, it is very difficult to assess which secondary structure change or crosslinks initiate insolubility during storage. To address this issue, controlled ageing conditions have been applied to a NPC powder (which was obtained by spray drying a concentrate containing a higher content of casein (90%), whey protein (8%) and lactose (few %)). Evolution of structure and loss of solubility, with the effects of temperature and time of storage were systematically reported. Methods: FTIR spectroscopy, Raman and Circular Dichroism were used to monitor changes of secondary structure in dry powder and in solution after rehydration. Besides, proteomic tools and electrophoresis have been performed after varying storage conditions for evaluating aggregation and post translational modifications, like lactosylation or phosphorylation. Finally, Tof Sims and MEB were used to follow in parallel evolution of structure in surface and skin formation due to storage. Results + conclusion: These results highlight the important role of storage temperature in the stability of NPC. It is shown that this is not lactosylation at the heart of formation of aggregates, as advanced in others publications This is almost the rise of multitude post translational modifications (chemical cross link), added to disulphide bridges (physical cross link) wich contribute to the destabilisation of structure and aggregation of casein. A relative quantification of each kind of cross link, source of aggregates, is proposed. In addition, it has been proved that migration of lipids and formation of skin in surface during the ageing also explains the evolution of structure casein and thus the alterations of functional properties of NPC powder.

Keywords: casein, cross link, powder, storage

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155 Socio-Sensorial Assessment of Nursing Homes in Singapore: Towards Integrated Enabling Design

Authors: Zdravko Trivic, John Chye Fung, Ruzica Bozovic-Stamenovic

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Within the context of rapidly ageing population in Singapore and the pressing demands on both caregivers and care providers, an integrated approach to ageing-friendly and ability-sensitive enabling environment becomes an imperative. This particularly applies to nursing home environments and their immediate surroundings, as they are becoming one of the main available options of long-term care for many senior adults who are unable to age at home. Yet, despite the considerable efforts to break the still predominant clinical approach to eldercare and to introduce more home-like design and person-centric care model, nursing homes keep being stigmatised and perceived as not so desirable environments to grow old in. The challenges are further emphasised by the associated physical, sensorial, psychological and cognitive declines that are the common consequences of ageing. Such declines have an immense impact on almost all aspects of older adults’ daily functioning, including problems with mobility and spatial orientation, difficulties in communication, withdrawal from social interaction, higher level of depression and decreased sense of independence and autonomy. However, typical nursing home designs tend to neglect the full capacities of balanced and carefully integrated multisensory stimuli as active component of care and ability building. This paper outlines part of a larger multi-disciplinary study of six nursing homes in Singapore, with overarching objectives to create new models of supportive nursing home environments that go beyond the clinical care model and encourage community integration with the nursing home settings. The paper focuses on the largely neglected aspects of sensorial comfort and multi-sensorial properties of nursing homes, including both indoor and immediate outdoor spaces (boundaries). The objective was to investigate the sensory rhythms and explore their role in nursing home users’ daily routine and therapeutic capacities. Socio-sensory rhythms were captured and analysed through a combination of on-site sensory recordings of “objective” quantitative sensory data (air temperature and humidity, sound level and luminance) using multi-function environment meter, perceived experienced data, spatial mapping, first-person observations of nursing home users’ activity patterns, and interviews. This was done in addition to employment of available assessment tools, such as Wisconsin Person Directed Care assessment tool, Dementia Quality of Life [DQoL] instrument, and Resident Environment Impact Scale [REIS], as these tools address the issues of sensorial experience insufficiently and selectively. Key findings indicate varied levels of sensory comfort, as well as diversity, intensity, and customisation of multi-sensory conditions within different nursing home spaces. Sensory stimulation is typically concentrated in communal living areas of the nursing homes or in the areas that often provide controlled or limited access, including specifically designed sensory rooms and outdoor green spaces (gardens and terraces). Opportunities for sensory stimulation are particularly limited for bed-bound senior residents and within more functional areas, such as corridors. This suggests that the capacities of nursing home designs to provide more diverse and better integrated pleasant sensory conditions as integrated “therapeutic devices” to build nursing home residents’ physical and mental abilities, encourage activity and improve wellbeing are far from exhausted.

