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de Souza, Paula Fernandes, Carolina Sant’anna Gusmão, Isabelle de Souza Januária, Myllene Aparecida Leite de Souza, and Isabela Mie Takeshita. "ELDERLY AND NURSING ACADEMICS IN HEALTH CONVERSATION IN A SOCIAL ASSISTANCE REFERENCE CENTER." Revista UNINGÁ 58 (March 11, 2021): eUJ3506-eUJ3506. http://dx.doi.org/10.46311/2318-0579.58.euj3506.
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O processo de envelhecimento ocasiona modificações biopsicossociais no indivíduo, que estão associadas à fragilidade. Com isso, muitas doenças podem surgir e gerar limitações ao idoso. É nesse cenário que os profissionais da saúde estão inseridos a fim de promover a saúde do idoso e fazer com que o envelhecimento seja saudável e ativo como preconizado nas políticas públicas de saúde. O objetivo deste artigo é relatar a experiência de acadêmicas do curso de Enfermagem ao desenvolverem atividades de educação em saúde para idosas. Este é um estudo do tipo descritivo, a partir de um relato de experiência de um projeto de Educação em Saúde, que ocorreu nos meses de maio e junho de 2018 no CRAS. O grupo era predominantemente de mulheres que tiveram o interesse em participar e, em média, 17 idosas compareceram a cada encontro. A experiência contribuiu no desenvolvimento de habilidades de comunicação e educação em saúde para as acadêmicas. Dessa forma, conclui-se que o modelo utilizado de roda de conversa estabelece uma relação de atendimento integral, constrói vínculos de confiança a partir do conhecimento das histórias de vida e da visão de mundo das idosas e permite, ainda, abordar, de forma educativa, os conteúdos acerca das principais doenças da faixa etária, orientando sobre a promoção e a prevenção destas. Os grupos que promovem a educação em saúde beneficiam os idosos, que passam a promover o autocuidado.
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Ribeiro, Edmar Geraldo, Fernanda Penido Matozinhos, Gilberto de Lima Guimarães, Alcimar Marcelo do Couto, Raquel Souza Azevedo, and Isabel Yovana Quispe Mendoza. "Self-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais." Revista Brasileira de Enfermagem 71, suppl 2 (2018): 860–67. http://dx.doi.org/10.1590/0034-7167-2017-0135.
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ABSTRACT Objective: To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. Method: This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson’s Chi-square test and Poisson regression models. Results: The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. Conclusion: Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.
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Maricle, Kenneth E., and Michael W. Little. "Product Service References of Elderly Life Care Center Residents." Health Marketing Quarterly 4, no. 1 (October 20, 1986): 13–32. http://dx.doi.org/10.1300/j026v04n01_03.
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Ratna, Dwi, Sandu Siyoto, and Byba Melda Suhita. "The Perception Customers about the Means Quality Infrastructure of Ngantang Public Health Center." Journal for Quality in Public Health 4, no. 1 (November 30, 2020): 258–64. http://dx.doi.org/10.30994/jqph.v4i1.161.
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Background: Ngantang Public Health Center, being a public health center, always tries to apply minimum service standards. Services provided are a form of effort organized to meet community needs.
Purpose: The research objective was to explore customer perceptions about the quality of buildings, equipment, human resources at Public Health Center Ngantang.
Methodhs: The design used in this research is a qualitative descriptive study with a case study design, which describes customer perceptions about infrastructure; quality of buildings, equipment, human resources at the Public Health Center Ngantang. The sampling technique of this research is purposive sampling technique. The informants in this study consisted of 21 people, namely 5 BPJS PBI, 5 General, 5 Independent BPJS and 6 patient companions as triangulation informants. Data collection techniques using observation, interviews and documentation.
Results: The results of the research on customer perceptions about the Public Health Center Ngantang building are the contours of lands prone to landslides, adequate parking facilities, unsafe security facilities, building components and materials are good enough, facilities for persons with disabilities and the elderly are incomplete, consumables are not yet available, furniture is less structured, human resources or labor lack of sympathy and empathy. Conclusion: By conducting this research, it can be used as a reference for Public Health Center Ngantang in improving the quality of infrastructure. consumables are not yet available, water furniture is less structured, human resources or labor lack sympathy and empathy. By conducting this research, it can be used as a reference for Public Health Center Ngantang in improving the quality of infrastructure.
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Carneiro, Jair Almeida, Rafael Rodrigues Cardoso, Meiriellen Silva Durães, Maria Clara Araújo Guedes, Frederico Leão Santos, Fernanda Marques da Costa, and Antônio Prates Caldeira. "Frailty in the elderly: prevalence and associated factors." Revista Brasileira de Enfermagem 70, no. 4 (August 2017): 747–52. http://dx.doi.org/10.1590/0034-7167-2016-0633.
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ABSTRACT Objective: to know the prevalence and factors associated with frailty in elderly assisted by the Centro Mais Vida de Referência em Assistência à Saúde do Idoso (Mais Vida Health Reference Center for the Elderly) in the North of Minas Gerais, Brazil. Method: cross-sectional study, with sampling by convenience. Data collection occurred in 2015. Demographic and socioeconomic variables, morbidities, use of health services and the score of the Edmonton Frail Scale were analyzed. The adjusted prevalence ratios were obtained by multiple analysis of Poisson regression with robust variance. Results: 360 elderly aged 65 or older were evaluated. Frailty prevalence was 47.2%. The variables associated with frailty were the following: advanced age elderly, who live without a partner, have a caregiver, present depressive symptoms, osteoarticular disease, as well as history of hospitalization and falls in the last twelve months. Conclusion: knowledge of factors associated with frailty allows development of health actions aimed at the elderly.
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Endang, Safruddin, and Muriyati. "Factors That Affect The Event Of Hipertension In Elderly In The Herlang Puskesmas Working Area." Comprehensive Health Care 3, no. 1 (April 14, 2019): 27–35. http://dx.doi.org/10.37362/jch.v3i1.217.
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According to data from the 2014 Bulukumba health service, there were 6,355 people with hypertension and in 2016 there were 10,430 people and there were 11,714 blood pressure measurements, this hypertension increased every year. The purpose of this study is to know the factors that influence the incidence of hypertension in the elderly. Research design with 'Cross-sectional' 'the population in this study were elderly in the working area of the Herlang Public Health Center many as 120 respondents, the sample in this study amounted to 62 respondents take by using a Multivariate formula, data analysis using the result of this study indicates using the chi-square test with the value (p = 0.027), which men that there is an effect of smoking on the incidence of hypertension. And the consumption of salt with values (p = 0.012), which means there is an influence of salt consumption on the incidence of hypertension and lack of physical activity obtained values (p = 0.012) which means there is an influence on the incidence of hypertension in the elderly. The conclusion of this research is' there is an influence between smoking, consuming salts and lack of physical activity in the working area of the Herlang Public Health Center. It is suggested that the results of this study can be used as scientific reading material in the library and can also be used as reference material for students who examine the problem.
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Putri Hastari, Dwi Anjaswati, Istar Yuliadi, and Rini Setyowati. "CORRELATION BETWEEN EMOTION REGULATION AND SPIRITUALITY WITH STRESS IN CAREGIVERS OF ELDERLY." al-Balagh : Jurnal Dakwah dan Komunikasi 5, no. 1 (June 8, 2020): 27–58. http://dx.doi.org/10.22515/al-balagh.v5i1.2269.
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Stress occurs while caring for the elderly due to several factors, namely the emotion regulation and spirituality. This study aims to examine the correlation between stress with emotion regulation and spirituality in caregivers of the elderly at Karangmojo 1 Health Center, Gunungkidul. The purposive sampling method was used to obtain data from 36 caregivers on the emotion regulation and spirituality as well as stress scale with Alpha Cronbach's reliability coefficient of 0.871, 0.921, and 0.905, respectively. The results showed that r = 0.485 and Sig. 0.012 (p 0.05). Therefore there is a correlation between stress, emotion regulation, and spirituality. This means that the higher the control of emotion and spiritual level, the lower the pressure. Furthermore, this research expects to provide input in the realm of psychology. For example, it can be used as a reference to help caregivers deal with stress by increasing their emotion regulation and spirituality skills.
