The level of actual functional fitness of men from different living environments in Poland and associations with health - a cross-sectional study.

BACKGROUND: The study aimed to assess the differences in functional fitness between older men living in social welfare homes (SWH) and men living in society. METHODS: The study involved 474 men aged 60-84, including 134 men living in social welfare homes and 340 men living in community. The Senior Fitness Test was used to assess functional fitness. Body weight and height were measured. Moreover, data on age, education, taking up physical activity and place of residence were collected. RESULTS: A significantly lower level of functional fitness of SWH residents was demonstrated compared to men living in the society (p < 0.001). A significant percentage of seniors living in SWH did not reach the normal range for the Polish population. Also, the level of education, physical activity and health self-assessment differentiated the institutionalized men from those living in the community. CONCLUSIONS: The place of residence is a factor that differentiates seniors' functional fitness levels. The reduced fitness of social welfare home residents may also result from the low level of their daily physical activity, education and health. Introducing physical activity programs for elderly residents in social welfare homes seems reasonable. TRIAL REGISTRATION: ISRCTN platform as 18,225,729; December 2020.

[The general practitioner in nursing homes : an incongruous actor ? Study in nursing homes in a deprived area]. / Le médecin généraliste en EHPAD : un acteur incongru ? Étude au sein des EHPAD d'un territoire défavorisé.

CONTEXT: Residential facilities for dependent elderly people have difficulties ensuring medical follow-up of their residents by general practitioners. The barriers to medical visits are well-known. Seine-Saint-Denis is particularly affected by the medical demography crisis. OBJECTIVES: To describe the organization of visits by general practitioners in residential facilities for dependent elderly people in Seine-Saint-Denis. To assess the influence of the institutions' status on this organization. METHOD: Quantitative descriptive cross-sectional study of 65 facilities in Seine Saint-Denis. A questionnaire drawn from the literature on known barriers to medical visits was used. RESULTS: Fifty institutions (76.9%) contributed. Most visits (88.0%) took place in patients' rooms. When the practitioner arrived, the patient was present at the site in 80.0% of the facilities, especially when they were private and associative (p = 0.01). The doctor was accompanied by a staff member in 30.0% of the facilities, especially when they were for-profit (p = 0.02). Exchanges between general practitioners and the staff were sporadic and unorganized. All in all, the public facilities seemed to be less well-organized to receive general practitioners. DISCUSSION: Residential facilities for the elderly do not seem to have implemented specific organization for visits by general practitioners, who are not integrated in the staff. CONCLUSION: Experiments with doctors gainfully employed in institutions could be carried out, following the example of several foreign countries.

Indoor Built Environment and Older Adults' Activity: A Systematic Review.

Although the physical environment can influence people's activity, there are few knowledge syntheses for indoor environments and older adults' daily life routines. Therefore, we conducted a systematic review of peer-reviewed evidence to inform future research and practice. Inclusion criteria were studies with any research designs, across all years and languages focused on older adults 60 years of age or more, on physical activity/sedentary behaviour and the indoor environment. After searching five databases, two authors completed title/abstract and full-text screening. The last search was on December 19, 2020. We screened 1,367 citations, and included 23 studies situated in private or collective dwellings (e.g., assisted living). We identified physical activity-supportive indoor features across three domains: campus (e.g., amenities, pathways), building (e.g., area, floor level), and fixtures (e.g., elevators, hallways). Knowledge of indoor environmental factors for older adults' engagement in daily activities can guide future research and policy on housing design.

Infection control measures promoted by the public health center for "housing for the elderly" facilities during norovirus cluster outbreaks.

