Search results for: treatment in older adults

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Karen J. Polvado, Betty Bowles, Jansen Lauren, Gibson Martha, Robin Lockhart

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The purpose of this study was to identify motivation to participate in the Hotter ‘n Hell Hundred (HHH) bicycling event, and the participants’ demographics, health risk factors, and preparation to ride in the event. A convenience sample of adults pre-registered for non-competitive cycling events (N = 7,472) were requested to complete a survey. Of these, 2,645 (35%) responded. Questions identified the participants’ demographics, preparation, previous experience with HHH, and motives for riding. The HHH attracted riders of all ages (18-80), genders, ethnicities, and educational levels. The majority were males, 40-59 years old, married, college graduates, and identified themselves as non-Hispanic whites. The majority (68%) reported no existing medical conditions, and were normal weight (70%), although 52% had been overweight or obese in the past. Preparation to ride in the HHH varied from riding more than five times a week for the last year, to riding 1-2 times per week one month before the event. Most (93%) had ridden in the HHH an average of 5 times. Motivations to ride included: personal challenge (75%); to experience the HHH ride (57%); a chance to ride with family/friends/coworkers (52%); improving health (47%); fun (33%); challenge by others (15%); part of a weight loss plan (11%); training for another event (10%); and raising money for a cause (2%). The motivation to participate appeared to move from extrinsic to intrinsic motivation as age increased. Exploration of the exercise habits and motivations of older adults (70+) is suggested by this study.

Keywords: cycling, motivation, physical activity, training

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Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

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This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

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Authors: Ibrahim Ahmed, Richard Amoateng, Akhil Jain, Mohamed Ahmed

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Alcoholic cardiomyopathy (ACM) is a type of acquired cardiomyopathy caused by chronic alcohol consumption. Frequently ACM is associated with arrhythmias such as atrial flutter. Our aim was to characterize the patient demographics and investigate the effect of atrial flutter (AF) on ACM. This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of alcoholic cardiomyopathy and atrial flutter from 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size, and teaching status. The primary outcome was all-cause mortality, and secondary outcomes were the length of stay (LOS) and total charge in USD. There was a total of 21,855 admissions with alcoholic cardiomyopathy, of which 1,635 had atrial flutter (AF-ACM). Compared to Non-AF-ACM cohort, AF-ACM cohort had fewer females (4.89% vs 14.54%, p<0.001), were older (58.66 vs 56.13 years, p<0.001), fewer Native Americans (0.61% vs2.67%, p<0.01), had fewer smaller (19.27% vs 22.45%, p<0.01) & medium-sized hospitals (23.24% vs28.98%, p<0.01), but more large-sized hospitals (57.49% vs 48.57%, p<0.01), more Medicare (40.37% vs 34.08%, p<0.05) and fewer Medicaid insured (23.55% vs 33.70%, p=<0.001), fewer hypertension (10.7% vs 15.01%, p<0.05), and more obesity (24.77% vs 16.35%, p<0.001). Compared to Non-AF-ACM cohort, there was no difference in AF-ACM cohort mortality rate (6.13% vs 4.20%, p=0.0998), unadjusted mortality OR 1.49 (95% CI 0.92-2.40, p=0.102), adjusted mortality OR 1.36 (95% CI 0.83-2.24, p=0.221), but there was a difference in LOS 1.23 days (95% CI 0.34-2.13, p<0.01), total charge $28,860.30 (95% CI 11,883.96-45,836.60, p<0.01). In patients admitted with ACM, the presence of AF was not associated with a higher all-cause mortality rate or odds of all-cause mortality; however, it was associated with 1.23 days increase in LOS and a $28,860.30 increase in total hospitalization charge. Native Americans, older age and obesity were risk factors for the presence of AF in ACM.

