Evaluating the Effectiveness of Geriatric-Specific Cancer Rehabilitation Programs on Patient Health Outcomes.

OBJECTIVE: This study evaluated a specialized rehabilitation program's impact on senior cancer patients' quality of life. METHODS: one hundred and thirty patients aged ≥65 years with various cancer types undergoing/recovering from treatment were enrolled in oncology clinics in Al-Ahsa, Saudi Arabia. The intervention arm (n=65) participated in a tailored geriatric cancer rehabilitation program. The control group (n=65) received standard oncology care. The Functional Assessment of Cancer Therapy-General (FACT-G) tool assessed the quality of life across physical, social, emotional, and functional domains. T-tests and multivariate regression analyses compared outcomes. RESULT: Total FACT-G scores showed a significantly higher quality of life for the geriatric cancer rehabilitation group versus standard care. Rehabilitation patients also demonstrated meaningful improvements across physical, social, and functional subscales. Rehabilitation involvement was the most predictive factor for optimized outcomes. CONCLUSION: Specialized geriatric cancer rehabilitation meaningfully improved several quality of life domains in older patients over standard care. Despite persistent barriers, rehabilitation programming optimized older cancer patients' physical and psychosocial health. Oncology and geriatrics must collaborate to ensure evidence-based rehabilitation access meets older cohorts' unique needs.

Telemedicine Preparedness Among Older Adults With Chronic Illness: Survey of Primary Care Patients.

BACKGROUND: Older adults are a high priority for telemedicine given their elevated COVID-19 risk and need for frequent provider contact to manage chronic illnesses. It seems that many older adults now use smartphones but few studies have examined their overall readiness for telemedicine. OBJECTIVE: The aim of this study is to survey older primary care patients about their telemedicine preparedness, including internet usage, internet-capable devices, telemedicine experiences and concerns, and perceived barriers. Results were used to inform a telemedicine preparedness training program. METHODS: Community-dwelling older adult patients (aged 65-81 years; N=30) with a chronic health condition that could be managed remotely who were present at a family medicine clinic that primarily serves an urban African American population for a prescheduled in-person appointment were asked to complete a brief survey written for this study. Data were collected February-June 2021 at a large, urban, Midwestern hospital. To minimize patient burden, the survey was limited to 10 questions, focused on the most critical topics. RESULTS: Most participants (21/30, 70%) reported having a device that could be used for telemedicine and using the internet. However, about half had only a single connected device, and messaging and video calling were the most commonly used applications. Few used email and none used online shopping or banking. Only 7 patients had had telemedicine appointments. Telemedicine users were younger than nonusers and used more internet functions than nonusers. Only 2 people reported problems with their telemedicine visits (technology and privacy). Nearly all respondents recognized avoiding travel and COVID-19 exposure as telemedicine benefits. The most common concerns were loss of the doctor-patient connection and inability to be examined. CONCLUSIONS: Most older adults reported having devices that could be used for telemedicine, but their internet use patterns did not confirm the adequacy of their devices or skills for telemedicine. Doctor-patient conversations could be helpful in addressing telemedicine concerns but device and skill gaps must be addressed as well.

An artificial neural network-based model to predict chronic kidney disease in aged cats.

BACKGROUND: Chronic kidney disease (CKD) frequently causes death in older cats; its early detection is challenging. OBJECTIVES: To build a sensitive and specific model for early prediction of CKD in cats using artificial neural network (ANN) techniques applied to routine health screening data. ANIMALS: Data from 218 healthy cats ≥7 years of age screened at the Royal Veterinary College (RVC) were used for model building. Performance was tested using data from 3546 cats in the Banfield Pet Hospital records and an additional 60 RCV cats-all initially without a CKD diagnosis. METHODS: Artificial neural network (ANN) modeling used a multilayer feed-forward neural network incorporating a back-propagation algorithm. Clinical variables from single cat visits were selected using factorial discriminant analysis. Independent submodels were built for different prediction time frames. Two decision threshold strategies were investigated. RESULTS: Input variables retained were plasma creatinine and blood urea concentrations, and urine specific gravity. For prediction of CKD within 12 months, the model had accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 87%, 70%, 53%, and 92%, respectively. An alternative decision threshold increased specificity and PPV to 98% and 87%, but decreased sensitivity and NPV to 42% and 79%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: A model was generated that identified cats in the general population ≥7 years of age that are at risk of developing CKD within 12 months. These individuals can be recommended for further investigation and monitoring more frequently than annually. Predictions were based on single visits using common clinical variables.