Objective: "Housing for the elderly" is a type of facility where a few healthcare staff and care workers provide long-term care to residents. This study aimed to explore the infection control measures promoted by the public health centers (PHC) when a cluster of norovirus cases occurred in this type of facility. Materials and Methods: This study involved a prefectural office in Japan and collected the records of PHC surveys/instructions of norovirus cluster cases that occurred in "housing for the elderly" facilities between 2017 and 2019. The records provided information about the case characteristics (cluster periods and number of infected individuals) and instructions for infection control by the PHC. We tabulated the case characteristics and performed a descriptive qualitative analysis to extract the instructions from the PHC. Results: Twelve clusters of cases were included in the study. Approximately 16% of the residents and care workers in each facility were infected, and it took an average of 23 days from the start of the outbreak to the end. Nine categories of PHC instructions emerged after the data analysis. "Collaboration with community healthcare workers" included instructions by the PHC to share information with external physicians and home-visiting nurses. In "precautions when caring for elderly residents with functional decline", the procedure for changing diapers and infection control measures considering the behavior of residents with dementia were advised. If the contents of the infection control manuals were deemed to be inadequate, an "improvement of the infection control manuals" was instructed. Conclusion: To implement effective infection control by care workers at "housing for the elderly" facilities, the PHC should promote the involvement of community physicians and nurses and advise on clear procedures based on residents' functional decline.

The prevalence and intensity of pain in older people living in retirement villages in Auckland, New Zealand.

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross-sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face-to-face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre-specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self-reported arthritis (OR = 3.88, 95% CI = 2.57-5.87), poor/fair self-reported health (OR = 3.19, 95% CI = 1.29-7.93), having no health clinic on-site (OR = 1.76, 95% CI = 1.10-2.83), and minimal fatigue (diminished energy but completes normal day-to-day activities) (OR = 1.77, 95% CI = 1.11-2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self-reported arthritis, self-reported poor/fair health, no health clinic on-site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on-site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality-of-life, though as we cannot prove causality, more research is needed.

Feasibility, Acceptability, and Performance of a Continuous Temperature Monitor in Older Adults and Staff in Congregate-Living Facilities.

OBJECTIVES: Residents of congregate-living facilities are susceptible to disability and mortality from infection given the presence of advanced age, multimorbidity, and frailty-as demonstrated in the recent COVID pandemic. This study assessed the feasibility, acceptability, and applicability of a continuous temperature monitoring device in a congregate-living facility with residents of independent living, assisted living, and their care-providing staff. We hypothesized that a wearable device compared with daily manual temperature assessment would be well tolerated and more effective at detecting temperature variances than current standard of care body temperature assessment. DESIGN: Feasibility study. SETTING AND PARTICIPANTS: Residents of assisted and independent living and staff of a retirement community. METHODS: Thirty-five participants, including residents in assisted- and independent-living facilities (25) and staff (10) were enrolled in a 90-day feasibility study and wore a continuous temperature sensor from March to July 2021. Primary outcomes included study completion, ability to reapply the sensor, temperature data acquisition, and data availability from the sensors. A secondary analysis of the temperature data involved comparing the method of obtaining temperature using the continuous monitoring device against standard of care using traditional manual thermometers. RESULTS: Overall, 91.3% of residents, who were in the study during the first reapplication, were able to apply the device without assistance (21 of 23), and 80% of resident participants completed the study (20 of 25). For staff participants, completion rates and reapplication rates were 100%. Data acquisition rates from the continuous temperature devices were much higher than manual temperatures. Four episodes of fever were detected by the devices; manual temperature checks did not identify these events. CONCLUSIONS AND IMPLICATIONS: Continuous temperature monitoring in an older adult population and the staff in congregate-living facilities is feasible and acceptable. This approach identified fever undetected by current standard of care indicating the capability of this device for earlier detection of fevers.

Futuro del cuidado gerontológico de enfermería. Perspectiva de futuros usuarios / The future of gerontologic nursing care. Next users' view

Objetivos: El cuidado institucionalizado de personas mayores es una realidad en España. Muchos hijos acompañan a sus padres en esa experiencia de vida y conforman su propia opinión. El objeto del estudio es conocer esa opinión, proponiendo una mirada hacia el futuro cuidado que ellos podrán recibir, partiendo de la opinión que tienen del cuidado actual que reciben sus padres. Metodología: La metodología utilizada es cualitativa, mediante entrevistas en profundidad y análisis de contenido, en una muestra integrada por hijos/as de residentes de dos centros residenciales de la ciudad de Jaén. Resultados: El resultado es que aceptan el modelo de cuidados actual para sus padres, salvo por algunas cuestiones que podrían mejorar, pero no lo admiten para sí mismos. Conclusiones: Se concluye que es necesaria la evolución de la asistencia, a través de la domiciliación y la especialización del cuidado (AU)

