Search results for: elderly households
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1250

Search results for: elderly households

1130 Understanding Climate Change with Chinese Elderly: Knowledge, Attitudes and Practices on Climate Change in East China

Authors: Pelin Kinay, Andy P. Morse, Elmer V. Villanueva, Karyn Morrissey, Philip L Staddon, Shanzheng Zhang, Jingjing Liu

Abstract:

The present study aims to evaluate the climate change and health related knowledge, attitudes and practices (KAP) of the elderly population (60 years plus) in Hefei and Suzhou cities of China (n=300). This cross-sectional study includes 150 participants in each city. Data regarding demographic characteristics, KAP, and climate change perceptions were collected using a semi-structured questionnaire. When asked about the potential impacts of climate change over 79% of participants stated that climate change affected their lifestyle. Participants were most concerned about storms (51.7%), food shortage (33.3%) and drought (26%). The main health risks cited included water contamination (32%), air pollution related diseases (38.3%) and lung disease (43%). Finally, a majority (68.3%) did not report receiving government assistance on climate change issues. Logistic regression models were used to analyse the data in order to understand the links between socio-demographical factors and KAP of the participants. These findings provide insights for potential adaptation strategies targeting the elderly. It is recommended that government should take responsibility in creating awareness strategies to improve the coping capacity of elderly in China to climate change and its health impacts and develop climate change adaptation strategies.

Keywords: China, climate change, elderly, KAP

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1129 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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1128 Retirement and Tourism Consumption - Evidence from the Elderly in China

Authors: Sha Fan, Renuka Mahadevan

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In recent years, the subject of how retirement influences consumption behaviours has garnered attention in economic research. However, a significant gap persists in our understanding of how retirement precisely impacts tourism consumption patterns among the elderly demographic. To address this gap, this research conducts an in-depth exploration into the multifaceted relationship between retirement and elderly tourism consumption.To achieve this, the study employs regression discontinuity design, using three waves of panel data from China covering a span of six years. This approach aims to identify the causality between retirement and tourism consumption. Furthermore, the study scrutinizes the pathways through which retirement's impact on tourism consumption unfolds. It adopts a dual-pronged perspective, examining the roles played by economic status and the availability of leisure time. The economic dimension underscores the financial adjustments that retirees make as they transition into a new phase of life, impacting their propensity to allocate resources towards tourism activities. Meanwhile, considering leisure time recognizes that retirement often heralds an era of newfound freedom, allowing retirees the luxury to engage in leisurely pursuits like tourism.

Keywords: tourism consumption, retirement, the elderly, regression discontinuity design

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1127 Examining the Extent and Magnitude of Food Security amongst Rural Farming Households in Nigeria

Authors: Ajibade T., Omotesho O. A., Ayinde O. E, Ajibade E. T., Muhammad-Lawal A.

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This study was carried out to examine the extent and magnitude of food security amongst farming rural households in Nigeria. Data used for this study was collected from a total of two hundred and forty rural farming households using a two-stage random sampling technique. The main tools of analysis for this study include descriptive statistics and a constructed food security index using the identification and aggregation procedure. The headcount ratio in this study reveals that 71% of individuals in the study area were food secure with an average per capita calorie and protein availability of 4,213.92kcal and 99.98g respectively. The aggregated household daily calorie availability and daily protein availability per capita were 3,634.57kcal and 84.08g respectively which happens to be above the food security line of 2,470kcal and 65g used in this study. The food insecure households fell short of the minimum daily per capita calorie and protein requirement by 2.1% and 24.9%. The study revealed that the area is food insecure due to unequal distribution of the available food amongst the sampled population. The study recommends that the households should empower themselves financially in order to enhance their ability to afford the food during both on and off seasons. Also, processing and storage of farm produce should be enhanced in order to improve on availability throughout the year.

Keywords: farming household, food security, identification and aggregation, food security index

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1126 Turning Parameters Affect Time up and Go Test Performance in Pre-Frail Community-Dwelling Elderly

Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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1125 Assessing the Impact of Adopting Climate Smart Agriculture on Food Security and Multidimensional Poverty: Case of Rural Farm Households in the Central Rift Valley of Ethiopia