Keywords: alcoholic cardiomyopathy, atrial flutter, cardiomyopathy, arrhythmia

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Authors: Ghassen Kharroubi, Ines Cherif, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret McCarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Influenza vaccination (IV) is recommended for elderly persons, especially those with underlying conditions. In countries where IV rates in the elderly remain unsatisfactory, exploring attitudes of older persons toward the flu vaccine could be useful to identify barriers and facilitators to IV. The aim of this study was to determine the reasons for IV acceptance or decline in the Tunisian elderly. A national cross-sectional study was conducted in 2019, among persons aged 60 years and over with chronic disease. Data were collected using a standard administered questionnaire. Of the 1191 older persons included, 19.4% received the influenza vaccine in the 2018-2019 flu season. The two main reasons that may lead to refusal of vaccination were concerns that the vaccine could cause side effects (71.5%) and a belief that the vaccine was ineffective (33.9%). The main reason that may lead to accepting vaccination was a doctor’s recommendation (41.1%). Doctors were by far the most trusted source for information regarding influenza vaccine (91.5%) followed by pharmacists (17.6%). Our results highlighted the important role that doctors could play in promoting IV among the Tunisian elderly. Physicians should correct misconceptions about adverse events and the efficiency of the vaccine. In fact, influenza vaccines are generally effective and safe among older persons.

Keywords: attitudes, influenza vaccination, older persons, Tunisia

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Authors: Miramar Damanhouri

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This study examines the relationship between language use in computer-mediated communication and the social identity of the user. The data were collected by surveying 298 Saudi bilingual speakers who are familiar with Arabizi, a blend of Latin characters and Arabic numerals to transliterate Arabic sounds, and then analyzed quantitatively by running tests for statistical confidence in order to determine differences in perceptions between young adults (ages 15-25 years) and middle-aged adults (ages 26-50 years). According to the findings of this study, English is the dominant language among most of the young adults surveyed, and when they do use Arabic, they use Arabizi because of its flexibility, compatibility with modern technology, and its acceptance among people of their age and sociocultural backgrounds. On the other hand, most middle-aged adults surveyed here tend to use Arabic, as they believe that they should show their loyalty to their origin. The results of the study demonstrate a mutual relationship between language use in computer-mediated communication and the user’s social identity, as language is used both to reflect and construct that identity.

Keywords: Arabizi, computer mediated communication, digital communication, language use

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Authors: S. Saleem, L. J. Mason, M. Hasan, M. Sagheer, Q. Ali, S. Akhtar, C. M. S. Hanif

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Ozone has been documented as a potential fumigant against major insect pests of stored commodities due to its highly oxidative properties. Present studies were conducted in the Smith Hall (Department of Entomology), Purdue University, USA, to examine the fumigant toxicities of ozone gas (O₃) against stored grain insect pests. Adults of Tribolium castaneum and Cryptolestes ferrugineus were exposed to different concentrations (100, 200, 480, 700, and 800 ppm) of ozone gas. Test insects were fumigated by keeping a constant temperature of 27 ± 2 °C and 75 ± 5% relative humidity, while dead insects were recorded after 6, 12, 18, 24, 30, and 36 hr of treatment. C. ferrugineus was found susceptible, with mean mortality of 90.99% as compared to T. castaneum (53.22%). Fumigation, even with lower concentrations (100 ppm) of ozone gas for 36 hr, exhibited 100% mortality against C. ferrugineus. Mortality increased with the increase in concentration and exposure time. 100% mortality was achieved with 800 ppm concentration after 18hr of treatment against T. castaneum and with 700 ppm after 6 hr of treatment against C. ferrugineus.

Keywords: ozone gas, toxicity, O₃, Tribolium castaneum, Cryptolestes ferrugineus, stored grain insect pests

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Authors: Mary Butler

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Background: Screening programmes for older drivers in Europe (though not the UK), and in many states in the US and in Australia are based on medical assessment of fitness to drive. These programmes require physicians (including general practitioners) to carry out an assessment of fitness to drive in their offices. In 2006, New Zealand changed from doing on-road driving tests with all older drivers from the age of 80, to a screening programme that uses medical assessment of fitness to drive only. Aim: This study set out to understand the experience of New Zealand GPs as they manage the process of medical assessment of fitness to drive assessments for older people. In particular, it aimed to establish how GPs understand the role of specialist driving assessment and rehabilitation carried out by occupational therapists. Design and setting: The study used an interpretive descriptive approach to analyze data from ten interviews with GPs in New Zealand. Results: The results indicated that GPs lack understanding about how occupational therapists can assist their patients, and tend to refer only when there is a disagreement with the patient. Conclusion: There are problems with the medical assessment of fitness to drive carried out by GPs, and there is a need for a more comprehensive community approach to driving cessation. Patients, families and the multidisciplinary team all have a role in deciding when driving cessation should occur. Occupational therapists have a particular responsibility for strategic leadership in this area of practice.