Objectives: The nursing home care of the elderly is a reality in Spain. Many of them are accompanied by their children in this life experience, whom create their own opinion. Knowing the children opinion including a future perspective is the main purpose of the research, on the basis of their current opinion of caring. Methods: A qualitative survey is used, with in-depth interviews and content analysis. The sample was selected from two nursing homes in the city of Jaen. Results: The main outcome was than they are satisfied with this kind of caring but not for themselves. Conclusions: We conclude that elderly care needs moving to home and through care specialization (AU)

Impact of care level, setting and accommodation costs on a newly developed oral care nursing plan format for elderly patients with care needs - Results from a cross-sectional study.

OBJECTIVES: A new oral care nursing plan format for improved communication among dentists, nursing staff and caregivers has been developed in Germany. We aimed to (1) describe this plan, (2) investigate the prevalence of oral health problems among elderly patients with care needs documented by the plan, outline the recommendations in the plans and (3) investigate whether the accommodation costs or care needs of patients influenced oral care quality or the need for oral hygiene support documented within the plan. METHODS: In this cross-sectional trial, oral care nursing plans were collected from outpatient and inpatient care clinics. Items on the oral care nursing plan were divided into three areas (oral health, oral hygiene needs, and coordination needs and dental therapy) and were correlated with the care level and accommodation costs. RESULTS: Oral care nursing plans were collected from seven dentists (N = 747; 94.5% from inpatient and 5.5% from outpatient care). The plans enabled documentation of well-known oral health and hygiene problems among elderly patients. In their current form, the plans provided recommendations for obvious oral hygiene tasks such as toothbrushing or fluoridating, rather than specialized tasks such as nutritional advice or dry mouth asymptomatic therapeutic approaches. Although accommodation costs were associated with the need for oral hygiene support (not with oral care condition), the care level influenced both measures. CONCLUSIONS: The oral care nursing plan can facilitate documentation of oral health and hygiene among elderly individuals with care needs. Further clarification of the plan would help promote careful documentation by dentists.

Living with dementia in supported housing: A systematic review and thematic synthesis of qualitative research.

Supported housing has been highlighted as a potential way to facilitate independent living for people with dementia by integrating housing with support or care services. However, the benefits and challenges of living with dementia in supported housing are not fully understood. This systematic review and thematic synthesis sought to understand how living in supported housing influences the lives of people with dementia, from the perspectives of people with dementia, their supporters, health and social care professionals. Seven databases were searched for qualitative research, date range: 1 January 2000-31 July 2021. Eleven published articles were included in the thematic synthesis. One core theme was generated, Maintaining Independence and Autonomy, divided into three subthemes - Support and Care, Social Relationships and the Physical Environment. Factors like person-centred care, social interaction and good environmental design contributed to the maintenance of independence and autonomy. Barriers like low staff ratios, stigma and limited access to the community led to a loss of independence and autonomy - often leading to people with dementia being referred or managed out of the settings. Although the articles acknowledged the importance of maintaining independence and autonomy for people with dementia, it appeared that supported housing settings often lacked the resources and facilities to make this a reality. More high-quality research is needed, particularly from the perspectives of people with dementia and their supporters, to understand if supported housing can delay care home admission, promote independence and autonomy and facilitate social networks and community connections for this population.