Authors: Hussien Ali, Mesfin Menza, Fitsum Hagos, Amare Haileslassie

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Climate change has perverse effects on agricultural productivity and natural resource base, negatively affecting the well-being of the households and communities. The government and NGOs promote climate smart agricultural (CSA) practices to help farmers adapt to and mitigate the negative effects of climate change. This study aims to identify widely available CSA practices and examine their impacts on food security and multi-dimensional poverty of rural farm households in the Central Rift Valley, Ethiopia. Using three-stage proportional to size sampling procedure, the study randomly selected 278 households from two kebeles from four districts each. A cross-sectional data of 2020/21 cropping season was collected using structured and pretested survey questionnaire. Food consumption score, dietary diversity score, food insecurity experience scale, and multidimensional poverty index were calculated to measure households’ welfare indicators. Multinomial endogenous switching regression model was used to assess average treatment effects of CSA on these outcome indicators on adopter and non-adopter households. The results indicate that the widely adopted CSA practices in the area are conservation agriculture, soil fertility management, crop diversification, and small-scale irrigation. Adopter households have, on average, statistically higher food consumption score, dietary diversity score and lower food insecurity access scale than non-adopters. Moreover, adopter households, on average, have lower deprivation score in multidimensional poverty compared to non-adopter households. Up scaling the adoption of CSA practices through the improvement of households’ implementation capacity and better information, technical advice, and innovative financing mechanisms is advised. Up scaling CSA practices can further promote achieving global goals such as SDG 1, SDG 2, and SDG 13 targets, aimed to end poverty and hunger and mitigate the adverse impacts of climate change, respectively.

Keywords: climate-smart agriculture, food security, multidimensional poverty, upscaling CSA, Ethiopia

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1124 A Real-time Classification of Lying Bodies for Care Application of Elderly Patients

Authors: E. Vazquez-Santacruz, M. Gamboa-Zuniga

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In this paper, we show a methodology for bodies classification in lying state using HOG descriptors and pressures sensors positioned in a matrix form (14 x 32 sensors) on the surface where bodies lie down. it will be done in real time. Our system is embedded in a care robot that can assist the elderly patient and medical staff around to get a better quality of life in and out of hospitals. Due to current technology a limited number of sensors is used, wich results in low-resolution data array, that will be used as image of 14 x 32 pixels. Our work considers the problem of human posture classification with few information (sensors), applying digital process to expand the original data of the sensors and so get more significant data for the classification, however, this is done with low-cost algorithms to ensure the real-time execution.

Keywords: real-time classification, sensors, robots, health care, elderly patients, artificial intelligence

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1123 Climate Change Impacts, Vulnerability, and Adaptation among Rural Households in Ethiopia

Authors: Birtukan Atinkut Asmare

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Climate change disproportionately affects many Africans who heavily rely on climate-exposed sectors such as rain-fed agriculture and fishing, rendering them highly vulnerable. Gender plays a significant role, as men and women experience unequal impacts and vulnerabilities due to gender norms, labor divisions, resource access, and power dynamics. Drawing on an integrated framework, this study sheds light on the gendered impacts of climate change on household’s livelihood, their vulnerability, and adaptation in rural Ethiopia's Lake Tana Basin. This study utilized mixed research methods, integrating diverse qualitative techniques such as focus group discussions, key informant interviews, and field observations, along with quantitative data gathered through household surveys. The findings reveal that women-headed households were more vulnerable to climate change than male-headed households. Flood was the major climate-induced hazards in the area that threatened the lives and livelihoods of households. In response to climate change, households undertook different adaptation measures such as agroforestry practices, crop diversification, seasonal migration, petty trading, charcoal and fuel wood sales. However, the adaptation strategies were slightly varied based on the gender of the household head. Women-headed households specifically engaged in fuelwood collection and selling and petty trading activities. The main constraints for adaptation were limited access to technologies, extension services, information, and financial services. Therefore, this research urges attention from research, policy, and advisory services on rural households who are trying to survive in the face of climate change.

Keywords: agriculture, climate change impacts, ethiopia, gender

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1122 Using Artificial Intelligence Method to Explore the Important Factors in the Reuse of Telecare by the Elderly

Authors: Jui-Chen Huang

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This research used artificial intelligence method to explore elderly’s opinions on the reuse of telecare, its effect on their service quality, satisfaction and the relationship between customer perceived value and intention to reuse. This study conducted a questionnaire survey on the elderly. A total of 124 valid copies of a questionnaire were obtained. It adopted Backpropagation Network (BPN) to propose an effective and feasible analysis method, which is different from the traditional method. Two third of the total samples (82 samples) were taken as the training data, and the one third of the samples (42 samples) were taken as the testing data. The training and testing data RMSE (root mean square error) are 0.022 and 0.009 in the BPN, respectively. As shown, the errors are acceptable. On the other hand, the training and testing data RMSE are 0.100 and 0.099 in the regression model, respectively. In addition, the results showed the service quality has the greatest effects on the intention to reuse, followed by the satisfaction, and perceived value. This result of the Backpropagation Network method is better than the regression analysis. This result can be used as a reference for future research.