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de Onis, Mercedes, and Jean-Pierre Habicht. "Anthropometric Reference Data for International Use: Recommendations from a who Expert Committee." Food and Nutrition Bulletin 18, no. 2 (January 1997): 1–12. http://dx.doi.org/10.1177/156482659701800204.
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The World Health Organization (WHO) convened an Expert Committee to re-evaluate the use of anthropometry at different ages for assessing health, nutrition, and social well-being. The Committee's task included identifying reference data for anthropometric indices when appropriate, and providing guidelines on how the data should be used. For foetal growth, the Committee recommended an existing sex-specific multiracial reference. In view of the significant technical drawbacks of the current National Center for Health Statistics (NCHS)/WHO reference and its inadequacy for assessing the growth of breastfed infants, the Committee recommended the development of a new reference concerning weight and length/height for infants and children, which will be a complex and costly undertaking. Proper interpretation of mid-upper-arm circumference for pre-schoolers requires age-specific reference data. To evaluate adolescent height-for-age, the Committee recommended the current NCHS/WHO reference. Use of the NCHS body mass index (BMI) data, with their upper percentile elevations and skewness, is undesirable for setting health goals; however, these data were provisionally recommended for defining obesity based on a combination of elevated BMI and high subcutaneous fat. The NCHS values were provisionally recommended as reference data for subscapular and triceps skinfold thicknesses. Guidelines were also provided for adjusting adolescent anthropometric comparisons for maturational status. Currently, there is no need for adult reference data for BMI; interpretation should be based on pragmatic BMI cut-offs. Finally, the Committee noted that few normative anthropometric data exist for the elderly, especially for those over 80 years of age. Proper definitions of health status, function, and biologic age remain to be developed for this group.
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Palanisami, Sowbarnika, and Vasudha Kulkarni. "Association between Muscle Mass and Body Mass Index in Elderly Diabetic Patients Attending Tertiary Care Center in Bangalore, India." International Journal of Medical Students 4, no. 3 (December 31, 2016): 96–99. http://dx.doi.org/10.5195/ijms.2016.159.
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Background: Sarcopenia is a disorder causing age-related loss of muscle mass. Its multifaceted nature has been linked to an increased risk of disability and mortality. Equally, obesity is a well-known risk factor for a host of disorders. A combination of sarcopenia and obesity in elderly diabetics can synergistically lead to increased insulin resistance and risk of metabolic syndrome. This study aimed to identify the association between sarcopenia and obesity in elderly diabetic patients by a cost-effective anthropometric method. Methods: A case-control study was conducted from January 2016 to April 2016 at Dr. B. R. Ambedkar Medical College in Bangalore. Height, weight, mid-arm circumference, and triceps skin fold thickness of 112 diabetic patients and 131 healthy adults were measured. Descriptive statistical analysis and multiple linear regression analysis were carried out. Results: 26.8% of male and 76.8% of female diabetic patients were obese (body mass index ≥25 kg/m2). Incidence of sarcopenia (muscle mass one standard deviation smaller than healthy reference population, cut-off value for diabetic males being <9.79 kg/m2 and for diabetic females <8.53 kg/m2) were 12.5% in male diabetic patients and 5.4% in female diabetic patients. Conclusion: Sarcopenia and obesity are co-morbid illnesses which can cause functional and metabolic impairments in elderly diabetic patients. There exists a moderate association between muscle mass and body mass index. Loss of muscle strength (dynapenia), rather than loss of muscle mass (sarcopenia), is closely associated with disabilities in these patients.
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Sun, Feng-Ching, Hui-Chi Li, and Hsiu-Hung Wang. "The Effect of Group Music Therapy with Physical Activities to Prevent Frailty in Older People Living in the Community." International Journal of Environmental Research and Public Health 18, no. 16 (August 20, 2021): 8791. http://dx.doi.org/10.3390/ijerph18168791.
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Background: The frail elderly are prone to falls and fractures, which can result in dependency, disability, admission to institutions, and even death. They are at increased risk of frailty due to decreased physical activity, cognitive decline, and depression. Some evidence suggests that music therapy with physical activities may be particularly beneficial. Objective: This study aimed to investigate the intervention effect of music therapy with physical activities (MTPA) on frail elderly in the community. Methods: A quasi-experimental design was adopted. We selected 10 community care centers in southern Taiwan, in which elderly people over the age of 65 were assigned to a MTPA group and a comparison group after obtaining their informed consent. The MTPA group performed group music activities once a week for 120 min for 12 weeks, while the comparison group only continued with their daily activities. Instruments in this study included the Kihon Checklist, Senior Fitness Test (with Body Mass Index (BMI) and seven physical fitness items), Mini-Mental Status Examination (MMSE), and Geriatric Depression Scale Short Form (GDS-SF). Results: A total of 132 community elders agreed to participate in this study, and 122 completed both the pretest and posttest, with 62 in the music therapy group and 60 in the comparison group. The results of ANCOVA showed that after intervention, except for BMI, the Kihon frailty assessment, seven fitness scores individually and in total, MMSE, and depression showed significant improvements in the music therapy group relative to the comparison group (all p < 0.05). Conclusion: MTPA can improve the frailty index, cognitive function, depression, and physical fitness index in the community elderly. The results of this study can be used as a reference for the design of activities for the community elderly, to provide them with appropriate activities, improve their physical functions, and improve or delay their disability.
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Daromes, Verronica R., Maria Terok, and Femmy Lumi. "CHANGES IN STRESS LEVELS IN PATIENTS FOR AGE HYPERTENSION AFTER GETTING MUSIC THERAPY." Jurnal Ilmiah Perawat Manado (Juiperdo) 7, no. 2 (December 31, 2019): 137–45. http://dx.doi.org/10.47718/jpd.v7i2.811.
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Background: Stress is the response of the body and mind to everything that disturbs a person's balance. Stress can also be experienced by anyone without knowing the age limit and has a long-term effect, it also results in to increase in disease conditions one of which is hypertension in every stage of human life, especially in the elderly (Elderly). One of non-pharmacological method that can reduce blood pressure is by providing music therapy. Aims: This study to determine music therapy for changes in stress levels in elderly hypertensive patients. The design of this study is analytic operational using the cross-sectional approach. Methods: was analytic correlation using a cross-sectional approach. The population in this study amounted to 214 people. A sample of 21 respondents was obtained using a purposive sampling technique, and data were collected using the DASS (Depression Anxiety Stress Scale) questionnaire and a blood pressure measurement tool for sphygmomanometers. Result: Chi-Square analysis with an alternative test is the Exact Test using SPSS. The results of the study stress levels in elderly hypertensive patients are in the mild category that is 81%. This shows that there is a significant relationship between stress levels and hypertension in elderly hypertension patients with significance level α = 0.05 or 95% value ρ = 0.012 <α = 0.05. Conclusion: The conclusion is the relationship of music therapy to changes in stress levels in elderly hypertensive patients in the working area of the Tateli Health Center in Mandolang District. Suggestions for future researchers This study can be used as a reference to increase knowledge in carrying out nursing care in hypertensive patients, especially it is recommended that you use an audiometry device in order to know the level of hearing.
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Unnikrishnan, Rahul, George Paul, Sunil K. Senan, and Priya Vijayakumar. "Prostate Specific Antigen Values of Geriatric Individuals Visiting a Tertiary Care Hospital in Southern India for Comprehensive Check Up." International Journal Of Medical Science And Clinical Invention 5, no. 1 (January 17, 2018): 3435–38. http://dx.doi.org/10.18535/ijmsci/v5i1.12.