Saberes e práticas preventivas de pessoas idosas sobre a COVID-19 / Elderly people's knowledge and preventive practices about COVID-19

RESUMO Objetivo compreender os saberes e as práticas preventivas de pessoas idosas sobre a COVID-19. Métodos pesquisa qualitativa e desenvolvida com 11 pessoas idosas residentes em um condomínio do idoso. Dados obtidos com uso da técnica de entrevistas individuais e, a seguir, submetidos à análise lexicográfica por meio da Classificação Hierárquica Descendente utilizando o software IRaMuTeQ®; e discussão à luz da literatura sobre COVID-19. Resultados emergiram seis classes: Construindo saberes e práticas preventivas sobre a COVID-19; Consequências emocionais; Práticas preventivas e de controle; Reconhecimento e importância das estratégias de prevenção; Impactos físicos, sociais e econômicos e Fatores de risco individuais e coletivos. Conclusão as pessoas idosas compreendem as consequências negativas da COVID-19, identificando os fatores de risco individuais e coletivos, apreendidos com base em vivências durante a pandemia, experiências prévias, diálogos e fontes de informação. Reconhecem a importância das práticas preventivas, realizando cuidados no ambiente domiciliar e urbano. Contribuições para a prática o estudo contribui positivamente para a assistência às pessoas idosas com a construção de conhecimentos acerca da COVID-19, sobretudo, no contexto de pessoas idosas residentes em um condomínio do idoso, sensibilizando e embasando os profissionais de saúde para planejarem e desenvolverem ações educativas problematizadoras, impactando na prática profissional.

ABSTRACT Objective to understand the knowledge and preventive practices of elderly people about COVID-19. Methods qualitative research developed with 11 elderly people living in a condominium for the elderly. Data were obtained using the technique of individual interviews and then submitted to lexicographic analysis by means of the Descending Hierarchical Classification using the software IRaMuTeQ®; and discussion in the light of the literature on COVID-19. Results six classes emerged: Building knowledge and preventive practices about COVID-19; Emotional consequences; Preventive and control practices; Recognition and importance of prevention strategies; Physical, social, and economic impacts; and Individual and collective risk factors. Conclusion the elderly understands the negative consequences of COVID-19, identifying the individual and collective risk factors, learned based on experiences during the pandemic, previous experiences, dialogues, and sources of information. They recognize the importance of preventive practices, carrying out care in the home and urban environment. Contributions to practice the study contributes positively to the care of the elderly with the construction of knowledge about COVID-19, especially in the context of elderly residents in a condominium for the elderly, sensitizing and grounding health professionals to plan and develop problematizing educational actions, impacting on professional practice.

Infection control measures promoted by the public health center for “housing for the elderly” facilities during norovirus cluster outbreaks / Journal of Rural Medicine

Objective: “Housing for the elderly” is a type of facility where a few healthcare staff and care workers provide long-term care to residents. This study aimed to explore the infection control measures promoted by the public health centers (PHC) when a cluster of norovirus cases occurred in this type of facility.Materials and Methods: This study involved a prefectural office in Japan and collected the records of PHC surveys/instructions of norovirus cluster cases that occurred in “housing for the elderly” facilities between 2017 and 2019. The records provided information about the case characteristics (cluster periods and number of infected individuals) and instructions for infection control by the PHC. We tabulated the case characteristics and performed a descriptive qualitative analysis to extract the instructions from the PHC.Results: Twelve clusters of cases were included in the study. Approximately 16% of the residents and care workers in each facility were infected, and it took an average of 23 days from the start of the outbreak to the end. Nine categories of PHC instructions emerged after the data analysis. “Collaboration with community healthcare workers” included instructions by the PHC to share information with external physicians and home-visiting nurses. In “precautions when caring for elderly residents with functional decline”, the procedure for changing diapers and infection control measures considering the behavior of residents with dementia were advised. If the contents of the infection control manuals were deemed to be inadequate, an “improvement of the infection control manuals” was instructed.Conclusion: To implement effective infection control by care workers at “housing for the elderly” facilities, the PHC should promote the involvement of community physicians and nurses and advise on clear procedures based on residents’ functional decline.

Choosing and Managing Aged Care Services from Afar: What Matters to Australian Long-Distance Care Givers.

This research aims to identify the factors that influence caregivers' decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively sampled and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A sample of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.