Indicators of Abnormal Hand Grip Strength Among Older Egyptian Adults.

BACKGROUND: Hand grip strength (HGS) is gaining the attention of researchers and clinicians, including geriatricians as a readily available, inexpensive, and useful measure of muscle strength. OBJECTIVE: To identify the indicators of abnormal HGS as measured by a Jamar handheld dynamometer in community-dwelling Egyptian senior citizens. STUDY DESIGN: The study was approved by the relevant ethical committee. This cross-sectional study included 200 randomly selected older adults of both sexes who attended geriatric and internal medicine outpatient clinics. Informed consent was obtained, and comprehensive geriatric assessment was performed, including assessment of the health-related quality of life by the 12-Item Short-Form Health Survey (SF-12). MEASUREMENT: HGS was measured, and values of 20 kg or less in females and 30 kg or less in males were considered abnormal. STATISTICAL METHODS: IBM SPSS statistics v25.0 was used for data analysis. Data were expressed as the mean ± SD for quantitative parametric measures and as the number and percentage for categorical data. Student's t-test, the chi-squared test, the diagnostic validity test, and multiple logistic regression analysis were performed. The ROC (receiver operating characteristic) curve was constructed, and the AUC (area under the curve) was also calculated. RESULTS: The subjects' ages ranged from 60 to 95 years with a mean age of 69 ± SD 7.1 years. The sample consisted of 117 females (58.5%) and 83 males (41.5%). The chi-squared test showed that abnormal findings for grip strength were significantly more common among females than males (67.7% vs 32.3%). Student's t-test showed that both height and weight were significantly lower among subjects with abnormal than normal HGS, while body mass index (BMI) showed a non-significant difference. Stepwise multiple logistic regression analysis showed that there was no actual relationship between sex and abnormality of HGS. CONCLUSION: The best indicators of abnormal HGS were found to be a general health score below 25 points on the SF-12 and a height of less than 178 cm. As the values of general health and height decrease below those cut-off points, HGS decreases as well, and vice versa.

Triagem auditiva em idosos: avaliação da acurácia e reprodutibilidade do teste do sussurro / Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test

Resumo Devido à alta prevalência da presbiacusia e as suas consequências, métodos de triagem auditiva são necessários no âmbito da atenção primária. Diante disso, o objetivo do estudo foi verificar a reprodutibilidade e acurácia do teste do sussurro como metodologia de triagem auditiva em idosos. Trata-se de estudo transversal com medidas de acurácia que incluiu 210 idosos, entre 60 e 97 anos, submetidos ao teste do sussurro com dez expressões diferentes e ao exame de referência audiometria tonal limiar. Calculou-se a sensibilidade, a especificidade, o valor preditivo positivo, o valor preditivo negativo e a acurácia do teste, avaliada por meio da área sob a curva Receiver Operating Characteristic (ROC). O teste foi repetido em 20% das orelhas por um segundo examinador com a finalidade de avaliar a reprodutibilidade interexaminador (RIE). As expressões que apresentaram melhor área sob a curva ROC (AUC) e RIE foram: "sapato" (AUC = 0,918; RIE = 0,877), "janela" (AUC = 0,917; RIE = 0,869), "parece que vai chover" (AUC = 0,911; RIE = 0,810) e o "ônibus está atrasado" (AUC = 0,900; RIE = 0,810). Estas são, pois, as expressões propostas para fazerem parte do protocolo do teste do sussurro que mostrou-se como uma ferramenta útil para triagem auditiva em idosos.