Keywords: artificial intelligence, backpropagation network (BPN), elderly, reuse, telecare

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1121 Contribution of Income Diversification to Total Rural Households Income in the Upper East Region, Ghana

Authors: Yakubu Abdulai, Kenichi Matsui

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The agricultural industry has faced a variety of challenges in meeting the expanding income demand of the rural population. As a result, rural households must diversify their income sources to meet their income demand. Although income diversification strategies help rural households, it contributes to total household income, and the socio-demographic determinants are not known in the Upper East Region of Ghana. For these reasons, the purpose of this study was to determine the contribution of income diversification strategies to household income and the socio-demographic factors influencing it. We conducted a questionnaire survey among 360 rural households in the Upper East Region of Ghana. We asked about their socio-demographic information, their choice of income diversification strategies, and their remittances through rural-city migration. The questionnaire survey findings demonstrate that the main livelihood income source contributes 22%, and on-farm income diversification contributes the most to household total income (47%), followed by non-farm diversification income (16%) and off-farm diversification income (15%). Calculations from the income diversity index showed that the average income diversification strategy was 0.5 out of 1. The calculation of the income dependence index also showed that the average dependent on a particular source of income was 0.2 out of 1. All the respondents said household members temporarily migrate to contribute to household income through remittances. The results further reveal that their choice of income diversification is influenced by their age, educational background, experience, and farm size. The paper recommends the promotion of rural development policies that increase income-generating activities and educate rural households on how to increase returns from their investment.

Keywords: income diversification, poverty alleviation, rural households, upper east region

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1120 The Effectiveness of the Orem Self-Care Model on Single Parent Women’s General Health

Authors: Sahar Esmaeili, Ramezanali Ghaderi sanavi, Masoomeh Maarefvand, Samaneh Hosseinzadeh

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Introduction: Conducted researches reveal that nowadays, 60 percent of women around the world are the households. The adverse economic condition causes female-headed households and their children to be the most vulnerable people against social harm. Mainly a symptoms of mental illness such as depression, anxiety, obsession and aggression can be seen in female-headed households and their children are potentially exposed to issues such as crime-work, child labor in the black and informal jobs, education deprivation and malnutrition. The aim of this study is to evaluate the effect of Orem self-care education with the FGC technique on the public health of female-headed households. Methods: Sixty-four Female-headed householders who were supported by Saleh Foundation participated in a clinical trial study and were assigned to the case (n=32) and control (n=32) groups. The case group received 4-session Orem’s self-care education with family group conferencing technique. Data were collected using the demographic questionnaire and General Health Questionnaire (GHQ-28) prior to intervention and post-intervention. ANOVA was used to evaluate outcomes. Results: The results showed significant improvement of the intervention group in GHQ (P<0.001) and subscales of Physical Health (P<0.001) Agitation and Insomnia (P<0.001) and Social disorder (P<0.001) and Depression (P<0.001) compared with the control group after the intervention. Conclusion: The intervention of Orem’s self-care education with family group conferencing technique was effective in improving the General Health of Female-headed households

Keywords: orem’s self-care, female-headed households, general health, group

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1119 Obtaining Norms for Arabic Translated Version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Battery in Normal Elderly Omanis Attending a Tertiary Hospital in Oman

Authors: Ammar Alobaidy, Lamees Alsawafi, Malak Almawali, Balqees Alabri, Hajer Alhamrashdi

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Background: There is scarce data in the literature concerning the use of Arabic version neuron psychological cognitive tests in the geriatric age group of the Omani population. Objectives: Our aim is to obtain norms for normal elderly Omanis assessed by The Consortium to Establish a Registry for Alzheimer's disease (CERAD) neuro psychological battery and to compare these norms with other studies in the literature. Methods: 84 attendants and visitors of in-patients at Sultan Qaboos University Hospital, elder than 55 years, were interviewed. All participants were assessed by Dementia Rating Scale & Geriatric Depression Scale to ensure the integrity of their activities of daily living and the absence of depression, respectively. The performance of all participants in the CERAD battery was rated by a single rater to optimize the inter-rater reliability. Results: The cut-point for average performance in CERAD battery is dependent on the age, sex, and level of education and cannot be set as a single cut-point for all elderly Omanis. Conclusion: This study has shown the effect of age, sex, and level of education on the cognitive performance of normal elderly Omanis. The normative data obtained from this study can be utilized to differentiate between the cognitive decline of normal aging and the cognitive impairment due to various neuro cognitive disorders in the elderly Omanis, and probably culturally similar Arabic speaking communities.