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Prostate Specific Antigen (PSA) has become the most commonly used tumour marker for prostate cancer. Studies have suggested that age specific cutoff values for PSA screening are better than the currently used standard cutoff of 4.0ng/ml and different races have their own reference ranges. The objective of this study was to measure the PSA values of elderly individuals attending a tertiary care centre in southern India and postulate the possible normal values of PSA in different age groups of elderly. A total of 1038 males over the age of 60 years presenting to the Elderly Comprehensive Health clinic at the Department of Geriatrics of a tertiary hospital in Southern India between March 2009 and February 2011were studied. 4ml blood was collected and PSA was estimated by Chemiluminiscent Micro-particle Immunoassay. PSA values were analyzed in terms of mean, standard deviation and 5th and 95th percentiles. Results showed that 5th and 95th percentile values were 0.27 and 3.82 among those who were 60-69 years, 0.28 and 3.43 among those who were 70-79 years and 0.26 and 3.95 among those who were more than 80 years. 10 % of the elderly population in all age subsets had PSA values over the normal. This study showed that the PSA values from South India are similar to the expected. The age specific Indians being ethnically distinct, need to have separate PSA reference ranges which need to be established with large community-based multicentre Indian studies.
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Suwarni, Sri, Cilmiaty Risya, Dono Indarto, and Suradi Pulmonology. "Helicobacter Pylori is associated with decrease serum level of the thyroid hormonal in healthy elderly population." Bangladesh Journal of Medical Science 16, no. 4 (August 19, 2017): 515–20. http://dx.doi.org/10.3329/bjms.v16i4.33604.
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Background: Helicobacter pylori infection is the most prevalence infectious disease as it affects more than half of the world population and causes chronic cellular inflammatory response in the gastric mucosa. Helicobacter pylori infection has been epidemiologically proven to be linked to extra-digestive conditions and disease. It has been speculated that H.pylori infection may be responsible for various endocrine disorders. The thyroid may be one of the targets of Helicobacter pylori chronic inflammation. Here we sought too investigate whether H.pylori infections were associated with decrease level of the thyroid hormonal.Methods: This study involved elderly aged 50-90 years who had visited a health promotion center for elderly. A total 101 euthyroid subjects were been enrolled in this cross-sectional study. Diagnosed of Helicobacter.pylori infections by ELISA of Ig G antibodies of Helicobacter pylori. We examine serum T3 level and serum TSH level by ELEXIS. For statistical method we use Pearson bivariat analysis to determine the association of two variable,and linier regression to determine which variable is more influented by Helicobacter pylori.Results: Fourty-two (41,6 %) subjects had been diagnosed with H.pylori infections. Pearson bivariat analysis showed that Helicobacter pylori infection was significantly associated with decreased serum T3 level ( correlations coefficient r = -0,66 ,p< 0,001 ). The prevalence of Helicobacter pylori infection showed a increasing trend as serum TSH level decreased (correlations coefficient r = -0,53, p < 0,001). Linier regression analysis showed thatHelicobacter pylori infection was significantly associated with the risk of decreased thyroid hormonal fuction ( B = -0,272. R2 = 0,676. P < 0.001 ).Conclusion: Our results suggested that H.pylori infections were significantly associated with the decreased serum level of T3 and TSH serum level in the healthy elderly population, whose thyroid functions were in the reference range.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.515-520
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Oldewage-Theron, Wilna H., Lilian Salami, Francis B. Zotor, and Christine Venter. "Health status of an elderly population in Sharpeville, South Africa." Health SA Gesondheid 13, no. 3 (November 18, 2008): 3–17. http://dx.doi.org/10.4102/hsag.v13i3.282.
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The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and biochemical measurements taken. The results indicate that the majority of respondents had an income of between R501 and R1 000 (South African rand) per month and most of them reported an occasional lack of funds to meet basic household needs, confirming the presence of food insecurity. Daily dietary intakes (mean±Standard Deviation [SD]) of the women were 5 395±2 946 kJ energy, 47±27 g protein, 28±21 g fat and 196±123 g carbohydrates compared to 8 641±3 799 kJ, 86±48 g, 49±32 g and 301±139 g of the men, respectively. The majority (83.6%) of the women were overweight (body mass index [BMI] >25) or obese (BMI > 30) whilst 78% had a mid-upper arm circumference (MUAC) of > 21.7 cm. Mean intakes of micronutrients were low in comparison to reference standards and serum zinc levels were suboptimal. Obesity, hypertension and raised total serum cholesterol levels indicated an increased risk for coronary heart disease. It can be concluded that a low income, household food insecurity and risk factors associated with malnutrition and non-communicable diseases were prevalent in this elderly population.
Opsomming
Die doelwit van hierdie dwarssnitstudie was ‘n omvattende bepaling van voeding- en gesondheidstatus om as basis te dien vir toekomstige intervensie-strategieë vir ’n groep bejaardes wat ’n dagsentrum besoek. Sosiodemografiese, gesondheid- en 24-uur herroep-dieetinname vraelyste is voltooi en antropometriese en biochemiese metings is geneem. Die resultate het bevestig dat die meerderheid respondente ‘n maandelikse inkomste van tussen R501 en R1 000 (Suid-Afrikaanse rand) gehad het. Die meeste het ‘n geldtekort vir basiese huishoudelike behoeftes gerapporteer wat dui op huishoudelike voedselin-sekuriteit. Daaglikse dieetinnames (gemiddeld± standaardafwyking [SA]) van die vroue was onderskei- delik 5 395±2 946 kJ energie, 47±27 g proteïen, 28±21 g vet en 196±123 g koolhidrate in vergelyking met 8 641±3 799 kJ, 86±48 g, 49±32 g en 301±139 g vir die mans. Die meerderheid (83.6%) van die vroue was oorgewig (liggaamsmassa-indeks [LMI] >25) of vetsugtig (LMI > 30) en 78% het ’n middel-bo-armomtrek (MUAC) van > 21.7 cm gehad. Gemiddelde mikronutriëntinnames was laag in vergelyking met die verwysingstandaarde en serumsink was suboptimaal. Vetsug, hipertensie en verhoogde totale serumcholesterolvlakke het op ‘n verhoogde risiko van kardiovaskulêre siekte gedui. Die resultate het dus bewys dat lae inkomste, huishoudelike voedselin-sekuriteit en die risikofaktore wat met wanvoeding en leefstylsiektes geassosieer word, teenwoordig was.
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Sheykhi, Mohammad Taghi. "A Study of the Elderly People Living in Nursing Homes in Iran with a Specific Focus on Tehran." African and Asian Studies 3, no. 2 (2004): 103–18. http://dx.doi.org/10.1163/1569209041641822.
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Abstract In the present research the author has tried to bring together the literature and collected data to examine elderly people's quality of life in Iran. In the exploratory phase, a focused group of elderly people was approached and observed. The paper also is intended for students of social policy and those responsible for the elderly people. The author hopes that the present research would act as a beginning step to expand gerontology, which is less developed in countries like Iran, as a new academic discipline. Older people are particularly interesting to study, not only because they are builders of our past, and what has led to the present, but also more importantly, they constitute the group to which, in due course, most of us will belong.This paper examines the living conditions of the elderly residing at the elderly centers in Iran with special reference to Tehran through an empirical method. In this research, while reviewing the relevant literature, the author has referred to various theories as required to assess the elderly people's quality of life. The paper also explores a perspective of the elderly people in Tehran so far as their needs, expectations, their retirement life, and their health weaknesses are concerned. The survey is carried out in the hope of creating further research drives and incentives among the young social researchers.However, as the number of elderly people is on the rise in Iran due to change in the entire social structure of the country and increase in life expectancy, there is a need for further investments to prevent the likely future challenges.
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Gowanlock, Zachary, Swetha Sriram, Alison Martin, Anargyros Xenocostas, and Alejandro Lazo-Langner. "Erythropoietin in Elderly Patients with Anemia of Unknown Etiology." Blood 126, no. 23 (December 3, 2015): 3346. http://dx.doi.org/10.1182/blood.v126.23.3346.3346.