Abstract Given the high prevalence of presbycusis and its detrimental effect on quality of life, screening tests can be useful tools for detecting hearing loss in primary care settings. This study therefore aimed to determine the accuracy and reproducibility of the whispered voice test as a screening method for detecting hearing impairment in older people. This cross-sectional study was carried out with 210 older adults aged between 60 and 97 years who underwent the whispered voice test employing ten different phrases and using audiometry as a reference test. Sensitivity, specificity and positive and negative predictive values were calculated and accuracy was measured by calculating the area under the ROC curve. The test was repeated on 20% of the ears by a second examiner to assess inter-examiner reproducibility (IER). The words and phrases that showed the highest area under the curve (AUC) and IER values were: "shoe" (AUC = 0.918; IER = 0.877), "window" (AUC = 0.917; IER = 0.869), "it looks like it's going to rain" (AUC = 0.911; IER = 0.810), and "the bus is late" (AUC = 0.900; IER = 0.810), demonstrating that the whispered voice test is a useful screening tool for detecting hearing loss among older people. It is proposed that these words and phrases should be incorporated into the whispered voice test protocol.

Geriatric comanagement reduces perioperative complications and shortens duration of hospital stay after lumbar spine surgery: a prospective single-institution experience.

OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown. METHODS A unique model of comanagement for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Perioperative Optimization of Senior Health (POSH) program was launched with the aim of improving outcomes in elderly patients (> 65 years old) undergoing complex lumbar spine surgery. In this model, a geriatrician evaluates elderly patients preoperatively, in addition to performing routine preoperative anesthesia surgical screening, and comanages them daily throughout the course of their hospital stay to manage medical comorbid conditions and coordinate multidisciplinary rehabilitation along with the neurosurgical team. The first 100 cases were retrospectively reviewed after initiation of the POSH protocol and compared with the immediately preceding 25 cases to assess the incidence of perioperative complications and clinical outcomes. RESULTS One hundred twenty-five patients undergoing lumbar decompression and fusion were enrolled in this pilot program. Baseline characteristics were similar between both cohorts. The mean length of in-hospital stay was 30% shorter in the POSH cohort (6.13 vs 8.72 days; p = 0.06). The mean duration of time between surgery and patient mobilization was significantly shorter in the POSH cohort compared with the non-POSH cohort (1.57 days vs 2.77 days; p = 0.02), and the number of steps ambulated on day of discharge was 2-fold higher in the POSH cohort (p = 0.04). Compared with the non-POSH cohort, the majority of patients in the POSH cohort were discharged to home (24% vs 54%; p = 0.01). CONCLUSIONS Geriatric comanagement reduces the incidence of postoperative complications, shortens the duration of in-hospital stay, and contributes to improved perioperative functional status in elderly patients undergoing elective spinal surgery for the correction of adult degenerative scoliosis.

Observations on quality senior health business: success patterns and policy implications.

OBJECTIVE: Population ageing is a global issue that affects almost every country. Most ageing researches focused on demand side and studies related to supply side were relatively scarce. This study selected quality enterprises focus on ageing health and analysed their patterns on providing quality services successfully. DESIGN: Our study selected quality senior health enterprises and explored their success patterns through face-to-face semi-structured in-depth interviews with CEO of each enterprise in 2013. SETTING: Thirty-three quality senior health enterprises in Taiwan. PARTICIPANTS: Thirty-three CEO's of enterprises were interviewed individually. INTERVENTION: None. MAIN OUTCOME MEASURES: Core values and vision, historical development, organization structure, services/products provided, delivering channels, customer relationships and further development strategies. RESULTS: Our results indicated success patterns for senior enterprises that there were meeting diversified lifestyles and substitutive needs for the elderly and their caregivers, providing a total solution for actual/virtual integration and flexible one-stop shopping services. We classified these enterprises by used degree of clicks-and-mortar of services and residing situation of the elderly. Industry characteristics and policy implications were summarized. CONCLUSIONS: Our observations will serve as a primary evidenced base for enterprises developing their senior market, and also for opening dialogue between customers and enterprises to facilitate valuable opportunities for co-creation between the supply and demand sides.