Keywords: CERAD, neuropsychological battery, normal aging, elderly Omanis

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1118 The Effect of 8 Weeks Endurance Training and L-NAME on Apelin in Adipose Tissue, Glucose and Insulin in Elderly Male's Rats

Authors: Asieh Abbassi Daloii, Fatemeh Fani, Ahmad Abdi

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Objective: The aim of this study was to determine the effect of 8 weeks endurance training and L-NAME on apelin in adipose tissue, glucose and insulin in elderly male’s rats. Methods: For this purpose, 24 vistar elderly rats with average 20 months old purchased from Razi Institute and transferred to Research Center were randomly divided into four groups: 1. control, 2. training, 3.training and L-NAME and 4. L-NAME. Training protocol performed for 8 weeks and 5 days a week with 75-80 VO2 max. All rats were killed 72 hours after the final training session and after 24 hours of fasting adipose tissue samples were collected and kept in -80. Also, Data was analyzed with One way ANOVA and Tucky in p < 0/05. Results: The results showed that the inhibition of nitric oxide on apelin in adipose tissue of adult male rats after eight weeks of endurance training increased significantly compared to the control group (p < 0.00). Also, the results showed no significant difference between the levels of insulin and glucose groups. Conclusion: It is likely that the increased apelin in adipose tissue in mice independent of insulin and glucose.

Keywords: endurance training, L-NAME, apelin in adipose tissue, elderly male rats

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1117 Inclusive Business and Its Contribution to Farmers Wellbeing in Arsi Ethiopia: Empirical Evidence

Authors: Senait G. Worku, Ellen Mangnus

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Inclusive business models which integrates low-income people with companies value chain in a commercially viable way has gained momentum for the perceived potential to contribute to poverty alleviation and food security in developing countries. This article investigates the impact of Community Revenue Enhancement through Technology Extension (CREATE) project of Heineken brewery on smallholder farmers’ wellbeing in Arsi zone Oromia regional state of Ethiopia. CREATE is a Public-Private Partnership (PPP) between Ministry of Foreign Affairs of the Netherlands and Heineken N.V. which source malt barely from smallholder farmers in three zones of Oromia. The study assessed the impact of CREATE on malt barley productivity, food security and new asset purchase in Arsi zone by comparing households that participate in the project with non-participating households using propensity score matching method. The finding indicated that households that participated in the CREATE project had higher malt barley productivity and purchased more new assets than non-participating households. However, there is no significant difference on food security status of participating and non-participating households indicating that the project has a profound impact on asset accumulation than on food security improvement.

Keywords: inclusive business, malt barley, propensity score matching, wellbeing

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1116 Food Insecurity Determinants Amidst the Covid-19 Pandemic: An Insight from Huntsville, Texas

Authors: Peter Temitope Agboola

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Food insecurity continues to affect a large number of U.S households during this coronavirus COVID-19 pandemic. The pandemic has threatened the livelihoods of people, making them vulnerable to severe hardship and has had an unanticipated impact on the U.S economy. This study attempts to identify the food insecurity status of households and the determinant factors driving household food insecurity. Additionally, it attempts to discover the mitigation measures adopted by households during the pandemic in the city of Huntsville, Texas. A structured online sample survey was used to collect data, with a household expenditures survey used in evaluating the food security status of the household. Most survey respondents disclosed that the COVID-19 pandemic had affected their life and source of income. Furthermore, the main analytical tool used for the study is descriptive statistics and logistic regression modeling. A logistic regression model was used to determine the factors responsible for food insecurity in the study area. The result revealed that most households in the study area are food secure, with the remainder being food insecure.

Keywords: food insecurity, household expenditure survey, COVID-19, coping strategies, food pantry

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1115 Explaining the Role of Iran Health System in Polypharmacy among the Elderly

Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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1114 Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life

Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: ethnographic study, health care needs, Malay elderly people, Malaysia, Quality of life, Residential home

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1113 Catastrophic Health Expenditures: Evaluating the Effectiveness of Nepal's National Health Insurance Program Using Propensity Score Matching and Doubly Robust Methodology