Keywords: assessment, driving, older people, occupational therapy

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Rukiye Pinar Boluktas

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According to 2015 statistics, in Turkey, 46% of older people live alone in their homes, 55% have poor health perceptions, 18% face poverty, and 43% are unhappy. Prevalence of depression is between 14% and 20%. In 2013, rate of suicide was 6.5. However, the most of older people prefer to live in their community although they are lonely, they face poverty, and face limitations as a result of chronic diseases and disabilities. Community based care for older people is also encouraged by Ministry of Health as it is more cost-effective. Music therapy is a simple, effective, safe, and nonpharmacologic intervention that may be used to decrease depression and to improve cognition, and health related quality of life (HRQOL). In Turkish culture, music is typically described as ‘food for soul’. This study aimed to investigate the effect of Turkish classical music songs in 32 community dwelling older people. Participants were received interventions two or three times per week, 50-60 min per session, for 8 weeks at a day health center. Each intervention session started listening music for 15-20 min to get remember songs, then followed singing songs as a group. Participants were assessed at baseline (week 0), and two follow-up at month 1 and month 2. Compared to baseline, at two follow-up, we observed that cognition improved, depression decreased, and SF-36 scores, including 8 domains and two summary scores increased. We conclude that an intervention comprising listening and singing Turkish classical music improve cognition, depression and HRQOL in older people.

Keywords: cognitive function, depression, elderly, quality of life, Turkish classical music

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

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

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

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Authors: Sun Woo Lee, Tae Bum Lee, Yoon Hwa Park, Yoo Jeong Kim

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Cervical dentinal hypersensitivity (CDH) affects 8-30% of adults and nearly 85% of perio-treated patients. Various treatment schemes have been applied for treating CDH, among them being fluoride application, laser irradiation, and, recently, bioglass. The purpose of this study was to investigate the influence of bioglass, copper-bromide (Cu-Br) laser irradiation and their combination on dentinal tubule occlusion as a potential dentinal hypersensitivity treatment for CDH. 45 human dentin surfaces were organized into three equal groups: group A received Cu-Br laser only; group B received bioglass only; group C received bioglass followed by Cu-Br laser irradiation. Specimens were evaluated with regard to dentinal tubule occlusion under environmental scanning electron microscope. Treatment modality significantly affected dentinal tubule occlusion (p<0.001). Groups B and C scored higher dentinal tubule occlusion than group A. Binary logistic regression showed that bioglass application significantly (p<0.001) contributed to dentinal tubule occlusion, compared with other variables. Under the conditions used herein and within the limitations of this study, bioglass application, alone or combined with Cu-Br laser irradiation, is a superior method for producing dentinal tubule occlusion, and may lead to an effective treatment modality for CDH.

Keywords: bioglass, Cu-Br laser, cervical dentinal hypersensitivity, dentinal tubule occlusion

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Authors: Budsarin Padwang, Darunee Jongudomkarn, Thawan Nieamsup, Autchareeya Patumwan, Rutja Phuphaibul

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In Northern Thailand, a pilot study by the qualitative data, on caring for family members with chronic illness/bedridden based on in-depth interviews of the 12 elderly caregivers in family was carried out during November to December 2017. There are four families that living with three generations in the family. This report is part of a larger study of 'The intergenerational contract of the family in long-term care for older members' to understand the situation and context related to the research questions. Content analysis was obtained and the results revealed as followings. 1) No choice and no freedom: most caregivers were asked by their family members to do the care giving roles because of various appropriate reasons and they could not refuse and felt like having no freedom. 2) ‘Katanyu’ to the parents: The Thai ideology of making merit by taking care of parents was beliefs to do the best in their caregiver roles. 3) The family commitments: The issues of family caring and relationships were the key value of keeping family members to take care of older members with chronic illness/bedridden. The preliminary findings can be beneficial for other regions and will lead to in-depth explore to answer the research questions of the larger study in the future.