Perfil dos residentes de uma Instituição de Longa Permanência para Idosos em Mossoró (RN) / Profile resident dos of an Institution of Long Permanence for Seniors in Mossoró (RN)

A dependência física e financeira, bem como a falta de cuidadores, podem levar o idoso à institucionalização. Objetiva-se, neste estudo, identificar o perfil do idoso residente em uma Instituição de Longa Permanência para Idosos localizada na cidade de Mossoró (RN). Trata-se de um estudo descritivo documental. Nessa Instituição há 33 mulheres e 24 homens, com 40,3% deles com idade entre 75 e 85 anos. Conhecer o perfil de morbidade, dentre os aspectos biopsicossociais do idoso, torna possível aos profissionais de saúde viabilizar ações de assistência, adequar terapêuticas específicas e desenvolver ações preventivas e de promoção à saúde.

The dependence physical, financial and caretakers' lack take the senior the institutionalization. It is aimed at in this study to identify the senior resident's of a located Institute profile in the city of Mossoró (RN). It is a documental descriptive study. In the Institute there are 33 women and 24 men, 40,3% have age between 75 and 85 years. To know the profile of the senior's morbidity turns possible to the professionals of health to make possible actions of attendance, to adapt specific therapeutics and to develop preventive actions and of promotion to the health.

Perfil dos residentes de uma Instituição de Longa Permanência para Idosos em Mossoró (RN) / Profile resident dos of an Institution of Long Permanence for Seniors in Mossoró (RN)

A dependência física e financeira, bem como a falta de cuidadores, podem levar o idoso à institucionalização. Objetiva-se, neste estudo, identificar o perfil do idoso residente em uma Instituição de Longa Permanência para Idosos localizada na cidade de Mossoró (RN). Trata-se de um estudo descritivo documental. Nessa Instituição há 33 mulheres e 24 homens, com 40,3% deles com idade entre 75 e 85 anos. Conhecer o perfil de morbidade, dentre os aspectos biopsicossociais do idoso, torna possível aos profissionais de saúde viabilizar ações de assistência, adequar terapêuticas específicas e desenvolver ações preventivas e de promoção à saúde.(AU)

The dependence physical, financial and caretakers' lack take the senior the institutionalization. It is aimed at in this study to identify the senior resident's of a located Institute profile in the city of Mossoró (RN). It is a documental descriptive study. In the Institute there are 33 women and 24 men, 40,3% have age between 75 and 85 years. To know the profile of the senior's morbidity turns possible to the professionals of health to make possible actions of attendance, to adapt specific therapeutics and to develop preventive actions and of promotion to the health.(AU)

Actividad física y envejecimiento poblacional. Repercusión en la calidad de vida / Physical activity and population aging. Repercussion in the quality of life / Atividade física eo envelhecimento da população. Impacto na qualidade de vida

El mundo enfrenta en el presente siglo un gran reto: el envejecimiento poblacional. La calidad de vida en la vejez es un \r\nconcepto multidimensional con componentes tanto objetivos como subjetivos. Si distintos grupos sociales van a vivir \r\nhasta los 90 años y más, habría que preguntarse cómo lograr llegar a la longevidad con una vida saludable, autova\r\n-\r\nlidismo, sin deterioro cognoscitivo y activo sexualmente. Con base en esto y en investigaciones previas de la autora, \r\nse realizó el estudio de un grupo poblacional del municipio Playa, ubicado en la Provincia La Habana (Cuba), como \r\nparte de un proyecto de investigación de calidad de vida y factores de riesgo aterogénicos, con el objetivo de deter\r\n-\r\nminar características sociodemográficas y evaluar la calidad de vida de las personas mayores incorporadas al grupo de \r\nrealización de ejercicios. Se desarrolló un estudio descriptivo transversal evaluando la calidad de vida que presentan \r\nestas personas respecto a diferentes variables sociodemográficas. Se hizo énfasis en su vinculación al círculo de realiza\r\n-\r\nción de ejercicios. La muestra la conformaron 66 personas mayores; la mayoría se encontraba entre los 65 y 70 años, \r\npertenecía al sexo femenino y estaba casada. Los resultados indican que gozan de una gran autonomía para realizar \r\nlas actividades de la vida diaria y, a pesar del consumo de medicamentos para afecciones del sistema osteoarticular, \r\ncardiovascular y la diabetes y de desarrollar poca práctica deportiva, calificaron su salud entre regular y buena. Según \r\nel análisis, sobresalen las categorías alta y media de calidad de vida entre los adultos mayores.