Fragility syndrome: determinant factors ininstitutionalized elderly / Síndrome de fragilidade: fatores determinantes em idosos institucionalizados / Síndrome de fragilidad: factores determinantes em personas institucionalizadas

The aim of the study was to evaluate the frailty syndrome in residents of a Long-Term Care Facility for the Elderly. A cross-sectional study was carried out on 24 subjects over the age of 60 years. For the screening of frailty syndrome, the criteria of the Cardiovascular Study were used, which classifies the subjects into fragile, pre-fragile and non-fragile according to five criteria: decreased handgrip strength; self-reported fatigue; decrease in walking speed; unintentional weight loss; and low level of physical activity. The average age of the population studied was 81.13 years, with 54.20% being female. Among the elderly, 83.33% were frail, 12.50% were pre-frail and 4.17% were not frail. Elderly people over 80 years old had a higher incidence of frailty when compared to those aged 60 -79 years, with 85.7% and 80%, respectively. Since 66.67% of the elderly had decreasedhandgrip muscle strength, 37.50% reported fatigue, 41.67% demonstrated decreased gait speed, 12.50% unintentional weight loss and 87.50% were physically inactive. We identified a high prevalence of DES among the elderly residing in the institution studied, thus reinforcing the importance of early screening for frailty in institutionalized elderly(AU)

O objetivo do estudo foi avaliar a síndrome de fragilidade em residentes de uma Instituição de Longa Permanência para Idosos. Foi realizado um estudo transversal em 24 sujeitos com idade superior a 60 anos. Para rastreamento da síndrome de fragilidade foram utilizados os critérios do Estudo Cardiovascular que classifica os sujeitos em frágil, pré-frágil e não frágil de acordo com cinco critérios: diminuição da força de preensão manual; auto-relato de fadiga; diminuição da velocidade de marcha; perda de peso não intencional; e baixo nível de atividade física. A idade média da população estudada foi de 81,13 anos, sendo 54,20% do sexo feminino. Entre os idosos houve 83,33% com fragilidade, 12,50% eram pré-frágeis e 4,17% não frágeis. Os idosos acima de 80 anos apresentaram incidência maior de fragilidade quando comparados aos de 60 ­79 anos, com 85,7% e 80%, respectivamente. Sendo que 66,67% dos idosos apresentaram diminuição da força muscular de preensão manual, 37,50% relataram fadiga, 41,67% demonstraram diminuição da velocidade da marcha, 12,50% perda de peso não intencional e 87,50 % eram inativos fisicamente. Identificamos alta prevalência de SF entre os idosos residentes na Instituição estudada, reforçando assim a importância do rastreamento precoce da fragilidade em idosos institucionalizados(AU)

El objetivo del estudio fue evaluar el síndrome de fragilidad en los residentes de un centro de atención a largo plazo para ancianos. Se realizó un estudio transversal en 24 sujetos mayores de 60 años. Para el cribado de síndrome de fragilidad, se utilizaron los criterios del Estudio Cardiovascular, que clasifica a los sujetos en frágiles, pre-frágiles y no frágiles de acuerdo con cinco criterios: disminución de la fuerza del mango; fatiga autoinformada; disminución de la velocidad al caminar; pérdida depeso involuntaria; y bajo nivel de actividad física. La edad promedio de la población estudiada fue de 81.13 años, con un 54.20% de mujeres. Entre los ancianos, 83.33% eran frágiles, 12.50% eran pre-frágiles y 4.17% no eran frágiles. Las personas mayores de más de 80 años tuvieron una mayor incidencia de fragilidad en comparación con las personas de 60 a 79 años, con 85.7% y 80%,respectivamente. Dado que el 66.67% de los adultos mayores había disminuido la fuerza muscular de la empuñadura, el 37.50% informó fatiga, el 41.67% demostró una disminución de la velocidad de la marcha, 12.50% de pérdida de peso no intencional y 87.50% físicamente inactivo Identificamos una alta prevalencia de DES entre los ancianos que viven en la institución estudiada, lo que refuerza la importancia de la detección temprana de la fragilidad en ancianos institucionalizados(AU)

Health Impacts of the Stay-at-Home Order on Community-Dwelling Older Adults and How Technologies May Help: Focus Group Study.