Keywords: intergenerational contract, long term care, older members, generational family

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Authors: Qian Sun, Dannie Dai, Vivian Lou

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Background: Changes in population structure and modernization have left traditional channels of achieving intergenerational solidarity in crisis. Policies and projects purposefully structuring intergenerational interaction are regarded as effective ways to enhance positive attitude changes between generations. However, few inter-generational interaction program has put equal emphasis on promoting positive changes on both attitude and behavior across generational groups. Objective: This study evaluated the effectiveness of an intergenerational interaction program which aims to facilitate positive attitude and behavioral interaction between both young and old individuals in Hong Kong. Method: A quasi-experimental design was adopted with the sample of 150 older participants and 161 young participants. Among 73 older and 78 young participants belong to experiment groups while 77 older participants and 84 young participants belong to control groups. The Age Group Evaluation and Description scale (AGED) was adopted to measure attitude toward young people by older participants and the Chinese version of Kogan’s Attitude towards Older People (KAOP) as well as Polizzi’s refined version of the Ageing Semantic Differential Scale (ASD) were used to measure attitude toward older people by the younger generation. The interpersonal behaviour of participants was assessed using Beglgrave’s behavioural observation tool. Six primary verbal or non-verbal interpersonal behaviours including smiles, looks, touches, encourages, initiated conversations and assists were identified and observed. Findings Effectiveness of attitude and behavior changes on both younger and older participants was confirmed in results. Compared with participants from the control group, experimental participants of elderly showed significant positive changes of attitudes toward the younger generation as assessed by AGED (F=138.34, p < .001). Moreover, older participants showed significant positive changes on three out of six behaviours (visual attention: t=2.26, p<0.05; initiate conversation: t=3.42, p<0.01; and touch: t=2.28, p<0.05). For younger participants, participants from experimental group showed significant positive changes in attitude toward older people (with F-score of 47.22 for KAOP and 72.75 for ASD, p<.001). Young participants also showed significant positive changes in two out of six behaviours (visual attention: t=3.70, p<0.01; initiate conversation: t=2.04, p<0.001). There is no significant relationship between attitude change and behaviour change in both older (p=0.86) and younger (p=0.22) groups. Conclusion: This study has brought practical implications for social work. The effective model of this program could assist social workers and allied professionals to design relevant projects for nurture intergenerational solidarity. Furthermore, insignificant results between attitude and behavior changes revealed that attitude change was not a strong predictor for behavior change, hence, intergenerational programs against age-stereotype should put equal emphasis on both attitudinal and behavioral aspects.

Keywords: attitude and behaviour changes, intergenerational interaction, intergenerational solidarity, program design

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Authors: Abhijeet Ostawal, Parmjit Lall

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The run times for a large strategic model that we were managing had become too long leading to delays in project delivery, increased costs and loss in productivity. Software developers are continuously working towards developing more efficient tools by changing their algorithms and processes. The issue faced by our team was how do you apply the latest technologies on validated existing models which are based on much older versions of software that do not have the latest software capabilities. The multi-model transport model that we had could only be run in sequential assignment order. Recent upgrades to the software now allowed the assignment to be run in parallel, a concept called parallelization. Parallelization is a Python script working only within the latest version of the software. A full model transfer to the latest version was not possible due to time, budget and the potential changes in trip assignment. This article is to show the method to adapt and update the Python script in such a way that it can be used in older software versions by calling the latest version and then recalling the old version for assignment model without affecting the results. Through a process of trial-and-error run time savings of up to 30-40% have been achieved. Assignment results were maintained within the older version and through this learning process we’ve applied this methodology to other even older versions of the software resulting in huge time savings, more productivity and efficiency for both client and consultant.