The world faces the great challenge of an aging popula\r\n-\r\ntion this century. The quality of life in the senior years is \r\na multidimensional concept that includes objective and \r\nsubjective components. As individuals in several social \r\ngroups increasingly live over 90 years, a question arises: \r\nHow do we achieve longevity in a healthy, independent \r\nlife without cognitive and sexual decline? From this ques\r\n-\r\ntion and using the author's previous research, a study of \r\na population was performed in the Playa municipality, \r\nlocated in Havana Province, Cuba, including a research \r\nproject of quality of life and atherogenic risk factors. The \r\npurpose was to determine socio-demographic charac\r\n-\r\nteristics and evaluate the quality of life of the seniors \r\ngroup involved in the exercises. A descriptive transversal \r\nstudy was performed evaluating the Quality of Life in \r\nrelation to various demographic variables, emphasizing \r\ntheir association with the exercise group. A total of 66 \r\nseniors were included, most of them 65-70 years old, \r\nfemale, and married. The results showed great autonomy \r\nto accomplish daily activities, and despite the intake of \r\nmedications for osteo-articular and cardiovascular affec\r\n-\r\ntions and diabetes and little sports practice, participants \r\nqualified their own health between normal and good. \r\nThis analysis highlighted the medium to high quality of \r\nlife within seniors. A series of actions were performed \r\ntaking into account the protective factors that facilitate a \r\nbetter quality of life and the achievement of satisfactory \r\nlongevit y.

O mundo encontra um grande desafio neste século: \r\no envelhecimento da população. A qualidade de vida \r\nna terceira idade é um conceito multidimensional que \r\ninclui componentes objetivos e subjetivos. Como os \r\ngrupos sociais vão viver até mais dos 90 anos, gente \r\ndeve perguntar-nos como alcançar uma vida saudável e \r\nautovalidismo sem comprometo cognitivo o atividades \r\nsexuais? Pensando nesta pregunta com base em uma \r\npesquisa anterior do autor, um estudo de um grupo do \r\npopulação do município Playa, localizada em Havana, \r\nCuba. Este estudo inclui um projeto pesquisando a quali\r\n-\r\ndade da vida e fatores de risco aterogênico. Também \r\ndetermina as características sociodemográficas e avaliar \r\na qualidade da vida das pessoas idosas incorporadas nos \r\nexercícios. Um estudo transversal avaliando a qualidade \r\nde vida em relação a vários variáveis sociodemográficas, \r\nenfatizando sua ligação com o grupo que faz exercício \r\nfoi realizado. Com um total de 66 pessoas antigas, onde \r\no grupo predominante eram das 65 a 70 anos, casados e \r\ndo sexo feminino. Os resultados verificou que os parti\r\n-\r\ncipantes tiniam um nível autonomia considerável para \r\nrealizar as atividades da vida diária e apesar do uso dos \r\nremédios para condições de osteoarticular, o sistema \r\ncardiovascular, diabetes e pouca atividade física, as parti\r\n-\r\ncipantes classificaram sua saúde da normal a bem. Uma \r\nseria de ações foram realização considerando os fatores \r\nde proteção que facilitam uma qualidade de vida melhor \r\ne alcançam uma longevidade satisfatória.

A saúde de idosos residentes em Instituições de longa permanência apoiada na Teoria de Nightingale / The Health elderly people living in long-stay institutions supported by the Nightingale Theory