Keywords: ageing-supportive environment, enabling design, multi-sensory assessment, nursing home environment

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154 Characterization of CuO Incorporated CMOS Dielectric for Fast Switching System

Authors: Nissar Mohammad Karim, Norhayati Soin

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To ensure fast switching in high-K incorporated Complementary Metal Oxide Semiconductor (CMOS) transistors, the results on the basis of d (NBTI) by incorporating SiO2 dielectric with aged samples of CuO sol-gels have been reported. Precursor ageing has been carried out for 4 days. The minimum obtained refractive index is 1.0099 which was found after 3 hours of adhesive UV curing. Obtaining a low refractive index exhibits a low dielectric constant and hence a faster system.

Keywords: refractive index, Sol-Gel, precursor aging, aging

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153 The Cost of Healthcare among Malaysian Community-Dwelling Elderly with Dementia

Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti

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An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.

Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion

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152 Frailty Patterns in the US and Implications for Long-Term Care

Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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151 An Exploratory Study of Entrepreneurial Satisfaction among Older Founders

Authors: Catarina Seco Matos, Miguel Amaral

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The developed world is facing falling birth rates and rising life expectancies. As a result, the overall demographic structure of societies is becoming markedly older. This leads to an economic and political pressure towards the extension of individuals’ working lives. On the other hand, evidence shows that some older workers choose to stay in the labour force as employees, whereas others choose to pursue a more entrepreneurial occupational path. Thus, entrepreneurship or self-employment may be an option for socioeconomic participation of older individuals. Previous research on senior entrepreneurship is scarce and it focuses mainly on entrepreneurship determinants and individuals’ intentions. The fact that entrepreneurship is perceived as a voluntary or involuntary decision or as a positive or a negative outcome by older individuals is, to the best of our knowledge, still unexplored in the literature. In order to analyse the determinants of entrepreneurial satisfaction among older individuals, primary data were obtained from a unique questionnaire survey, which was sent to Portuguese senior entrepreneurs who have launched their company aged 50 and over (N=181). Portugal is one of the countries in the world with the with the largest ageing population and with a high proportion of older individuals who remain active after their official retirement age – which makes it an extremely relevant case study on senior entrepreneurship. Findings suggest that non pecuniary factors (rather than pecuniary) are the main driver for entrepreneurship at older ages. Specifically, results show that the will to remain active is the main motivation of older individuals to become entrepreneurs. This is line with the activity and continuity theories. Furthermore, senior entrepreneurs tend to have had an active working life (using their professional experience as a proxy) and, thus, want to keep the same lifestyle at an older age (in line with theory of continuity). Finally, results show that even though older individuals’ companies may not show the best financial performance that does not seem to affect their satisfaction with the company and with entrepreneurship in general. The present study aims at exploring, discussing and bring new research on senior entrepreneurship to the fore, rather than assuming purely deductive approach; hence, further confirmatory analyses with larger sets from different countries of data are required.

Keywords: active ageing, entrepreneurship, older entrepreneur, Portugal, satisfaction, senior entrepreneur

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150 Thermal Perception by Older People in Open Spaces in Madrid: Relationships between Weather Parameters and Personal Characteristics