Keywords: model run time, demand model, parallelisation, python scripting

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Authors: Gabriela Ilie, Robert D. H. Rutledge

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A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

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Authors: Yetunde M. Dairo, Johnny Collett, Helen Dawes

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Background and Aim: Engagement with physical activity (PA) research is poor among adults with intellectual disabilities (ID), particularly in those from residential homes. This study explored why, by asking managers of residential homes, adults with ID and their carers. Methods: Participants: A convenient sample of 23 individuals from two UK local authorities, including a group of ID residential home managers, adults with ID and their support staff. Procedures: A) Residential home managers (n=6) were asked questions about their willingness to allow their residents to participate in PA research; B) eleven adults with ID and their support workers (n=6) were asked questions about their willingness to accept 7-day accelerometer monitoring and/or the International Physical Activity Questionnaire-short version (IPAQ-s) as PA measures. The IPAQ-s was administered by the researcher and they were each provided with samples of accelerometers to try on. Results: A) Five out of six managers said that the burden of wearing the accelerometer for seven days would be too high for the people they support, the majority of whom might be unable to express their wishes. They also said they would be unwilling to act as proxy respondents for the same reason. Additionally, they cited time pressure, understaffing, and reluctance to spend time on the research paperwork as further reasons for non-participation. B) All 11 individuals with ID completed the IPAQ-s while only three accepted the accelerometer, one of whom was deemed inappropriate to wear it. Reasons for rejecting accelerometers included statements from participants of: ‘too expensive’, ‘too heavy’, ‘uncomfortable’, and two people said they would not want to wear it for more than one day. All adults with ID (11) and their support workers (6) provided information about their physical activity levels through the IPAQ-s. Conclusions: Care home managers are a barrier to research participation. However, adults with ID would be happy for the IPAQ-s as a PA measure, but less so for the 7-day accelerometer monitoring. In order to improve participation in this population, the choice of PA measure is considered important. Moreover, there is a need for studies exploring how best to engage ID residential home managers in PA research.

Keywords: intellectual disability, physical activity measurement, research engagement, research participation

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Authors: Ummuhan Bas Aslan, Sehmus Aslan

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Objective: Physical disability includes impairments, activity limitations, and participation restrictions. Individuals with physical disabilities have lower self-esteem compared non-disabled people. Self-esteem is widely accepted as a key indicator of emotional stability and adjustment to life demands. There is very limited study to investigate the effect of sports on self-esteem in physically disabled people. The aim of the present study was to evaluate of self-esteem in physically disabled adults who participated in sports. Methods: Fifty physically disabled adults who participated in sports aged between 18 to 35 years participated in the study. Self-esteem of the participants was assessed by Rosenberg Self-Esteem Scale. The scale is a 10-item measure of global self-esteem. The higher score on the scale indicates greater self-esteem. Scores between 15 and 25 are the normal range of and scores below 15 suggest low self-esteem. Results: Average age of participants was 25.18±6.20 years. 58% of the participants were 23 (46.0%) of the participants were wheelchair users, 8 (16.0%) were mobile with a walking aid and 19 (38.0%) were mobile without a walking aid. The length of physically disabled adults had been participating in their sports (basketball: 54%, athleticism: 32%, volleyball: 6%, cycling: 6%) was 4.94±3.86 years. The average Rosenberg Self-Esteem Scale score of the participants was 21.88 ±4.34. Conclusions: Our results suggest that physically disabled adults who participated in sports have the healthy level of self-esteem. Participating in sports could have positive effects on self-esteem in that physically, disabled people. There is needed future comparative studies on this topic.

Keywords: adult, physical disability, self-esteem, sport

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Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin

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Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.