This is a descriptive quantitative approach that has the general objective is to analyze the health of elderly living in long-stay institutions and characterize these institutions for physicostructural and organizational skills. Was developed in four long-term institutions located in the Sanitary District Itapagipe in the city of Salvador - Bahia, from September to November 2013. Participants were 117 elderly residents of four coordinators seven elderly caregivers of these institutions that agreed to participate . Two questionnaires as a tool for data collection, containing sociodemographic and health issues of the elderly, and questions about the organizational structure of the institutions were used. The quantitative data was analyzed using SPSS software and interpreted according to Environmentalist Theory of Florence Nightingale. Most seniors were female (85.5%), aged 81 years, mulatto (64.1%), Catholics (88.0%), a native of Salvador, Bahia (51.3% ), had 1┤8 years of study (27.4%) had family members (80.3%) received no visits (65.0%), single (48.7%), with an income of a minimum wage, retirees (90.3%), coming from home (38.5%), led to the institution by family members other than children (66.2%), living in these residences for approximately 51 months, had visual change (96.6 %) had sleep disturbances (56.4%) had pressure ulcers in the sacral region (30.8%) and right trochanteric region (11.1%), falls in the past year (43.6%) , hypertension was the most prevalent disease (54.7%), made constant use of medications (82.9%), proved to be dependent on the realization of Activities of Daily Living (68.4%), the risk of dementia for seniors who had schooling was 14.8% and for the illiterate or had not record of schooling the risk of dementia was 45.7% and 39.5% respectively. Most seniors are carriers of diseases, is dependent for performing daily life and with impaired cognitive ability activities. The Institutions for the Aged require adaptation in physical structure and re-organization of services for the purpose of responding mainly to the increasing demand of geriatric population and meet the needs of the elderly residents in order to promote the maintenance of their independence and autonomy. (AU)

Trata-se de uma pesquisa descritiva, de corte transversal, de abordagem quantitativa que teve como objetivo geral: analisar as condições de saúde de idosos que residem em instituições de Longa Permanência e caracterizar estas instituições quanto aos aspectos físico-estruturais e organizacionais. Foi desenvolvida em quatro instituições de longa permanência localizadas no Distrito Sanitário de Itapagipe, na cidade de Salvador-Bahia, de setembro a novembro de 2013. Participaram do estudo 117 idosos residentes, quatro coordenadores e sete cuidadores de idosos destas instituições. Foram utilizados dois questionários como instrumento de coleta de dados, contendo questões sóciodemográficas e de saúde dos idosos e, questões sobre a estrutura organizacional das instituições. Os dados quantitativos foram tratados por meio do software SPSS e interpretados segundo a Teoria Ambientalista de Florence Nightingale. Os resultados mostraram que a maioria (85,5%) dos idosos era do sexo feminino, na faixa etária de 81 anos, (64,1%) era de cor parda, (88,0%) era da religião católica, (51,3%) era natural de Salvador - Bahia, possuíam 1┤8 anos de estudo (27,4%), tinham familiares (80,3%), não recebiam visitas (65,0%), solteiros (48,7%), com renda de um salário mínimo, aposentados (90,3%), procedentes da casa própria (38,5%), levados à instituição por familiares que não os filhos (66,2%), residindo nestas residências há aproximadamente 51 meses, possuíam alteração visual (96,6%), apresentavam alterações do sono (56,4%), apresentavam úlceras por pressão em região sacra (30,8%) e em região trocanteriana direita (11,1%), sofreram quedas no último ano (43,6%), a hipertensão arterial foi a doença mais prevalente (54,7%), faziam uso constante de medicamentos (82,9%), se mostraram dependentes na realização das Atividades da Vida Diária (68,4%), o risco de demência para os idosos que possuíam escolaridade foi de 14,8% e para os analfabetos ou que não se tinha registro sobre escolaridade o risco de demência foi de 45,7% e 39,5% respectivamente. A maioria dos idosos é portadora de morbidades, é dependente para realização das atividades de vida diária e com a capacidade cognitiva comprometida. As Instituições de Longa Permanência para Idosos investigadas necessitam de adequação na estrutura física e reorganização dos serviços com o propósito de responder, principalmente, a demanda crescente da população gerontogeriátrica e atender as necessidades de saúde dos idosos residentes, de forma a estimular e promover a manutenção da sua independência e autonomia. (AU)

A Saúde de Idosos Residentes em Instituições de Longa Permanência apoiada na Teoria de Nightingale / The Health elderly people living in long-stay institutions supported by the Nightingale Theory / Las personas mayores de salud que viven en instituciones de larga estadía con el apoyo de la Teoría Nightingale