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Abstract Background: The underlying etiology of anemia is unclear in a large proportion of elderly patients. The term "anemia of unknown etiology" (AUE) applies when investigations do not suggest a specific cause. It has been suggested that erythropoietin (EPO) may be relatively decreased in patients with AUE but previous studies have been limited by methodological considerations. To address this question we investigated the EPO response in elderly patients with AUE in comparison to other etiologies in a large cohort. Patients and methods: We conducted a retrospective cohort study including all consecutive hematology patients referred to our center and who had EPO levels determined between 2005 and 2013. We included patients 60 years or older who met the World Health Organization criteria for anemia (<130 g/L in men, <120 g/L in women) excluding patients with insufficient electronic medical records. Three reviewers independently adjudicated each patient's anemia to one of ten diagnostic groups (chronic kidney disease [CKD], iron deficiency anemia [IDA], anemia of chronic disease [ACD], myelodysplastic syndrome [MDS], AUE, suspected MDS, vitamin B12 deficiency, folate deficiency, other etiology, or multifactorial) using predetermined criteria. The etiology reported by at least two of the three reviewers was used in the analysis, with differences resolved by consensus. Inter-observer agreement was assessed using Kappa and Fleiss' Kappa statistics. Patients with IDA served as the reference group. EPO levels were compared between groups using unpaired t-tests. To adjust for potential confounders we constructed stepwise linear regression models in order to estimate the effect of each etiology on EPO level compared to the reference group. Models were adjusted for hemoglobin level, glomerular filtration rate (eGFR) and comorbidity using the Charlson Comorbidity Index. EPO concentration was log transformed to maintain the assumption of homoscedasticity. Regression coefficients were back-transformed using the exponential function and thus they represent the ratio of EPO for each given etiology relative to the reference group. Results: Of 1511 potentially eligible patients, 570 met our inclusion criteria. Diagnostic groups with 20 or less patients were excluded and thus 531 patients were included in the final analysis. The mean age was 75.7 years and 60% were male.The mean Charlson Comorbidity Index was 1.5. Inter-observer agreement for diagnostic categories was adequate. Compared to IDA, EPO was significantly lower in CKD, ACD and AUE, and higher in MDS and other etiologies. The results remained significant for CKD, ACD and AUE after adjusting for hemoglobin and eGFR, but not for MDS and other etiologies (Table). The effect of comorbidity on the models was negligible in all analyses and thus this data is not shown. Conclusion: Our results suggest that the EPO response is inadequate in elderly patients with AUE even after accounting for hemoglobin and renal function. This suggests that decreased EPO production or a blunted EPO response to anemia may play a role in the pathogenesis of AUE and that this may indeed constitute a distinct entity. Further studies exploring the potential mechanisms and clinical interventions are warranted. Table 1. Mean Erythropoietin Levels and Regression Analysis Diagnostic group N Erythropoietin (IU/L) Linear regression models Unadjusted Adjusted for Hb Adjusted for Hb and eGFR Mean P-valuea Coefficient (95% CI) Coefficient (95% CI) Coefficient (95% CI) Iron deficiency 59 102.4 - Ref. Ref. Ref. Chronic kidney disease 33 31.2 0.001 0.29 (0.18 - 0.48) b 0.29 (0.19 - 0.46) b 0.47 (0.27 - 0.81) b Chronic disease 31 26.8 < 0.001 0.42 (0.27 - 0.66) b 0.49 (0.33 - 0.72) b 0.55 (0.38 -0.79) b Myelodysplastic syndrome 180 287.8 0.002 1.68 (1.11 - 2.56) b 1.32 (0.93 - 1.87) 1.34 (0.95 - 1.87) Anemia of unknown etiology 110 38.2 0.003 0.43 (0.32 - 0.59) b 0.62 (0.46 - 0.83) b 0.73 (0.55 - 0.97) b Other etiologies 118 271.4 0.002 1.36 (0.86 - 2.15) 1.10 (0.75 - 1.60) 1.11 (0.77 - 1.58) a For the comparison with iron deficiency using a Student's t-test b P < 0.05 Disclosures Lazo-Langner: Bayer: Honoraria; Pfizer: Honoraria.
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Робинсон, K. Robinson, Ахмадуллин, F. Akhmadullin, Харисова, E. Kharisova, Ахмадеева, L. Akhmadeeva, Вайтсмэн, and B. Vaytsmen. "Effectiveness of clinical and instrumental tools to predict falls In elderly patients neurological hospital." Journal of New Medical Technologies. eJournal 8, no. 1 (November 5, 2014): 0. http://dx.doi.org/10.12737/7220.
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The purpose of this study was evaluation of the most effective clinical and paraclinical methods for prediction of falls in elderly patients of neurology ward. Мaterials and methods: the study included 251 patients (all retired by age) who admitted to neurology ward at the Hospital of Bashkir State Medical University (Ufa, Russia). The following tools were used: “Timed up and Go” (TUG), Berg Balance Scale (B), Duncan test (D), reactive balance test (T) and computerized stabilometric tests on force platform «STABILO-MBN» (Moscow). Results: Mean age of patients was 66.68 years (SD=8.79, median=64 года). The mean results of the clinical tests were the following: TUG=13.42 sec, SD=5.57 (normal reference time is less than 10 sec.), B= 45.90 (SD=7.70), which is interpreted as low risk for falling, D= 26.10 сm (SD=7.77), which is significantly less than normal results, T= 1.50 (SD=0.54), which is also worse than in healthy individuals. The best predictive power for prognosis of falls was calculated for reactive balance test values and root-mean-square deviation of center of pressure in frontal (CPF) or sagittal plane with the eyes closed. The authors present the predictive equations for prognosis of the number of falls. For instance, the predicted number of falls during 12 months =1.476 + 0.122TUG – 1.411T + 0.0161CPF. Conclusion: The tools evaluated in this study, have different effectiveness for prognosis of falls in patients and could be used in clinical practice as a part of predictive mathematical model.
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Muniz, Isis de Araújo Ferreira, Welliton Silva Souto, Allan Jonattan de Lima Queiroz, Carolinne Medeiros de Araújo Souza, Clarissiane Serafim Cardoso, Joyce Andreza Moreira Pessôa, Sara Brito Silva Costa Cruz, Paulo Rogério Ferreti Bonan, and André Ulisses Dantas Batista. "Association between depressive symptoms and oral health care in non-institutionalized elders in Northeastern Brazil." Research, Society and Development 10, no. 4 (March 28, 2021): e1110413745. http://dx.doi.org/10.33448/rsd-v10i4.13745.
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This work aims to investigate the association between geriatric depression and oral self-perception, assessing functional scales, socioeconomic determinants, and normative oral conditions. The study was based on an inductive approach, with statistical procedures and descriptive technique using direct observation with 250 elders enrolled at the Reference Center, located in João Pessoa, Paraíba, Northeastern Brazil. Data collection was carried out focusing on a socioeconomic survey. A clinical examination was performed to obtain data on DMFT, edentulism, the need and use of prosthesis, and oral lesion. GOHAI, Pfeffer, Katz and Geriatric Depression Scales (GDS-15) were made. The elders were mostly illiterate women, from 60 to 70 years old, with low income. The average DMFT was 28.17, and edentulism was perceived in 55.2%. Oral self-perception was unfavorable for 87.2%, depressive symptoms affected 33.2% of individuals and functional dependence was noticed in 9.2%. The Katz and Pfeffer scales were statistically associated with the GDS-15 scale (p<0.05). The depressive symptoms were associated with the female gender, illiterate condition, and poor food intake after binary regression. However, they are not associated with normative oral conditions and oral self-perception in non-institutionalized elders in Northeastern Brazil.
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Burke, Shanna L., Peter Maramaldi, Tamara Cadet, and Walter Kukull. "Associations between depression, sleep disturbance, and apolipoprotein E in the development of Alzheimer's disease: dementia." International Psychogeriatrics 28, no. 9 (March 29, 2016): 1409–24. http://dx.doi.org/10.1017/s1041610216000405.
