What interventions and programmes are available to support older nurses in the workplace? A literature review of available evidence.

BACKGROUND: High exit rates, stalling entry rates, population ageing, and, most recently, the COVID-19 pandemic have placed significant strain on the world's nursing workforce. Both developed and developing countries face similar predicaments. Evidence-based programmes to support older nurses in the workplace are urgently needed to ensure the sustainability of a career in nursing for this group of healthcare professionals. OBJECTIVES: To scope and synthesise available evidence on evaluated programmes and interventions implemented to support the ageing nursing workforce's health, wellbeing, and retention. DESIGN: A literature review of available evidence using a systematic approach. METHOD: Medline, Scopus, PsycINFO and CINAHL were searched for relevant peer-reviewed evidence. Data from the peer-reviewed literature were extracted separately into purpose designed-extraction spreadsheets. Information relevant to study design, intervention design, outcome constructs, intervention outcomes, and barriers and enablers to intervention success were collected. The protocol for this review was registered in PROSPERO [CRD42021274491]. RESULTS: Eighteen published studies were included in this review. We identified a range of interventions and programmes that have been implemented to support older nurses, which included flexible and reduced work arrangements, mentoring programmes, exercise and lifestyle interventions, continued professional development and purpose-designed remote retreats. We found limited evidence of evaluated outcomes from workplace support interventions that addresses the actual challenges faced by ageing nurses as reported in previous literature reviews. Interventions that were designed to promote a sense of purpose at work resulted in positive outcomes and appeared to more directly address the stated needs of older nurses. Holistic programmes and interventions that could potentially promote both physical well-being and psychological well-being required a broader, whole-of-organisation approach rather than more piecemeal interventions addressing individual physical and mental health concerns. Interventions which acknowledged older nurses' clinical expertise and experience (e.g., mentoring programmes) were linked to positive outcomes. CONCLUSION: Future intervention efforts should acknowledge and balance intervention participation opportunities against existing everyday workload constraints faced by older nurses. Our review suggests the need for further intervention studies assessing specific outcomes such as psychological and emotional health, as well as interventions that more directly address the most pressing concerns that ageing nurses report at personal and organisational levels. A paradigm shift in productivity measurement in clinical nursing work is required in order to increase the value placed on the unique contribution of older nurses working clinically, particularly in sharing their acquired knowledge, skill, and expertise.

Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: a cluster-randomized controlled trial TCTR20190412004.

BACKGROUND: Populations around the world are ageing faster, with the majority living in low- and middle-income countries where health and social care are yet to be universal and inclusive for the ageing population. This community-integrated intermediary care (CIIC) model is a novel prevention-based, long-term care model enhancing the family-based care system traditionally practised in Thailand and neighbouring Asian countries, and many low-and middle-income countries globally. This study assessed the effectiveness of the CIIC model in Chiang Mai, Thailand. METHODS: The two-arm parallel intervention study was designed as a cluster-randomized controlled trial. The study population at randomization and analysis was 2788 participants: 1509 in six intervention clusters and 1279 in six control clusters. The research protocol was approved by the WHO Research Ethics Review Committee (WHO/ERC ID; ERC.0003064). The CIIC service intervention model is a combination of formal care and informal care in a subdistrict setting consisting of three components: (1) care prevention delivered as community group exercise and home exercise; (2) care capacity-building of the family caregiver; and (3) community respite service. The primary outcome was family caregivers' burden at 6-month follow-up, and secondary outcome was activities of daily living. Analysis applied the intention-to-treat approach using cluster-level analysis via STATA 16 SE. RESULTS: Baseline characteristics did not differ between the two arms. Loss of follow up was 3.7%. Mean age of the participants was 69.53 years. Women constituted 60%. The COVID-19 pandemic caused delayed implementation. The proportion of families with reduced caregiver burden at 6-month follow-up was higher among the intervention clusters (mean 39.4%) than control clusters (mean 28.62%). The intervention clusters experienced less functional decline and fewer people with depression. CONCLUSIONS: When communities are integrated for preventing care, and families are empowered for giving care, it is possible to secure universal access to health and social care for the older persons, with basic resources mobilized from communities. This study had shown the CIIC model as an effective and potential step to the realization of universal health and long-term care coverage being inclusive of ageing populations in Thailand and globally. TRIAL REGISTRATION: This trial was registered at the Thailand Clinical Trial Registry-Trial registration number TCTR20190412004, https://www.thaiclinicaltrials.org/.

Population Dynamics in Russia in the Context of Global Trends.