Authors: Simrin Kafle, Ulrika Enemark

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Catastrophic health expenditure (CHE) is a critical issue in low- and middle-income countries like Nepal, exacerbating financial hardship among vulnerable households. This study assesses the effectiveness of Nepal’s National Health Insurance Program (NHIP), launched in 2015, to reduce out-of-pocket (OOP) healthcare costs and mitigate CHE. Conducted in Pokhara Metropolitan City, the study used an analytical cross-sectional design, sampling 1276 households through a two-stage random sampling method. Data was collected via face-to-face interviews between May and October 2023. The analysis was conducted using SPSS version 29, incorporating propensity score matching to minimize biases and create comparable groups of enrolled and non-enrolled households in the NHIP. PSM helped reduce confounding effects by matching households with similar baseline characteristics. Additionally, a doubly robust methodology was employed, combining propensity score adjustment with regression modeling to enhance the reliability of the results. This comprehensive approach ensured a more accurate estimation of the impact of NHIP enrollment on CHE. Among the 1276 samples, 534 households (41.8%) were enrolled in NHIP. Of them, 84.3% of households renewed their insurance card, though some cited long waiting times, lack of medications, and complex procedures as barriers to renewal. Approximately 57.3% of households reported known diseases before enrollment, with 49.8% attending routine health check-ups in the past year. The primary motivation for enrollment was encouragement from insurance employees (50.2%). The data indicates that 12.5% of enrolled households experienced CHE versus 7.5% among non-enrolled. Enrollment into NHIP does not contribute to lower CHE (AOR: 1.98, 95% CI: 1.21-3.24). Key factors associated with increased CHE risk were presence of non-communicable diseases (NCDs) (AOR: 3.94, 95% CI: 2.10-7.39), acute illnesses/injuries (AOR: 6.70, 95% CI: 3.97-11.30), larger household size (AOR: 3.09, 95% CI: 1.81-5.28), and households below the poverty line (AOR: 5.82, 95% CI: 3.05-11.09). Other factors such as gender, education level, caste/ethnicity, presence of elderly members, and under-five children also showed varying associations with CHE, though not all were statistically significant. The study concludes that enrollment in the NHIP does not significantly reduce the risk of CHE. The reason for this could be inadequate coverage, where high-cost medicines, treatments, and transportation costs are not fully included in the insurance package, leading to significant out-of-pocket expenses. We also considered the long waiting time, lack of medicines, and complex procedures for the utilization of NHIP benefits, which might result in the underuse of covered services. Finally, gaps in enrollment and retention might leave certain households vulnerable to CHE despite the existence of NHIP. Key factors contributing to increased CHE include NCDs, acute illnesses, larger household sizes, and poverty. To improve the program’s effectiveness, it is recommended that NHIP benefits and coverage be expanded to better protect against high healthcare costs. Additionally, simplifying the renewal process, addressing long waiting times, and enhancing the availability of services could improve member satisfaction and retention. Targeted financial protection measures should be implemented for high-risk groups, and efforts should be made to increase awareness and encourage routine health check-ups to prevent severe health issues that contribute to CHE.

Keywords: catastrophic health expenditure, effectiveness, national health insurance program, Nepal

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1112 Pain Intensity, Functional Disability and Physical Activity among Elderly Individuals with Chronic Mechanical Low Back Pain

Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

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Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

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1111 Effects of Knowledge on Fruit Diets by Integrating Posters and Actual-Sized Fruit Models in Health Education for Elderly Patients with Type 2 Diabetes Mellitus

Authors: Suchada Wongsawat

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The objectives of this quasi-experiment were: 1) to compare pretest and posttest scores of the experimental group who were given health education on the “Fruit Diets for Elderly Patients with Type 2 Diabetes Mellitus”; and 2) to compare the posttest scores between experimental group and controlled group. The samples of this study were elderly patients with type 2 Diabetes Mellitus at Tambon Kanai Health Promoting Hospital, Thailand. The samples were randomly assigned to experimental and controlled groups, with 30 patients in each group. Statistics used in the data analysis included frequency, percentage, average, standard deviation, paired t-test and independent t-test. The study revealed that the patients in the experimental group had significantly higher posttest scores than the pretest scores in the health education at the .05 statistical level. The posttest scores of the experimental group in the health education were significantly higher than the controlled group at the .05 statistical level.