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ABSTRACTBackground:Alzheimer's disease (AD) is a neurodegenerative brain disease that causes cognitive impairment and dementia. Within the US, AD is the most common form of dementia in the elderly, affecting 1 in 10 people over the age of 65. Sleep disturbance has been called a “public health epidemic” and, like depression, is a prodromal symptom of AD but may also contribute to the risk of developing AD. It was hypothesized that sleep disturbance, depression, and the apolipoprotein E (APOE) genotype increase the likelihood of AD.Methods:Utilizing data from the National Alzheimer's Coordinating Center, information from evaluations of 11,453 cognitively asymptomatic participants was analyzed. Survival analysis was used to explore the independent relationships between depression, sleep disturbance, and APOE genotypes with eventual AD diagnosis. Cox proportional hazard models were utilized to explore the main effects and synergistic effects of psychosocial factors as moderated by APOE genotypes.Results:This study reinforced the association between APOE and AD. The hazard of developing AD was eight times higher for those with recent depression and the Ɛ4 homozygote (HR = 8.15 [3.70–17.95]). Among Ɛ4 carriers with clinician-verified depression, the hazard was ten times that of the reference group (HR = 10.11 [4.43–23.09]). The hazard for Ɛ4 carriers reporting sleep disturbance was almost 7 times greater than the reference group (HR = 6.79 [2.38–19.37]).Conclusion:Findings suggest that sleep disturbance, depression, and APOE Ɛ4 genotype are associated with AD during follow-up evaluations among a group of initially cognitively asymptomatic participants. This study contributes to the literature base exploring an increased hazard or risk of AD due to potential modifiable risk factors as well as genetic biomarkers, such as APOE.
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Lee, J. H., S. K. Park, J. H. Ryoo, C. M. Oh, J. M. Choi, R. S. McIntyre, R. B. Mansur, H. Kim, S. Hales, and J. Y. Jung. "U-shaped relationship between depression and body mass index in the Korean adults." European Psychiatry 45 (September 2017): 72–80. http://dx.doi.org/10.1016/j.eurpsy.2017.05.025.
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AbstractBackground:Although a number of studies have examined the relationship between depression and obesity, it is still insufficient to establish the specific pattern of relationship between depression and body mass index (BMI) categories. Thus, this study was aimed to investigate the relationship between depression and BMI categories.Methods:A cross-sectional study was conducted for a cohort of 159,390 Korean based on Kangbuk Samsung Health Study (KSHS). Study participants were classified into 5 groups by Asian-specific cut-off of BMI (18.5, 23, 25 and 30 kg/m2). The presence of depression was determined by Center for Epidemiologic Studies-Depression scales (CES-D) = 16 and = 25. The adjusted odd ratios (ORs) for depression were evaluated by multiple logistic regression analysis, in which independent variable was 5 categories of BMI and dependent variable was depression. Subgroup analysis was conducted by gender and age.Results:When normal group was set as a reference, the adjusted ORs for depression formed U-shaped pattern of relationship with BMI categories [underweight: 1.31 (1.14–1.50), overweight: 0.94 (0.85–1.04), obese group: 1.01 (0.91–1.12), severe obese group: 1.28 (1.05–1.54)]. This pattern of relationship was more prominent in female and young age group than male and elderly subgroup. BMI level with the lowest likelihood of depression was 18.5 kg/m2 to 25 kg/m2 in women and 23 kg/m2 to 25 kg/m2 in men.Conclusions:There was a U-shaped relationship between depression and BMI categories. This finding suggests that both underweight and severe obesity are associated with the increased risk for depression.
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Ningsih, Murti Sari, Erika Erika, and Rismadefi Woferst. "Pengaruh Kegel Exercise terhadap Inkontinensia Urine pada Ibu Postpartum Multipara." Holistic Nursing and Health Science 4, no. 1 (June 8, 2021): 26–33. http://dx.doi.org/10.14710/hnhs.4.1.2021.26-33.
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Introduction: One of problems experienced post-partum mothers is urine incontinence. Kegel exercise effects on urine incontinence post-partum mothers and elderly. However, limited study search for its effect on multiparous post-partum mothers. This study aims to determine the effect of Kegel exercise on urinary incontinence in multiparous post-partum mothers.Methods: The research design used was a quasi-experiment with a post-test with control group design which was divided into an experimental group and a control group. The research was conducted in the work area of Rejosari Public Health Center with a sample size of 34 respondents with the criteria of multiparous postpartum mothers who experienced urinary incontinence in normal labor with a purposive sampling technique. The measuring instrument used was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Data analysis used dependent and independent t-test.Results: The results of the dependent t-test statistic with α 0.05 showed that Kegel exercise was effective against urinary incontinence in the experimental group p value (0.000) and the control group p value (0.033) and the results of the independent t-test showed that there was an effect of Kegel exercise on urinary incontinence in the experimental group and the control group p value (0.004). The results of this study can be used as a reference for using Kegel exercises as a way to deal with complaints of urinary incontinence in multiparous post-partum mothers.
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Souza, Luciária Silva, Naiane Pereira dos Santos, Pollyanna Viana Lima, Isnara Teixeira de Britto, Alessandra Souza de Oliveira, and Luciana Araújo dos Reis. "Avaliação da funcionalidade familiar em pessoas idosas convivendo com HIV/AIDS." Revista Recien - Revista Científica de Enfermagem 11, no. 33 (March 29, 2021): 99–106. http://dx.doi.org/10.24276/rrecien2021.11.33.99-106.
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O presente artigo tem como objetivo identificar a funcionalidade familiar em pessoas idosas convivendo com HIV/AIDS. Trata-se de um estudo de caráter exploratório, descritivo com abordagem quanti-qualitativa, desenvolvida em um Centro de Atenção e Apoio especializado de referência em atendimento para pessoas convivendo com IST’s e HIV/AIDS em um município baiano com 26 pessoas idosos. Utilizou-se roteiro semi-estruturado para entrevista e questionário com dados sociodemográficos e de saúde e o Apgar da família, para avaliação da funcionalidade familiar. Verificou-se no estudo que a maior parte das pessoas idosas diagnosticadas com HIV/AIDS deste estudo convivem em uma família disfuncional grave (34,61%), o que corrobora para que a grande maioria dos idosos mantenham em sigilo o diagnóstico da doença para o seu núcleo familiar, outros convivem com a estigmatização o isolamento e o preconceito. Conclui-se que os idosos convivem em uma família disfuncional grave, com repercussões negativas para o enfretamento da doença.Descritores: Idoso, Funcionalidade Familiar, HIV, AIDS. Assessment of family functionality in elderly people living with HIV/AIDSAbstract: This article aims to identify family functionality in elderly people living with HIV/AIDS. This is an exploratory, descriptive study with a quantitative and qualitative approach, developed in a specialized Care and Support Center of reference in care for people living with STIs and HIV/AIDS in a municipality in Bahia with 26 elderly people. A semi-structured script was used for the interview and questionnaire with sociodemographic and health data and the family Apgar, to assess family functionality. It was found in the study that most elderly people diagnosed with HIV/AIDS in this study live in a severe dysfunctional family (34.61%), which corroborates that the vast majority of the elderly keep the diagnosis of the disease confidential. their family nucleus, others live with stigmatization, isolation and prejudice. It is concluded that the elderly live in a severe dysfunctional family, with negative repercussions for coping with the disease.Descriptors: Elderly, Family Functionality, HIV, AIDS. Evaluación de la funcionalidad familiar en personas mayores que viven con VIH/SIDAResumen: Este artículo tiene como objetivo identificar la funcionalidad familiar en personas mayores que viven con VIH / SIDA. Se trata de un estudio exploratorio, descriptivo con enfoque cuantitativo y cualitativo, desarrollado en un Centro de Atención y Apoyo especializado de referencia en la atención a personas viviendo con ITS y VIH / SIDA en un municipio de Bahía con 26 ancianos. Se utilizó un guión semiestructurado para la entrevista y cuestionario con datos sociodemográficos y de salud y el Apgar familiar, para evaluar la funcionalidad familiar. En el estudio se encontró que la mayoría de las personas mayores diagnosticadas con VIH / SIDA en este estudio viven en una familia disfuncional severa (34,61%), lo que corrobora que la gran mayoría de las personas mayores mantienen confidencial el diagnóstico de la enfermedad. su núcleo familiar, otros viven con estigmatización, aislamiento y prejuicio. Se concluye que los ancianos viven en una familia severamente disfuncional, con repercusiones negativas para el afrontamiento de la enfermedad.Descriptores: Anciano, Funcionalidad Familiar, VIH, SIDA.