The article examines the current demographic trends in Russia as compared to population changes in the world and its major regions based on data from the Russian Federal State Statistics Service (Rosstat), Eurostat, and the UN Population Division. It is shown that in terms of a number of characteristics of population reproduction-low fertility, ageing population structure, natural population decline-Russia is quite similar to the developed countries group. However, Russia is behind many countries in reducing the mortality rate of the middle-aged and older population, especially in men, and, correspondingly, in life expectancy for all age groups, which results in a noticeable increase in natural population decline and in deformation of the sex structure of the population. The specifics of the age structure of the Russian population that have been formed by a number of demographic waves are such that changes in the number of births and in age group sizes come in waves; this trend will continue in the coming decades. The article also analyzes excess mortality in Russia during the COVID-19 pandemic in comparison with similar data for the European Union (EU-27) and compares healthy life expectancy estimates for Russia, the entire world, individual countries, and different groups of countries by income.

Effect of vaccine efficacy on disease transmission with age-structured.

Recent outbreaks of novel infectious diseases (e.g., COVID-19, H2N3) have highlighted the threat of pathogen transmission, and vaccination offers a necessary tool to relieve illness. However, vaccine efficacy is one of the barriers to eradicating the epidemic. Intuitively, vaccine efficacy is closely related to age structures, and the distribution of vaccine efficacy usually obeys a Gaussian distribution, such as with H3N2 and influenza A and B. Based on this fact, in this paper, we study the effect of vaccine efficacy on disease spread by considering different age structures and extending the traditional susceptible-infected-recovery/vaccinator(SIR/V) model with two stages to three stages, which includes the decision-making stage, epidemic stage, and birth-death stage. Extensive numerical simulations show that our model generates a higher vaccination level compared with the case of complete vaccine efficacy because the vaccinated individuals in our model can form small and numerous clusters slower than that of complete vaccine efficacy. In addition, priority vaccination for the elderly is conducive to halting the epidemic when facing population ageing. Our work is expected to provide valuable information for decision-making and the design of more effective disease control strategies.

Loss of life expectancy due to respiratory infectious diseases: findings from the global burden of disease study in 195 countries and territories 1990-2017.

Understanding of the patterns of and changes in mortality from respiratory infectious diseases (RID) and its contribution to loss of life expectancy (LE) is inadequate in the existing literature. With rapid sociodemographic changes globally, and the current COVID-19 pandemic, it is timely to revisit the disease burden of RID. Using the approaches of life table and cause-eliminated life table based on data from the Global Burden of Disease Study (GBD), the study analyses loss of LE due to RID in 195 countries/territories and its changes during the period 1990-2017. Results indicate that loss of LE due to RID stood at 1.29 years globally in 2017 globally and varied widely by age, gender, and geographic location, with men, elderly people, and populations in middle/low income countries/territories suffering a disproportionately high loss of LE due to RID. Additionally, loss of LE due to RID decreased remarkably by 0.97 years globally during the period 1990-2017 but increased slightly among populations older than 70 years and in many high income countries/territories. Results suggest that RID still pose a severe threat for population and public health, and that amid dramatic sociodemographic changes globally, the disease burden of RID may resurge. The study presents the first examination of the life-shortening effect of RID at the global and country/territory levels, providing new understanding of the changing disease burden of RID and shedding light on the potential consequences of the current COVID-19 pandemic.

Will the COVID-19 pandemic affect population ageing in Australia?

The COVID-19 pandemic has caused extensive disruption to economies and societies across the world. In terms of demographic processes, mortality has risen in many countries, international migration and mobility has been widely curtailed, and rising unemployment and job insecurity is expected to lower fertility rates in the near future. This paper attempts to examine the possible effects of COVID-19 on Australia's demography over the next two decades, focusing in particular on population ageing. Several population projections were prepared for the period 2019-41. We formulated three scenarios in which the pandemic has a short-lived impact of 2-3 years, a moderate impact lasting about 5 years, or a severe impact lasting up to a decade. We also created two hypothetical scenarios, one of which illustrates Australia's demographic future in the absence of a pandemic for comparative purposes, and another which demonstrates the demographic consequences if Australia had experienced excess mortality equivalent to that recorded in the first half of 2020 in England & Wales. Our projections show that the pandemic will probably have little impact on numerical population ageing but a moderate effect on structural ageing. Had Australia experienced the high mortality observed in England & Wales there would have been 19,400 excess deaths. We caution that considerable uncertainty surrounds the future trajectory of COVID-19 and therefore the demographic responses to it. The pandemic will need to be monitored closely and projection scenarios updated accordingly.