BACKGROUND: As of March 2021, in the USA, the COVID-19 pandemic has resulted in over 500,000 deaths, with a majority being people over 65 years of age. Since the start of the pandemic in March 2020, preventive measures, including lockdowns, social isolation, quarantine, and social distancing, have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact their mental and physical health. OBJECTIVE: This study aimed to assess the impact of the COVID-19 pandemic and the resulting "Stay-at-Home" order on the mental and physical health of older adults and to explore ways to safely increase social connectedness among them. METHODS: This qualitative study involved older adults living in a Continued Care Senior Housing Community (CCSHC) in southern California, USA. Four 90-minute focus groups were convened using the Zoom Video Communications platform during May 2020, involving 21 CCSHC residents. Participants were asked to describe how they were managing during the "stay-at-home" mandate that was implemented in March 2020, including its impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods. RESULTS: Four themes emerged from the qualitative data: (1) impact of the quarantine on health and well-being, (2) communication innovation and technology use, (3) effective ways of coping with the quarantine, and (4) improving access to technology and training. Participants reported a threat to their mental and physical health directly tied to the quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from their friends and family. CONCLUSIONS: Our study findings suggest that technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized for future research.

Research in the retirement village community-The problems of recruiting a representative cohort of residents in Auckland, New Zealand.

OBJECTIVES: Retirement villages are semi-closed communities, access usually being gained via village managers. This paper explores issues recruiting a representative resident cohort, as background to a study of residents, to acquire sociodemographic, health and disability data and trial an intervention designed to improve outcomes. METHODS: We planned approaching all Auckland/Waitemata District villages and, via managers, contacting residents ('letter-drop'; 'door-knocks'). In 'small' villages (n ≤ 60 units), we planned contacting all residents, randomly selecting in 'larger' villages. We excluded those with doubtful or absent legal capacity. RESULTS: We approached managers of 53 of 65 villages. Thirty-four permitted recruitment. Some prohibited 'letter-drops' and/or 'door-knocks'. Hence, we recruited volunteers (23 villages) via meetings, posters, newsletters and word-of-mouth, that is representative sampling obtained from 11/34 villages. We recruited 578 residents (median age = 82 years; 420 = female; 217:361 sampled:volunteers), finding differences in baseline parameters of sampled vs. volunteers. CONCLUSION: Due to organisational/managers' policy, and national legislation restrictions, our sample does not represent our intended population well. Researchers should investigate alternative data sources, for example electoral rolls and censuses.

Sex differences for predicting metabolic syndrome by adipose dysfunction markers in institutionalized elderly.

AIMS: Recent studies have emphasized that metabolic syndrome (MetS) was the most important modifiable risk factor for cardiovascular and cerebrovascular diseases in the institutionalized elderly. In addition, the occurrence of MetS was higher in those with longer age-adjusted institutionalization time. The present study was conducted to assess predictive value of markers of adipose tissue dysfunction for the early screening of MetS in this population. METHODS AND RESULTS: Two hundred and eleven institutionalized older adults (132 women, aged 74.3 ± 7.3 years; 79 men, aged 71.5 ± 7.3 years) were enrolled in the current cross-sectional study. Lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), and triglycerides (TG)/high-density lipoprotein (HDL)-cholesterol ratio were determined. The receiver operating characteristic curve was calculated to compare the area under the curve of each index. The total prevalence of MetS was 23.8%. In female group, VAI and TG/HDL ratio presented moderate-high sensitivity (77.78% and 78.38%, respectively) and specificity (77.62% and 73.49%, respectively). In males group, LAP presented moderate-high sensitivity (75%) and specificity (76.9%). CONCLUSION: Gender played a key role on the prediction of MetS by adipose dysfunction markers in institutionalized elderly. Accordingly, VAI and TG/HDL-cholesterol ratio showed the highest predictive value for MetS in female elderly. LAP was the strongest predictor of MetS in male elderly.