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Takahashi, Tsutomu, Ritsuro Suzuki, Hiroyasu Ogawa, Takahiro Fukuda, Kazuteru Ohashi, Shuichi Taniguchi, Yoshinobu Kanda, Hiromasa Abe, Yoshihisa Kodera, and Junji Suzumiya. "The Safety of Hematopoietic Stem Cell Harvest from Elderly Family Donor in Japan." Blood 126, no. 23 (December 3, 2015): 1897. http://dx.doi.org/10.1182/blood.v126.23.1897.1897.
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Abstract [Background and Objectives] The number of patients received allogeneic hematopoietic stem cell (HSC) transplantation is increasing year by year, particularly for elderly patients. Related donor is preferable than the unrelated, but the safety of elderly donors has not been clarified. For this purpose, the complications of elderly HSC donor were retrospectively analyzed in comparison with younger donors. [Materials and Methods] From September 2006 to December 2014, a total of 7,896 related HSC donations was reported to the Japan society for hematopoietic cell transplantation (JSHCT) registration system by 391 harvest teams. The day 30 check reports after harvest were available for 6,911 (87.5%) donations. Donors under 18 years old were excluded, and 6,297 donations were analyzed in the present study. For donor age analysis those ranging from 18 to 30 years were regarded as reference. The primary endpoint was the incidence of early severe adverse events (eSAEs) during the harvest or within the 30-day period. Statistical analyses were conducted using Fisher's exact test to compare the donor demographics and to identify the relationships between the incidence of eSAEs. Logistic regression analyses were used to analyze the factors influencing eSAEs. Data analyses were conducted using EZR software, version 1.23 (Saitama Medical Center, Jichi Medical University). This study was approved by the ethical committee of JSHCT and Shimane University. [Results] Median age of donors were 42 years old (range: 18-80). There were 3,232 male and 3,002 female donors. A total of 2,009 donations were planned to collect bone marrow (BM) and 4,288 donations were planned to collect peripheral blood stem cell (PBSC). Nine of the planned BM harvests and 64 of the planned PBSC collections were cancelled because of the various reasons including adverse reactions or poor stem cell mobilization. Three other donations planned to collect BM were changed to PBSC, and four donations planned to collect PBSC were changed to BM, vice versa. These altered cases were included to the analysis as an intention-to-harvest basis. Out of 6,297 HSC donations, 63 donors (1.0%) were reported by the harvest teams to have experienced eSAEs. SAEs were de\x{fb01}ned as follows: death, events dangerous to life, prolongation of hospitalization, permanent failure, disease or abnormality inherited to offspring and other important medical events. The details of eSAEs were pain (8), infection (8), allergy (6), blood access related (5), neuropathy (4), thrombocytopenia (4), liver dysfunction (2), gout (2), tetany (2), epidural hematoma (2), pulmonary embolism (1), and others (19). None died due to eSAEs and 81 percent of donors recovered from eSAEs in an average of 17 days. In comparison with reference (18 to 30 years) the relative risk of eSAEs was 0.74 for donors aged 31-35 years, 0.37 for 36-40 years, 0.62 for 41-45 years, 1.04 for 46-50 years, 0.77 for 51-55 years, 1.27 for 56-60 years, and 2.66 for 61-65 years. Those aged 61-65 years only had significantly elevated risk of eSAE by univariate analysis (P = 0.02). The incidence of eSAE in each age group are shown in the Table. Univariate logistic regression analysis also showed female sex (1.3% vs 0.7%, 95% CI 1.16-3.55, P = 0.01) and current health conditions (1.9% vs 0.9%, 95% CI 0.99-4.12, P = 0.04) were risk factors affecting eSAEs other than age. Donation type (bone marrow or peripheral blood), laboratory abnormality at health screening and JSHCT donor insurance eligibility criteria did not affect the eSAEs. Multivariate analysis revealed that age category of 61-65 years (Table) and female sex (OR 2.03, 95% CI 1.21-3.43, P = 0.01) were independent predictive factors. [Conclusion] The safety of elderly family HSC donors was significantly inferior to younger donors. Elderly family donors above age 61 should be selected carefully. These findings are useful for informed consent at donations of elderly family donors and consideration the upper limit of age of unrelated volunteer donors. Table 1. Relative risk of eSAE adjusted by sex Adjusted N incidence OR 95% CI P-value Total 1.0% 18-30 years 16/1493 1.1% 31-35 years 6/758 0.8% 0.75 0.29-1.91 0.54 36-40 years 3/756 0.4% 0.38 0.11-1.30 0.12 41-45 years 5/745 0.7% 0.62 0.23-1.71 0.36 46-50 years 8/720 1.1% 1.04 0.44-2.44 0.93 51-55 years 6/722 0.8% 0.77 0.30-1.98 0.59 56-60 years 10/739 1.4% 1.26 0.57-2.79 0.57 61-65 years 9/321 2.8% 2.66 1.16-6.06 0.02 66 years - 0/43 0.0% - - - Disclosures No relevant conflicts of interest to declare.
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Devolder, Raffaelly Ferreira Tuzze, and Fátima Helena Do Espírito Santo. "Intervention of complementary therapies for pain relief in the elderly: a literature integrative review study." Revista de Enfermagem UFPE on line 5, no. 7 (August 20, 2011): 1791. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0507201130.
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ABSTRACTObjective: to identify the scientific production in the field of nursing of nonpharmacological pain relief for the elderly through studies presented in the scientific literature. Method: this paper is a literature search performed in the Virtual Health Library (BVS), Latin American and Caribbean Center on Health Sciences (LILACS) and Database of Nursing (BDENF) during the last ten years. Results: we find that those complementary therapies can serve as excellent adjuvants to drug therapy and, in some cases, the non-pharmalogical way can even replace the regular drug therapy; making pain management more sensible and humane, contributing to improve the quality of life of elderly patients. Associated with conventional treatment, those complementary therapies can help improve the care of elderly patients, providing a healthy and comfortable way of dealing with everyday situations of pain experienced by them. Conclusion: the analysis of scientific literature shows that non-pharmacological interventions can help drug therapy for pain relief. Descriptors: pain; nursing care; complementary therapies; health of the elderly.RESUMOObjetivo: identificar produções científicas de enfermagem referente à intervenções não farmacológicas para alivio da dor em idosos através de estudos apresentadas na literatura cientifica. Método: trata-se de uma pesquisa bibliográfica realizada na Biblioteca Virtual em Saúde (BVS), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF), nos últimos dez anos. Resultados: constatamos que as terapias complementares podem atuar como excelente co-adjuvante à terapia medicamentosa e, em algumas situações, até substituí-la, tornando a abordagem da dor mais sensível e humanizada, contribuindo para a melhoria da qualidade de vida do paciente idoso. Associadas ao tratamento convencional, as terapias complementares podem contribuir para a melhora no cuidado do paciente idoso, proporcionando a esse uma forma sadia e confortável de lidar com as situações rotineiras de dor vivenciadas pelos idosos. Conclusão: a análise da produção científica apontam que intervenções não farmacológicas podem ajudar a terapia medicamentosa para o alívio da dor. Descritores: dor; cuidados de enfermagem; terapias alternativas; saúde do idoso.RESUMENObjetivo: analizar la producción científica de la enfermería relacionada a las intervenciones no farmacológicas para aliviar el dolor en los ancianos a través de estudios presentados en la literatura científica. Método: este trabajo es una búsqueda bibliográfica realizada en la Biblioteca Virtual en Salud (BVS), Centro Latinoamericano y del Caribe en Ciencias de la Salud (LILACS) y Base de Datos de Enfermería (BDENF) en los últimos diez años. Resultados: constatamos que las terapias complementarias pueden servir como complemento al tratamiento farmacológico y, en algunos casos, incluso sustituirlas, y por lo que el tratamiento del dolor más sensible y humano, contribuyendo a mejorar la calidad de vida de los pacientes de edad avanzada. Asociadas con el tratamiento convencional, las terapias complementarias pueden ayudar a mejorar el cuidado de los pacientes mayores, siempre que una forma sana y cómoda de hacer frente a situaciones cotidianas de dolor experimentadas por las personas mayores. Conclusión: el análisis de los estudios científicos demuestran que las intervenciones no farmacológicas pueden ayudar a la terapia con medicamentos para aliviar el dolor. Descriptores: dolor; atención de enfermería; terapias complementarias; salud de los ancianos.