Authors: María Teresa Baquero, Ester Higueras

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One of the challenges facing 21st century cities, is their adaptation to the phenomenon of an ageing population. International policies have been developed, such as the "Global Network for Age-friendly Cities and Communities". These cities must recognize the diversity of the elderly population, and facilitate an active, healthy, satisfied aging and promote inclusion. In order to promote active and healthy aging, older people should be encouraged to engage in physical activity, sunbathe, socialize and enjoy the public open spaces in the city. Some studies recognize thermal comfort as one of the factors that most influence the use of public open spaces. However, although some studies have shown vulnerability to thermal extremes and environmental conditions in older people, there is little research on thermal comfort for older adults, because it is usually analyzed based on the characteristics of the ¨average young person¨ without considering the physiological, physical and psychological differences that characterize the elderly. This study analyzes the relationship between the microclimate parameters as air temperature, relative humidity, wind speed and sky view factor (SVF) with the personal thermal perception of older adults in three public spaces in Madrid, through a mixed methodology that combines weather measurements with interviews, made during the year 2018. Statistical test like Chi-square, Spearman, and analysis of variance were used to analyze the relationship between preference votes and thermal sensation votes with environmental and personal parameters. The results show that there is a significant correlation between thermal sensation and thermal preference with the measured air temperature, age, level of clothing, the color of clothing, season, time of the day and kind of space while no influence of gender or other environmental variables was detected. These data would contribute to the design of comfortable public spaces that improve the welfare of the elderly contributing to "active and healthy aging" as one of the 21st century challenges cities face.

Keywords: healthy ageing, older adults, outdoor public space, thermal perception

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149 Effect of Resistance Training on BDNF and Inflammatory Markers in Healthy Older Adults

Authors: Obinna Afamefuna Echi

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Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.

Keywords: ageing, resistance training, BDNF, cognitive function

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148 Adapting to Rural Demographic Change: Impacts, Challenges and Opportunities for Ageing Farmers in Prachin Buri Province, Thailand

Authors: Para Jansuwan, Kerstin K. Zander

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Most people in rural Thailand still depend on agriculture. The rural areas are undergoing changes in their demographic structures with an increasing older population, out migration of younger people and a shift away from work in the agricultural sector towards manufacturing and service provisioning. These changes may lead to a decline in agricultural productivity and food insecurity. Our research aims to examine perceptions of older farmers on how rural demographic change affects them, to investigate how farmers may change their agricultural practices to cope with their ageing and to explore the factors affecting these changes, including the opportunities and challenges arising from them. The data were collected through a household survey with 368 farmers in the Prachin Buri province in central Thailand, the main area for agricultural production. A series of binomial logistic regression models were applied to analyse the data. We found that most farmers suffered from age-related diseases, which compromised their working capacity. Most farmers attempted to reduce labour intense work, by either stopping farming through transferring farmland to their children (41%), stopping farming by giving the land to the others (e.g., selling, leasing out) (28%) and continuing farming with making some changes (e.g., changing crops, employing additional workers) (24%). Farmers’ health and having a potential farm successor were positively associated with the probability of stopping farming by transferring the land to the children. Farmers with a successor were also less likely to stop farming by giving the land to the others. Farmers’ age was negatively associated with the likelihood of continuing farming by making some changes. The results show that most farmers base their decisions on the hope that their children will take over the farms, and that without successor, farmers lease out or sell the land. Without successor, they also no longer invest in expansion and improvement of their farm production, especially adoption of innovative technologies that could help them to maintain their farm productivity. To improve farmers’ quality of life and sustain their farm productivity, policies are needed to support the viability of farms, the access to a pension system and the smooth and successful transfer of the land to a successor of farmers.

Keywords: rural demographic change, older farmer, stopping farming, continuing farming, health and age, farm successor, Thailand

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147 The Role and Impact of Cold Spray Technology on Surface Engineering

Authors: Ionel Botef

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Studies show that, for viable product realisation and maintenance, a spectrum of novel processing technologies and materials to improve performance and reduce costs and environmental impact must constantly be addressed. One of these technologies, namely the cold spray process, has enabled a broad range of coatings and applications, including many that have not been previously possible or commercially practical, hence its potential for new aerospace, electronics, or medical applications. Therefore, the purpose of this paper is to summarise the state of the art of this technology alongside its theoretical and experimental studies, and explore the role and impact of cold spraying on surface engineering.

Keywords: surface engineering, cold spray, ageing aircrafts, corrosion, microchannels, maintenance

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146 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

Procedia PDF Downloads 82