Keywords: fruit, health education, elderly, diabetes

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1110 Relationship Between tcdA and tcdB Genes of Clostridium difficile with Duration of Diarrhea in Elderly Patients

Authors: Ni Luh Putu Harta Wedari

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Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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1109 Household Food Insecurity and Associated Coping Strategies in Urban, Peri-Urban and Rural Settings: A Case of Morogoro and Iringa Towns, Tanzania

Authors: U. Tumaini, J. Msuya

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Food insecurity is a worrying challenge worldwide with sub-Saharan Africa including Tanzania being the most affected. Although factors that influence household food access security status and ways of coping with such factors have been examined, little has been reported on how these coping strategies vary along the urban-rural continuum especially in medium-sized towns. The purpose of this study was to identify food insecurity coping strategies employed by households and assess whether they are similar along the urban-rural continuum. The study was cross-sectional in design whereby a random sample of 279 households was interviewed using structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 20 software. It was revealed that the proportion of households relying on less preferred and quality foods, eating fewer meals per day, undertaking work for food or money, performing farm and off-farm activities, and selling fall back assets was higher in rural settings compared to urban and peri-urban areas. Similarly, more households in urban and peri-urban areas cope with food access insecurity by having strict food budgets compared to those in rural households (p ≤ 0.001). The study concludes that food insecurity coping strategies vary significantly from one spatial entity to another. It is thereby recommended that poor, particularly rural households should be supported to diversify their income-generating activities not only for food security purposes during times of food shortage but also as businesses aimed at increasing their household incomes.

Keywords: food coping strategies, household food insecurity, medium-sized towns, urban-rural continuum

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1108 The Effects of in vitro Digestion on Cheese Bioactivity; Comparing Adult and Elderly Simulated in vitro Gastrointestinal Digestion Models

Authors: A. M. Plante, F. O’Halloran, A. L. McCarthy

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By 2050 it is projected that 2 billion of the global population will be more than 60 years old. Older adults have unique dietary requirements and aging is associated with physiological changes that affect appetite, sensory perception, metabolism, and digestion. Therefore, it is essential that foods recommended and designed for older adults promote healthy aging. To assess cheese as a functional food for the elderly, a range of commercial cheese products were selected and compared for their antioxidant properties. Cheese from various milk sources (bovine, goats, sheep) with different textures and fat content, including cheddar, feta, goats, brie, roquefort, halloumi, wensleydale and gouda, were initially digested with two different simulated in vitro gastrointestinal digestion (SGID) models. One SGID model represented a validated in vitro adult digestion system and the second model, an elderly SGID, was designed to consider the physiological changes associated with aging. The antioxidant potential of all cheese digestates was investigated using in vitro chemical-based antioxidant assays, (2,2-Diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, ferric reducing antioxidant power (FRAP) and total phenolic content (TPC)). All adult model digestates had high antioxidant activity across both DPPH ( > 70%) and FRAP ( > 700 µM Fe²⁺/kg.fw) assays. Following in vitro digestion using the elderly SGID model, full-fat red cheddar, low-fat white cheddar, roquefort, halloumi, wensleydale, and gouda digestates had significantly lower (p ≤ 0.05) DPPH radical scavenging properties compared to the adult model digestates. Full-fat white cheddar had higher DPPH radical scavenging activity following elderly SGID digestion compared to the adult model digestate, but the difference was not significant. All other cheese digestates from the elderly model were comparable to the digestates from the adult model in terms of radical scavenging activity. The FRAP of all elderly digestates were significantly lower (p ≤ 0.05) compared to the adult digestates. Goats cheese was significantly higher (p ≤ 0.05) in FRAP (718 µM Fe²/kg.fw) compared to all other digestates in the elderly model. TPC levels in the soft cheeses (feta, goats) and low-fat cheeses (red cheddar, white cheddar) were significantly lower (p ≤ 0.05) in the elderly digestates compared to the adult digestates. There was no significant difference in TPC levels, between the elderly and adult model for full-fat cheddar (red, white), roquefort, wensleydale, gouda, and brie digestates. Halloumi cheese was the only cheese that was significantly higher in TPC levels following elderly digestion compared to adult digestates. Low fat red cheddar had significantly higher (p ≤ 0.05) TPC levels compared to all other digestates for both adult and elderly digestive systems. Findings from this study demonstrate that aging has an impact on the bioactivity of cheese, as antioxidant activity and TPC levels were lower, following in vitro elderly digestion compared to the adult model. For older adults, soft cheese, particularly goats cheese, was associated with high radical scavenging and reducing power, while roquefort cheese had low antioxidant activity. Also, elderly digestates of halloumi and low-fat red cheddar were associated with high TPC levels. Cheese has potential as a functional food for the elderly, however, bioactivity can vary depending on the cheese matrix. Funding for this research was provided by the RISAM Scholarship Scheme, Cork Institute of Technology, Ireland.