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Zbrozhek, Svitlana. "Experience of EU countries in organizing of the circulation and availability of medicines for the population." Actual Problems of Medicine and Pharmacy 2, no. 1 (August 25, 2021): 1–15. http://dx.doi.org/10.52914/apmp.v2i1.27.
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Finland's health care system has evolved over the years, with its distinctive features being tax funding, the provision of the vast majority of medicines and medical services by public and municipal authorities. to study the experience of EU countries in the field of health care in the organization of circulation and availability of medicines. To achieve this goal used the methods of regulatory, documentary, comparative and graphical analysis. The increase in the cost of medical care leads to the fact that the state is increasingly thinking about containing costs. The level of co-financing by patients is growing, at the same time measures are being taken to limit the selling price of medicines. The existing system of reference prices promotes the entry of generics into the market and, apparently, this direction will develop. A characteristic feature of the health care and pharmaceutical supply system in the Nordic countries is coordination, which is implemented at different levels and in many forms. The organization of the circulation and accessibility of medicines for the population in Finland is based on covering the costs of medicines through the social insurance system, but with the participation of the state. The priority common aspects of the functioning of the national health care systems of the Scandinavian region remain: coordination between hospitals and definition of their areas of activity; coordination between general services and specialized assistance centers; coordination of the organization of drug circulation and medical care for certain categories of patients (privileged categories, patients with oncological diseases, etc.); coordination of pharmaceutical support and medical services for patients with chronic diseases (diabetes, etc.); coordination of long-term pharmaceutical provision and medical care for the elderly.
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Kraus-Friedberg, Chana. "Health Policy Reference Center." Charleston Advisor 19, no. 3 (January 1, 2018): 20–22. http://dx.doi.org/10.5260/chara.19.3.20.
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Fitzsimmons, Marie. "Health Reference Center-Academic." Journal of Consumer Health On the Internet 7, no. 3 (June 2003): 59–67. http://dx.doi.org/10.1300/j381v07n03_07.
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Sansone, Claudia M., Fabiano Prendin, Greta Giordano, Paola Casati, Anne Destrebecq, and Stefano Terzoni. "Relationship between Capillary Refill Time at Triage and Abnormal Clinical Condition: A Prospective Study." Open Nursing Journal 11, no. 1 (July 26, 2017): 84–90. http://dx.doi.org/10.2174/1874434601711010084.
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Background: Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. Objective: We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department. We investigated relations between capillary refill time and vital signs recorded in triage and blood tests, by analyzing the clinical records. Mortality at 24 hours, 7 days and over 14 days was investigated by calling the patients after discharge. Method: Observational, single-center study on a sample of consecutive patients aged ≥ 18 years in the Emergency Department of a major Milan hospital, from June to October 2014. Multivariate logistic regression was used to investigate the impact of clinical variables on capillary refill time. Results: 1001 patients were enrolled, aged 59 ± 21 (473 aged 65 or more). Longer refill times were found in patients admitted to hospital units after medical consultations in the emergency department compared to those discharged or sent to outpatients. In elderly patients, statistically significant association was found between increased capillary refill time and sepsis (sensitivity 100%, specificity 83.33%, area under the receiver operating characteristics curve 65.95% CI 47-83), oxygen saturation, mean blood pressure, and lactates. In persons aged 45 to 64, altered refill times were associated with abnormal values of glicemia, platelets, and urea. Conclusion: Capillary refill time can be used by nurses at triage as a complementary parameter to normal vital signs. This is one of the few studies investigating refill time in adult patients.
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Singh, Prabhsimranjot, Sudhamshi Toom, Makardhwaj S. Shrivastava, and William B. Solomon. "A Rare Combination of Genetic Mutations in an Elderly Female: A Diagnostic Dilemma!" Blood 128, no. 22 (December 2, 2016): 5487. http://dx.doi.org/10.1182/blood.v128.22.5487.5487.
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Introduction: JAK2 is located on chromosome 9p24 and includes 25 exons encoding a protein of about 1132 amino acids. JAK2 is one of the four Janus family non-receptor protein tyrosine kinases. JAK2V617F is by far the most prevalent mutation in BCR-ABL1-negative Myeloproliferative neoplasms (occurs in ∼95% of patients with polycythemia vera, in ∼55% with essential thrombocythemia and in ∼65% with primary myelofibrosis) 1, 2. More than 80% of hemochromatosis patients are homozygous for a C282Y mutation in HFE gene, and a smaller proportion are compound heterozygous for both the C282Y mutation and an H63D mutation3. Here we present the first case of an elderly female with concomitant diagnosis of Polycythemia Vera (PV) and hemochromatosis. To our knowledge, there is no literature about the co-existence or associations of these diseases. Case Reports: 75 year old female, former smoker with PMH of hemochromatosis and COPD with recent exacerbation, presented to the oncology clinic after hospital discharge for continuing care of her hemochromatosis requiring phlebotomy. She reports to have had multiple phlebotomies in the past fifteen years. Patient denied any history of liver disease, diabetes, arthralgia, skin pigmentation or sleep problems. Vital signs and examination were within normal limits. Her initial work up reported significantly elevated hemoglobin of 17.4gm/dl, hematocrit of 56.1%, RBC count of 6.98M/UL with MCV 80.4 fl, MCH 24.9 pg and platelet count of 673 K/UL. Peripheral smear showed normal red cell morphology and few giant platelets. Subsequently, further lab testing revealed ferritin of 25.7ng/ml. Her elevated hematocrit was further evaluated and erythropoietin was surprisingly <1mIU/ml. Genetic testing for HFE gene mutation screen was positive for homozygous C282Y mutation. Due to high suspicion for Polycythemia Vera, JAK2 mutation was also tested, which to our surprise, came back positive for JAK2 V617F point mutation. Patient is diagnosed with Polycythemia Vera and Hereditary Hemochromatosis and is recommended to start Aspirin, continue phlebotomy to maintain Hematocrit below 45% and take hydroxyurea for thrombocytosis. Discussion: It is interesting to note the co-existence of two un-related diseases. Franchini M et al analyzed 52 patients with PV for 12 HH gene mutations and found no significant association between the two conditions4. Hannuksela J et al studied C282Y and H63D mutations in 232 patients with hematological malignancies and reported no significant association5. Beaton and Adams in their review article about the myths and realities of hemochromatosis reports an elevated hemoglobin, in hemochromatosis's patient as a myth, based on their review of 634 C282Y homozygous patients at London health Science center, with mean hemoglobin of 145±13 g/L6. Our case re-iterates the importance of clinical suspicion of polycythemia Vera in a hemochromatosis patient with elevated hematocrit and undetectable erythropoietin. The coincidence is, phlebotomy is the treatment for both conditions as long as patient is fairly asymptomatic. References: 1. Ayalew Tefferi; Molecular drug targets in myeloproliferative neoplasms: mutant ABL1, JAK2, MPL, KIT, PDGFRA, PDGFRB and FGFR1; J Cell Mol Med. 2009 Feb; 13(2): 215-237. 2. Cross NC (2011); Genetic and epigenetic complexity in myeloproliferative neoplasms. Hematology Am Soc Hematol Educ Program 2011:208-214. 3. Feder JN, Gnirke A, Thomas W, et al. A novel MHC class I-like gene is mutated in patients with hereditary haemochromatosis. Nat Genet1996; 13:399-408. 4. Analysis of hemochromatosis gene mutations in 52 consecutive patients with polycythemia vera. Franchini M1, de Matteis G, Federici F, Solero P, Veneri D. Hematology. 2004 Oct-Dec;9(5-6):413-4. 5. Prevalence of HFE genotypes, C282Y and H63D, in patients with hematologic disorders. Hannuksela J, Savolainen ER, Koistinen P, Parkkila S. Haematologica. 2002 Feb;87(2):131-5. 6. The myths and realities of hemochromatosis Melanie D Beaton, Paul C Adams Can J Gastroenterol. 2007 February; 21(2): 101-104. PMCID: PMC2657669 Disclosures No relevant conflicts of interest to declare.