Keywords: self-administered medication, intervention, prescribing, older patients

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Authors: Jennis Delina Giles, Nimesha Liyanage, Damindi Senadheera, Dilan Randima, Kushnara Suriyawansa

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Mental health is essential during childhood, adolescence, and adulthood. Mental health issues can influence one's thoughts, disposition, and conduct. A record number of mental health problems are caused by a global pandemic. Prevention of mental disease is vital for both children and adults. We desired to develop a web application for those with mental health difficulties. This web application will provide group chat, discussion, a community feed, and counseling services. The community feed function provides information regarding scheduled conversation space meetings, and the counselor uploads uplifting thoughts and tales of patients who received proper care and overcame mental health issues. Community feed can filter content based on user preferences. The mental health system for adults and adolescents will be updated. The community feed delivers relevant and instructive postings, links, and images so that service recipients can benefit from other platform features and receive encouraging words to assist them in overcoming mental health difficulties.

Keywords: bio medical, mental helath care, empower youths & adults, counselling

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Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Sasiporn Rattanasupha, Settapat Chinviriyasit

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The treatment function adopts a continuous and differentiable function which can describe the effect of delayed treatment when the number of infected individuals increases and the medical condition is limited. In this paper, the SEIR epidemic model with treatment function is studied to investigate the dynamics of the model due to the effect of treatment. It is assumed that the treatment rate is proportional to the number of infective patients. The stability of the model is analyzed. The model is simulated to illustrate the analytical results and to investigate the effects of treatment on the spread of infection.

Keywords: basic reproduction number, local stability, SEIR epidemic model, treatment function

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Authors: Elineuda Do Socorro Santos Picanço Sousa, Ana Kerlly Souza da Costa

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This paper presents the analysis of the information society as a plural, inclusive and participatory society, where it is necessary to give all citizens, especially young people, the right skills in order to develop skills so that they can understand and use information through of contemporary technologies; well as carry out a critical analysis, using and producing information and all sorts of messages and / or informational language codes. This conviction inspired this article, whose aim is to present current trends in the use of technology in distance education applied as an alternative and / or supplement to classroom teaching for Youth and Adults, concepts and actions, seeking to contribute to its development in the state of Amapá and specifically, the Center for Professional of Amapá Teaching Professor Josinete Oliveira Barroso - CEPAJOB.

Keywords: youth and adults education, Ead. Professional Education, online courses, CEPAJOB

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Authors: Kassahun Tilahun

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Most of the studies available on adult psychological well-being have been centered on Western countries. However, psychological well-being does not have the same meaning across the world. The Euro-American and African conceptions and experiences of psychological well-being differ systematically. As a result, questions like, how do people living in developing African countries, like Ethiopia, report their psychological well-being; what would the context-specific prominent determinants of their psychological well-being be, needs a definitive answer. This study was, therefore, aimed at developing a new theory that would address these socio-cultural issues of psychological well-being. Consequently, data were obtained through interview and open ended questionnaire. A total of 438 adults, working in governmental and non-governmental organizations situated in Addis Ababa, participated in the study. Appropriate qualitative method of data analysis, i.e. thematic content analysis, was employed for analyzing the data. The thematic analysis involves a type of abductive analysis, driven both by theoretical interest and the nature of the data. Reliability and credibility issues were addressed appropriately. The finding identified five major categories of themes, which are viewed as essential in determining the conceptions and experiences of psychological well-being of Ethiopian adults. These were; socio-cultural harmony, social cohesion, security, competence and accomplishment, and the self. Detailed discussion on the rational for including these themes was made and appropriate positive psychology interventions were proposed. Researchers are also encouraged to expand this qualitative research and in turn develop a suitable instrument taping the psychological well-being of adults with different sociocultural orientations.

Keywords: sociocultural, psychological, well-being Ethiopia, adults

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Authors: Ramu Rawat

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Background: This paper is an effort to analyze the role of education and occupation as critical determinants in using smokeless tobacco among male adults in India and its selected states. Methodology: Global Adult Tobacco Survey (GATS) India 2009-10 data have been used for this study. Bivariate and Multivariate (Cox proportion hazards model) analyses are carried out to measure the impact of education and occupation on use of smokeless tobacco among male adults in India. Results and Conclusion: The study evidently suggests that, majority of Indian male adults are using Khaini and Gutkha (local names for smokeless tobacco). The analysis also shows that education and occupation are two important critical predictors of use of smokeless tobacco. The males at younger age with no or little education from rural area use smokeless tobacco more than their counterpart group from urban areas. This distinction can be attributable to their lack of knowledge or ignorance about the consequences of tobacco consumption. Place of residence played significant role for declining use of smokeless tobacco along with the effect of society. Society awareness about harmful effects of smokeless tobacco with local level government may play important role for controlling the use of any type of tobacco or tobacco products in India.