Keywords: antioxidants, cheese, in-vitro digestion, older adults

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1107 The Valuation of Employees Provident Fund on Long Term Care Cost among Elderly in Malaysia

Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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1106 The Role of Spiritual Experience, Gerotranscendence and Social Engagement on Successful Aging among Incarcerated Filipino Elderly: A Structural Equation Model

Authors: Les Paul Valdez, Rowena Manzarate, Joseph Carl Lunizo, Mary Thereze Mabaquiao, Mary Deo Luigi Mabunay

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Background: Across the literature, varying definitions of successful aging can be found. As a result, several determinants have been associated with successful aging. However, there is a paucity of literature exploring the relationship between successful aging and factors such as spiritual experience, gerotranscendence, and social engagement. Objective: Thus, this study purports to ascertain the relationship between and among spiritual experience, gerotranscendence, social engagement and successful aging. Methods: The Daily Spiritual Experience Scale (DSES), Social Engagement Scale (SES), Gerotranscendence Scale Revised (GS-R) and Expectations Regarding Aging (ERA) were fielded to 349 incarcerated elderly to measure spiritual experience, social engagement, gerotranscendence and successful aging respectively. Data was analyzed using Structural Equation Modelling through AMOS 21. The hypothesized model was evaluated using the goodness of fit and parsimony indices. Results: Social engagement (β= .179, p=.128) and spiritual experience (β= .375, p=.262) contribute to successful aging through the mediating effect of gerotranscendence (β= .973, p=.718). Conclusion: Today more than ever, healthcare providers in penal institutions are challenged to ensure that incarcerated elderly are socially and spiritually engaged; and have high levels of gerotranscendence.

Keywords: elderly, Filipino, gerotranscendence, social engagement, spiritual experience, successful aging

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1105 Social Capital and Adoption of Sustainable Management Practices of Non Timber Forest Product in Cameroon

Authors: Eke Bala Sophie Michelle

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The renewable resource character of NTFPs is an opportunity to its sustainability, this study analyzed the role of social capital in the adoption of sustainable management practices of NTFPs by households in the community forest (CF) Morikouali-ye. The analysis shows that 67% of households surveyed perceive the level of degradation of NTFPs in their CF as time passes and are close to 74% for adoption of sustainable management practices of NTFPs that are domestication, sustainable management of the CF, the logging ban trees and uprooting plants, etc. 26% refused to adopt these practices estimate that, at 39% it is better to promote logging in the CF. The estimated probit model shows that social capital through trust, solidarity and social inclusion significantly influences the probability of households to adopt sustainable NTFP management practices. In addition, age, education level and income from the sale of NTFPs have a significant impact on the probability of adoption. The probability of adoption increases with the level of education and confidence among households. So should they be animated by a spirit of solidarity and trust and not let a game of competition for sustainable management of NTFPs in their CF.

Keywords: community forest, social capital, NTFP, trust, solidarity, social inclusion, sustainable management

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1104 Providing Resilience: An Overview of the Actions in an Elderly Suburban Area in Rio de Janeiro

Authors: Alan Silva, Carla Cipolla

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The increase of life expectancy in the world is a current challenge for governments, demanding solutions towards elderly people. In this context, service design and age-friendly design appear as an approach to create solutions which favor active aging by social inclusion and better life quality. In essence, the age-friendly design aims to include elderly people in the democratic process of creation in order to strengthen the participation and empowerment of them through intellectual, social, civic, recreational, cultural and spiritual activities. All of these activities aim to provide resilience to this segment by granting access to the reserves needed for adaptation and growth in the face of life's challenges. On that approach, the following research brings an overview of the actions related to the integration and social qualification of the elderly people, considering a suburban area of Rio de Janeiro. Based on Design Thinking presented by Brown (2009), this research has a qualitative-exploratory approach demanding certain necessities and actions, which are collected through observation and interviews about the daily life of the elderly community individuals searching for information about personal capacitation and social integration of the studied population. Subsequently, a critical analysis is done on this overview, pointing out the potentialities and limitations of these actions. At the end of the research, a well-being map of solutions classified as physical, mental and social is created, also indicating which current services are relevant and which activities can be transformed into services to that community. In conclusion, the contribution of this research is the construction of a map of solutions that provides resilience to the studied public and favors the concept of active aging in society. From this map of solutions, it is possible to discriminate what are the resources necessary for the solutions to be operationalized and their journeys with the users of the elderly segment.