Trata-se de uma pesquisa descritiva, de corte transversal, de abordagem quantitativa que teve como objetivo geral: analisar as condições de saúde de idosos que residem em instituições de Longa Permanência e caracterizar estas instituições quanto aos aspectos físico-estruturais e organizacionais. Foi desenvolvida em quatro instituições de longa permanência localizadas no Distrito Sanitário de Itapagipe, na cidade de Salvador-Bahia, de setembro a novembro de 2013. Participaram do estudo 117 idosos residentes, quatro coordenadores e sete cuidadores de idosos destas instituições. Foram utilizados dois questionários como instrumento de coleta de dados, contendo questões sóciodemográficas e de saúde dos idosos e, questões sobre a estrutura organizacional das instituições. Os dados quantitativos foram tratados por meio do software SPSS e interpretados segundo a Teoria Ambientalista de Florence Nightingale. Os resultados mostraram que a maioria (85,5%) dos idosos era do sexo feminino, na faixa etária de 81 anos, (64,1%) era de cor parda, (88,0%) era da religião católica, (51,3%) era natural de Salvador - Bahia, possuíam 1┤8 anos de estudo (27,4%), tinham familiares (80,3%), não recebiam visitas (65,0%), solteiros (48,7%), com renda de um salário mínimo, aposentados (90,3%), procedentes da casa própria (38,5%), levados à instituição por familiares que não os filhos (66,2%), residindo nestas residências há aproximadamente 51 meses, possuíam alteração visual (96,6%), apresentavam alterações do sono (56,4%), apresentavam úlceras por pressão em região sacra (30,8%) e em região trocanteriana direita (11,1%), sofreram quedas no último ano (43,6%), a hipertensão arterial foi a doença mais prevalente (54,7%), faziam uso constante de medicamentos (82,9%), se mostraram dependentes na realização das Atividades da Vida Diária (68,4%), o risco de demência para os idosos que possuíam escolaridade foi de 14,8% e para os analfabetos ou que não se tinha registro sobre escolaridade o risco de demência foi de 45,7% e 39,5% respectivamente. A maioria dos idosos é portadora de morbidades, é dependente para realização das atividades de vida diária e com a capacidade cognitiva comprometida. As Instituições de Longa Permanência para Idosos investigadas necessitam de adequação na estrutura física e reorganização dos serviços com o propósito de responder, principalmente, a demanda crescente da população gerontogeriátrica e atender as necessidades de saúde dos idosos residentes, de forma a estimular e promover a manutenção da sua independência e autonomia.(AU)

Research in the correlation of job satisfaction, job performance and career plateau in senior health technical personnel / 中国实用护理杂志

Objective To explore the current situation and the relationship of job satisfaction,job performance and career plateau in senior health technical personnel.Methods The career plateau questionnaire,job satisfaction scale,job performance scale were adopted to carry out the questionnaire survey among 410 senior health technical personnel in Wanzhou district of Chongqing.The results underwent statistical description,correlation analysis and regression analysis.Results Senior health technical personnel's career plateau score was 2～5 points,with an average of (3.26±0.58) points,job satisfaction score was 20～60 points,with an average of (44.81±11.46) points,job performance score was 20～75 points,with an average of (35.79 ± 9.55) points.The score of career plateau was significantly negatively correlated with job satisfaction,and was significantly negatively correlated with job performance.The content of plateau was a factor affecting job satisfaction,and the content and the level of plateau were influencing factors of job performance.Conclusions Career plateau in senior health technical personnel was in a moderate level,while job satisfaction and job performance were relatively low.Hospital managers should take in occupation development assistance strategy and reduce negative influence of career plateau to improve job satisfaction and job performance in senior health technical personnel.

Clinical, behavioral, and treatment differences in nursing facility residents with dementia, with and without pseudobulbar affect symptomatology.