Comparison of retrograde ureterorenoscopy (URS) and percutaneous anterograde ureteroscopy for removal of impacted upper ureteral stones >10mm in the elderly population

ABSTRACT Purpose: We aimed to compare the success and complication rates of the anterograde and retrograde Ureterorenoscopy (URS) for impacted upper ureteral stones in patients > 65 years of age. Materials and Methods: Data of 146 patients >65 years of age and underwent anterograde URS (n=68) in supine position or retrograde URS (n=78) for upper ureteral impacted stones>10 mm between January 2014 and September 2018 were collected prospectively. The groups were compared for success and complication rates, duration of operation, hospital stay, and ancillary procedures. Results: Anterograde and retrograde URS groups were similar for demographic and stone related characteristics. The success rate of the anterograde URS group was significantly higher than the retrograde URS group (97.1% vs. 78.2%, p=0.0007). The complication rates were similar for the two groups (p=0.86). Clavien grade I and II complications were observed in 3 patients in each group. The mean hemoglobin drop was 0.5 g/dL in the anterograde URS group and blood transfusion was not performed in any of the patients. The mean duration of operation was 41.2±12.5 minutes in the mini-PNL group and 59.6±15.1 minutes in the RIRS group and the difference was statistically significant (p=0.02). The median duration of hospitalization was 1 day for both groups. Conclusions: Performing anterograde URS in supine position provided better success rates and similar complication rates compared to retrograde URS. Based on these results anterograde URS shall be considered as one of the primary treatment options for management of impacted upper ureteral stones in the elderly population.

El síndrome de burnout en trabajadores de centros sociosanitarios / Burnout Syndrome in Sociosanitary Center workers

Objetivo: determinar el grado de burnout de los profesionales de los centros sociosanitarios de la provincia de Salamanca, así como explorar cuál es la influencia de factores sociodemográficos y laborales en este problema.Método: se llevó a cabo un estudio descriptivo transversal con una muestra escogida por conveniencia de trabajadores de centros sociosanitarios de la provincia de Salamanca (n= 461). Se administró el cuestionario Maslach Burnout Inventory (MBI). Se realizó un análisis descriptivo y para la comparación entre variables se utilizó el test estadístico de Chi cuadrado con un nivel de significación elegido de p< 0,05.Resultados: se analizaron 368 cuestionarios; un 81% era mujer, un 64,4% auxiliar de Enfermería. La puntuación media en el MBI fue de 66,75 (DE: 12,14): un nivel medio-alto de burnout y casi el 16% padecía de burnout. Un 29,9% presentó nivel alto de cansancio emocional, un 64,4% nivel alto de despersonalización y un 26,6% un bajo nivel de realización personal. Se hallaron diferencias estadísticamente significativas entre el burnout global con el estado civil, la categoría profesional, la antigüedad en la profesión y tener alguna persona dependiente económicamente, aunque otras variables como la edad o la zona geográfica también estaban relacionadas con el cansancio emocional y la despersonalización, así como el sexo con la realización personal.Conclusiones: los profesionales presentaban un nivel medio-alto de burnout. Todas las variables sociodemográficas tenían asociación con alguna de las dimensiones del burnout. Se debe ofrecer formación a los profesionales para prevenir el burnout y mejorar la salud de los trabajadores y de sus pacientes.(AU)

Objective: to determine the burnout level of professionals from sociosanitary centers in the province of Salamanca, as well as to explore the influence of sociodemographic and occupational factors in this issue.Method: a cross-sectional descriptive study was conducted, including workers from sociosanitary centers of the province of Salamanca (n=461) selected through convenience sampling. The Maslach Burnout Inventory (MBI) questionnaire was applied. There was descriptive analysis, and the Chi Square statistical test was used for comparison between variables, with a significance level selected at p< 0.05.Results: in total, 368 questionnaires were analyzed; 81% of the participants were female, and 64.4% were Nursing Assistants. The mean MBI score was 66.75 (SD: 12.14): a medium-high burnout level, and almost 16% experienced burnout. A 29.9% presented a high level of emotional exhaustion, 64.4% presented a high level of depersonalization, and 26.6% a low level of personal fulfilment. There were statistically significant differences between overall burnout in terms of marital status, professional category, labor seniority, and having some person depending economically from them; although other variables such as age and geographical area were also associated with emotional exhaustion and depersonalization, as well as gender with personal fulfillment.Conclusions: professionals presented a medium-high level of burnout. All sociodemographic variables were associated with some of the burnout dimensions. Professionals must be offered training in order to prevent burnout and improve the health of workers and their patients.(AU)

Lonely in a crowd: loneliness in New Zealand retirement village residents.