Keywords: smokeless tobacco, male, Khaini, education, occupation

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Authors: Abdullah Alyoussef

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Folliculitis decalvans is a rare inflammatory scalp disorder. This paper gives an update to patient management and treatment modalities. Folliculitis decalvans is classified as primary neutrophilic cicatricial alopecia and predominantly occurs in middle-aged adults. The cause of folliculitis decalvans (FD) remains unknown. Staphylococcus aureus and a deficient host immune response seem to play an important role in the development of this disfiguring scalp disease. Lesions occur mainly in the vertex and occipital area. Clinically, the lesions present with follicular pustules, lack of ostia, diffuse and perifollicular erythema, follicular tufting, and, oftentimes, hemorrhagic crusts and erosions. Histology displays a mainly neutrophilic inflammatory infiltrate in early lesions and additionally lymphocytes and plasma cells in advanced lesions. Treatment is focused on the eradication of S. aureus and anti-inflammatory agents. Although the etiology of FD is unclear, S. aureus is almost always isolated from affected areas, and eradication is an important part of therapeutic management, in combination with systemic and ⁄ or topical anti-inflammatory treatment.

Keywords: cicatricial alopecia, folliculitis decalvans, tufted folliculitis, erosion

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Authors: Carol Cameletti

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The goal of this study was to perform a pilot survey to assess pain frequency and intensity in an elderly population and to assess treatment options for chronic pain that include complementary and alternative medicines (CAM). Ten participants were recruited from an independent and supportive living housing facility in Northern Ontario and asked to complete two questionnaires: 1) a self-assessment on pain, and 2) the use of CAM for pain. Results from our study show that 80% of the participants experienced pains other than the regular everyday pains such as minor headaches, sprains or toothaches. Although participants stated that on average the highest level of pain they experienced within the past 24 hours had a score of 6.5 (0=no pain, 10=worst pain imaginable) the level of pain they experienced moderately interfered with their daily activities. Unfortunately, participants stated that they were only able to attain minimal levels of pain relief using treatments or medications causing some of the participants to seek alternative therapies or self-help practices. The most commonly used CAMs were vitamins/minerals, herbs and supplements, and self-help practices such as meditation, prayer, visualization and relaxation techniques. Although some of the participants stated that they had received complementary treatments directly from their physician, four of the nine participants said that they had not disclosed CAM use to their physician thereby indicating a need to open the lines of communication between healthcare providers and patients with regards to CAM use. It is our hope that the data generated from this study will serve as the platform for a pain management clinic that is client-centered, consumer-driven and truly integrative and tailored in order to meet the unique needs of older adults in Great Sudbury, Ontario.

Keywords: alternative, complementary, elderly, medicine

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Authors: Shruti Soudi, Anushka Nayak

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Altruism is a voluntary helping behavior that is not motivated by rewards. The empathy-altruism hypothesis states that altruistic behavior results from empathy, a constant emotional response between the helper and the individual in need. Individual variances in familiar ways of thinking, feeling, and acting are called personalities. The personality of an individual determines their behavior. More importantly, Adler was among the first psychologists to document the importance of birth order on personality. The present study aims to understand the influence of personality and birth order on altruism. A questionnaire consisting of standardized tools to measure altruism (Hindi Self Report Altruism Scale) and personality (Big Five Personality Inventory) will aid in studying the relationship between these variables among young adults in India. A statistical analysis of the data will be completed using ANOVA and T-Test in the SPSS Software.

Keywords: altruism, personality, birth order, ANOVA, young adults

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Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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