OBJECTIVES: Characterize the prevalence and impact of crying and tearfulness as symptoms that may be suggestive of pseudobulbar affect (PBA) in residents of nursing facilities, including those with Alzheimer's disease (AD) and non-AD [non-AD-associated] associated dementia. DESIGN: Data were extracted retrospectively from a large repository of de-identified and linked Minimum Data Set 2.0 (MDS) and prescription claims records for the period between October 1, 2009, and September 30, 2010. A score of 1 or 2 on MDS item E1m ("crying, tearfulness") was used to identify potential PBA. SETTING: 19,000 nursing facilities in 48 states. PATIENTS/PARTICIPANTS: Prescription and MDS records of nursing facility residents. MAIN OUTCOME MEASURES: Comparison of concomitant diagnoses, MDS mood, and behavioral indicators, and psychopharmacologic medication use, in residents with crying/tearfulness to a control group matched for age, gender, diagnosis of AD or non-AD dementia, and diagnosis of depression. RESULTS: A total of 137,829 residents underwent at least one MDS assessment during the study period. Of these, 12,595 (9.1%) had item E1m ("crying, tearfulness") scored as a 1 or 2 on their MDS assessments. Ten thousand residents were then randomly selected from this group and matched to 10,000 controls without "crying, tearfulness" (MDS E1m = 0) for analysis. A total of 4,786 (47.9%) unique residents with "crying, tearfulness" had a diagnosis of AD (8.8%), non-AD dementia (31.5%), or both (7.6%). All of the MDS mood indicators were at least twice as prevalent in this group compared with those without "crying, tearfulness" Additionally, mood symptoms such as anger, worried/pained facial expressions, and repetitive verbalizations; and behavioral symptoms such as verbal/physical abuse and socially inappropriate/disruptive behavior, were more than twice as frequent in the "crying, tearfulness" group. Antipsychotic medications were also used more often in this group (50% vs. 36.1%), as were antidepressants (59.1% vs. 49.8%). CONCLUSIONS: In the absence of an International Classification of Diseases 9th edition, Clinical Modification code, the presence of "crying, tearfulness" on MDS 2.0 item E1m was used as a proxy to identify potential PBA. Nursing facility residents with "crying, tearfulness" had a higher prevalence of all mood and behavior indicators as well as psychopharmacological medication use, compared with matched controls without "crying, tearfulness." Similar results were seen in the subgroup of residents with an underlying diagnosis of AD and/or non-AD dementia. Further research should validate the actual prevalence of PBA in this population, and the corresponding impact on resident outcomes.

Dança de salão: repercussões nas atividades de vida diária / Ballroom dancing: repercussions to daily activities of elderly people

Trata-se de estudo descritivo objetivando: evidenciar os motivos que levam pessoas da terceira idade a praticar a dança de salão; conhecer, a partir dos discursos de pessoas da terceira idade, os efeitos da prática da dança de salão nas atividades de vida diária. Foi realizado numa escola de dança de salão conceituada em Fortaleza-CE, que trabalha com a terceira idade. Participaram da pesquisa treze (13) mulheres com idade mínima de 60 anos, praticantes da dança de salão. Para coleta de dados utilizou-se a entrevista estruturada focalizada gravada, durante o período de 05/05 a 05/06 de 2004. Constatou-se que a dança de salão é uma atividade física prazerosa e motivante, que auxilia pessoas a melhorar sua qualidade de vida e seu desempenho nas AVD?s, dando-lhes autonomia e prevenindo doenças causadas pela inatividade física. Os resultados sugerem que os indivíduos praticantes da dança de salão melhoraram os aspectos físicos, psíquicos e sociais, o que possibilita concluir que a prática da dança de salão tem preservado e melhorado as capacidades funcionais, a auto-estima e a socialização das pessoas da terceira idade, que é fundamental para a realização eficiente das tarefas vivenciais, facilitando o cotidiano dessas pessoas, que buscam permanentemente a emancipação.

This article refers to a descriptive study that aimed at: to investigate the reasons that make elderly people practice ballroom dancing; to know from those people?s speech the effects of the practice of the ballroom dancing in the daily activities of elderly people. It took place at an well appraised school of ballroom dancing in the city of Fortaleza, which works with people in advanced age. Thirteen women with minimum age of 60, who practice ballroom dancing participated regularly in the research. A structured, focalized and recorded interview was used to collect the data, during the period from 05/05 to 05/06 of 2004. It was verified that ballroom dancing is a pleasant and exciting physical activity, that aids people to improve their quality of life and their performance in daily activities, giving them autonomy, preventing diseases caused by sedentarism. It was concluded that individuals who practise ballroom dancing have had improved their physical, psychic and social aspects; what makes possible to infer that the practice of the ballroom dancing has been preserving and improving the functional capacities, the self-esteem and the socialization of aged people, which is fundamental for the efficient accomplishment of the everyday tasks of those, who permanently look for emancipation.