OBJECTIVES: The number of older people choosing to relocate to retirement villages (RVs) is increasing rapidly. This choice is often a way to decrease social isolation while still living independently. Loneliness is a significant health issue and contributes to overall frailty, yet RV resident loneliness is poorly understood. Our aim is to describe the prevalence of loneliness and associated factors in a New Zealand RV population. DESIGN: A resident survey was used to collect demographics, social engagement, loneliness, and function, as well as a comprehensive geriatric assessment (international Resident Assessment Instrument [interRAI]) as part of the "Older People in Retirement Villages Study." SETTING: RVs, Auckland, New Zealand. PARTICIPANTS: Participants included RV residents living in 33 RVs (n = 578). MEASUREMENTS: Two types of recruitment: randomly sampled cohort (n = 217) and volunteer sample (n = 361). Independently associated factors for loneliness were determined through multiple logistic regression with odds ratios (ORs). RESULTS: Of the participants, 420 (72.7%) were female, 353 (61.1%) lived alone, with the mean age of 81.3 years. InterRAI assessment loneliness (yes/no question) was 25.8% (n = 149), and the resident survey found that 37.4% (n = 216) feel lonely sometimes/often/always. Factors independently associated with interRAI loneliness included being widowed (adjusted OR 8.27; 95% confidence interval [CI] 4.15-16.48), being divorced/separated/never married (OR 4.76; 95% CI 2.15-10.54), poor/fair quality of life (OR 3.37; 95% CI 1.43-7.94), moving to an RV to gain more social connections (OR 1.55; 95% CI 0.99-2.43), and depression risk (medium risk: OR 2.58, 95% CI 1.53-4.35; high risk: OR 4.20, 95% CI 1.47-11.95). CONCLUSION: A considerable proportion of older people living in RVs reported feelings of loneliness, particularly those who were without partners, at risk of depression and decreased quality of life and those who had moved into RVs to increase social connections. Early identification of factors for loneliness in RV residents could support interventions to improve quality of life and positively impact RV resident health and well-being.

Comparison of retrograde ureterorenoscopy (URS) and percutaneous anterograde ureteroscopy for removal of impacted upper ureteral stones >10mm in the elderly population.

PURPOSE: We aimed to compare the success and complication rates of the anterograde and retrograde Ureterorenoscopy (URS) for impacted upper ureteral stones in patients > 65 years of age. MATERIALS AND METHODS: Data of 146 patients >65 years of age and underwent anterograde URS (n=68) in supine position or retrograde URS (n=78) for upper ureteral impacted stones>10 mm between January 2014 and September 2018 were collected prospectively. The groups were compared for success and complication rates, duration of operation, hospital stay, and ancillary procedures. RESULTS: Anterograde and retrograde URS groups were similar for demographic and stone related characteristics. The success rate of the anterograde URS group was significantly higher than the retrograde URS group (97.1% vs. 78.2%, p=0.0007). The complication rates were similar for the two groups (p=0.86). Clavien grade I and II complications were observed in 3 patients in each group. The mean hemoglobin drop was 0.5 g/dL in the anterograde URS group and blood transfusion was not performed in any of the patients. The mean duration of operation was 41.2±12.5 minutes in the mini-PNL group and 59.6±15.1 minutes in the RIRS group and the difference was statistically significant (p=0.02). The median duration of hospitalization was 1 day for both groups. CONCLUSIONS: Performing anterograde URS in supine position provided better success rates and similar complication rates compared to retrograde URS. Based on these results anterograde URS shall be considered as one of the primary treatment options for management of impacted upper ureteral stones in the elderly population.