Keywords: resilience, age-friendly design, service design, active aging

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1103 Smartphone Addiction and Reaction Time in Geriatric Population

Authors: Anjali N. Shete, G. D. Mahajan, Nanda Somwanshi

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Context: Smartphones are the new generation of mobile phones; they have emerged over the last few years. Technology has developed so much that it has become part of our life and mobile phones are one of them. These smartphones are equipped with the capabilities to display photos, play games, watch videos and navigation, etc. The advances have a huge impact on many walks of life. The adoption of new technology has been challenging for the elderly. But, the elder population is also moving towards digitally connected lives. As age advances, there is a decline in the motor and cognitive functions of the brain, and hence the reaction time is affected. The study was undertaken to assess the usefulness of smartphones in improving cognitive functions. Aims and Objectives: The aim of the study was to observe the effects of smartphone addiction on reaction time in elderly population Material and Methods: This is an experimental study. 100 elderly subjects were enrolled in this study randomly from urban areas. They all were using smartphones for several hours a day. They were divided into two groups according to the scores of the mobile phone addiction scale (MPAS). Simple reaction time was estimated by the Ruler drop method. The reaction time was then calculated for each subject in both groups. The data were analyzed using mean, standard deviation, and Pearson correlation test. Results: The mean reaction time in Group A is 0.27+ 0.040 and in Group B is 0.20 + 0.032. The values show a statistically significant change in reaction time. Conclusion: Group A with a high MPAS score has a low reaction time compared to Group B with a low MPAS score. Hence, it can be concluded that the use of smartphones in the elderly is useful, delaying the neurological decline, and smarten the brain.

Keywords: smartphones, MPAS, reaction time, elderly population

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1102 The Relationship between Elderly People with Depression and Built Environment Factors

Authors: Hung-Chun Lin, Tzu-Yuan Chao

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As the population aging has become an inevitable trend globally, issues of improving the well-being of elderly people in urban areas have been a challenging task for urban planners. Recent studies of ageing trend have also expended to explore the relationship between the built environment and mental condition of elderly people. These studies have proved that even though the built environment may not necessarily play the decisive role in affecting mental health, it can have positive impacts on individual mental health by promoting social linkages and social networks among older adults. There has been a great amount of relevant research examined the impact of the built environment attributes on depression in the elderly; however, most were conducted in the Western countries. Little attention has been paid in Asian cities with contrarily high density and mix-use urban contexts such as Taiwan regarding how the built environment attributes related to depression in elderly people. Hence, more empirical cross-principle studies are needed to explore the possible impacts of Asia urban characteristics on older residents’ mental condition. This paper intends to focus on Tainan city, the fourth biggest metropolis in Taiwan. We first analyze with data from National Health Insurance Research Database to pinpoint the empirical study area where residing most elderly patients, aged over 65, with depressive disorders. Secondly, we explore the relationship between specific attributes of the built environment collected from previous studies and elderly individuals who suffer from depression, under different socio-cultural and networking circumstances. To achieve the results, the research methods adopted in this study include questionnaire and database analysis, and the results will be proceeded by correlation analysis. In addition, through literature review, by generalizing the built environment factors that have been used in Western research to evaluate the relationship between built environment and older individuals with depressive disorders, a set of local evaluative indicators of the built environment for future studies will be proposed as well. In order to move closer to develop age-friendly cities and improve the well-being for the elderly in Taiwan, the findings of this paper can provide empirical results to grab planners’ attention for how built environment makes the elderly feel and to reconsider the relationship between them. Furthermore, with an interdisciplinary topic, the research results are expected to make suggestions for amending the procedures of drawing up an urban plan or a city plan from a different point of view.

Keywords: built environment, depression, elderly, Tainan

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1101 Microeconomic Consequences of the Housing Market Deformation in the Selected Region of the Czech Republic

Authors: Hana Janáčková

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Housing can be sorted as basic needs of households. Purchase of acceptable ownership housing is important investments for most them. For rental housing households must consider the part of rent expenditure paid in the total household income. For this reason, financial considerations of households in this area depend on the government innervations (public administration) in housing - on housing policy. Market system of housing allocation, whether ownership or tenancy, is based on the fact that housing is a scarce good. The allocation of housing is based on demand and supply. The market system of housing can sometimes have a negative impact on some households, the market is unable to satisfy certain groups of the population that are not able or willing to accept market price. For these reasons, there is a more or less regulation of the market. Regulation is both on the demand and supply side, and the state determines the rules of behaviour for all economic entities of the housing market. This article submits results of analysis of selected regulatory interference of the state in the housing market and assesses their implications deforming the market in the selected region of the Czech Republic. The first part describes tools of supports and the second part discusses deformations and analyses their consequences on the demand side of housing market and on supply side.

Keywords: housing, housing market, microeconomic consequences, deformation

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