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Keret, S., Y. Braun-Moscovici, M. Yigla, V. Shataylo, L. Guralnik, and A. Balbir-Gurman. "POS0871 CHARACTERISTICS OF INTERSTITIAL LUNG DISEASE IN PATIENTS WITH SYSTEMIC SCLEROSIS DURING LONG TERM FOLLOW-UP, SINGLE CENTER EXPERIENCE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 691–92. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3105.
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Background:ILD is one the leading causes of morbidity and mortality in patients with SSc. Diagnosis of SScILD is based on signs of fibrosis on chest x-rays or HRCT. Particular measurement of lung volumes by FVC and in gas exchange by DLCO supports the diagnosis. Associations between clinically significant SSc ILD and male gender, age, DcSSc, topoisomerase antibodies, low FVC at baseline, widespread lung involvement on baseline HRCT, and higher decline rate of FVC and DLCO during followup were reported. A standardized approach to assessing and treating SSc and SScILD in particular have been proposed. Main treatment regimens include cyclophosphamide and mycophenolate mofetil; recently antifibrotic drug nintedanib showed significant efficacy in hindering FVC decline rate in patients with SSc ILD. The data on survival changes in SSc generally and SScILD are conflicting.Objectives:To analyze demographic and clinical features and mortality of patients with SSc ILD.Methods:A retrospective study on Rambam Health Care Campus prospective cohort of SSc patients fulfilled ACR and EULAR Classification Criteria 2013 for the period between January 2000 and September 2020 was performed. Patients were recruited at one of their early visits to the clinic. The majority of recruited patients were included into EUSTAR prospective cohort 042, since 2004 the Rheumatology Institute at Rambam is affiliated to EUSTAR registry project. Data on patients not registered in EUSTAR database but treated at our institution was extracted via hospital electronic records. Patients with lung involvement underwent baseline and annual HRCT and pumonary function tests in addition to clinical assessment during their visit to combined rheumatology-pulmonology clinic. We registered age, gender, ethnicity, date of SSc diagnosis and ILD diagnosis, disease duration, SSc subset, pulmonary, cardiac, renal, and muscle involvement, treatment used, autoantibodies, FVC, DLCO, HRCT and pulmonary artery pressure. Statistical analysis included t-test, Pearson’s Chi-squared test, Fisher’s test, and Cox Regression analysis with p value less than 0.05 as significant.Results:Among 446 SSc patients (female 82.3%, mean age 46.5 and disease duration 11.6 years, DcSSc 39.2%; 27.4% dead during follow-up) 141 patients had ILD. Comparison between patient with ILD and witout ILD showed significant differences in term of nationality (Arabs 34% vs 18.7%), SSc related death 78.3% vs 50.7%), DcSSc (68.8% vs 25.6%), topoisomerase antibodies (61.7% vs 24.9%), myopathy (21.3% vs 10.2%) and pulmonary hypertension (34.8% vs 22.3%). Significantly more SSc ILD patients were treated with cyclophosphamide, mycophenolate mofetil and azathioprine. Survival Kaplan-Meier curve patiets demonstrate reduced survival in patients with ILD (p<0.01). Five years survival rates between years 2000 and 2015 have not changed significant. Mortality risk assessed with Cox regression analysis in the whole group was significantly higher in males, Arabs, DcSSc, elder age, heart and muscle involvement, and treatment with CYC. In the ILD group, the mortality was significantly higher in Arabs (3.3 times), elder age (8.9 times), presence of PAH (3.1 times) and treatment with CYC (2.8 times) compared to patients without ILD.Conclusion:In our SSc cohort, ILD affected about third of patients and had major impact on patients’ outcome. Male gender, Arab nationality, elder age, DcSSc, topoisomerase antibodies, heart and muscle involvement were significantly associated with worst prognosis. Despite active approach to assessing and treatment, survival rates of patients with SSc and SSc-ILD have not improved in last decades. Enrichment of the cohort with severe patients to a tertiary center due to reference bias and low efficacy of existed immunomodulatory drugs in SSc and in SSc related ILD particularly, could explain our results.Disclosure of Interests:None declared
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Bergman, Arik, and David MJ Naimark. "THE IMPACT OF ESTIMATED GLOMERULAR FILTRATION RATEREPORTING ON NEPHROLOGY REFERRAL PATTERN, PATIENT CHARACTERISTICS AND OUTCOME." Clinical & Investigative Medicine 31, no. 4 (August 1, 2008): 4. http://dx.doi.org/10.25011/cim.v31i4.4791.
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Background: Chronic kidney disease (CKD) is a growing public health problem worldwide. The key to reducing the burden of CKD is earlydetection and delay of disease progression. An elevated serum creatinine concentration, [Cr], is acommon indicator of CKD. However, even with advanced CKD, [Cr] may not be highamong patients with low muscle mass (particularly the elderly). Thus, the use of the estimated glomerular filtration rate (eGFR) has been advocated for identifying severe occult kidney disease. In January 2006, community laboratories in Ontario, Canada, began to report an eGFR value along with every [Cr] result. The present study sought to investigate the impact of eGFR reporting on nephrology referrals and subsequent patient outcome. Methods: The current study consisted of a retrospective analysis of all referrals to the adult general nephrology clinics at Sunnybrook Health Sciences Centre 15 months before and after eGFR reporting took effect on January 1, 2006. Results: eGFR reporting was associated with a significant rise in the number of referrals (971 to 1101, p=0.03), a 51% rise in patient wait-time (from 73 days to 110days, p < 0.001) and an increase in nephrologists’ workload. Patients referred after eGFR reporting were older, but suffered from fewer comorbidities such as hypertension, vascular disease, and dementia. There was an increase in the number of patients referred with stage 3 CKD, but no change in the proportion of stage 4 and 5 CKD referrals or the number of patients initiating dialysis. Conclusion: Laboratory reporting of eGFR increased nephrology referral volume, patient waiting times, and nephrologists’ workload, without a demonstrable benefit in terms of detection and referral of severe (stage 4 and 5) CKD nor in the reduction of ESRD frequency. Screening programs may need to be implemented along with knowledge translation strategies in order to achievethe goal of preventing and delaying progression of CKD. Reference: Canadian Society of Nephrology, September 2006. Careand referral of adult patients with reduced kidney function- Position paperfrom the Canadian Society of Nephrology.Available at: http://www.csnscn.ca/local/files/CSN-Documents/CSN%20Postion%20Paper%20Sept2006.pdf
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Sanyal, Amit, James M. Heun, Jessica Sweeney, and Clemens Janssen. "Mobile-Health Tool to Improve Care of Patients with Hematological Malignancies." Blood 136, Supplement 1 (November 5, 2020): 35–36. http://dx.doi.org/10.1182/blood-2020-143405.
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INTRODUCTION Adverse effects are common during treatment of hematological malignancies. Treatment toxicities can impact quality of life [1], impose financial hardship and cause cancer related distress[2]. Symptom monitoring using electronic technology can facilitate early detection of complications[3], reduce symptom burden[4], cost of care[5] and improve survival[6]. Cancer treatment also increases risk of mortality from infections such as coronavirus disease 2019 (COVID-19) and routine screening has been recommended[7]. METHODS We developed an application that periodically delivers toxicity questionnaires to patients during treatment . Based on NCI- PRO-CTCAE™, the questions are delivered through SMS or e-mail. Patient responses crossing prespecified thresholds trigger automated alerts on a dashboard, resulting in additional interventions as needed. Nature and time to intervention is tracked. Patient experience is measured using a Likert-scale and free-text box. Centers for Disease Control recommended COVID-19 screening questions were incorporated. Finally, a distress thermometer for cancer distress screening has been recently added. The app was offered to patients with hematological cancers in a community-based cancer center. RESULTS Since introduction in April 2020, we have enrolled 37 patients. 9 patients had chronic lymphocytic leukemia, 6 diffuse large B cell, 5 mantle cell, 4 Hodgkin's and 3 follicular lymphoma. 2 each had chronic myelogenous, multiple myeloma and Richter's syndrome. 1 each had hairy cell leukemia, acute myelogenous leukemia and T Cell lymphoma. Median age was 64 years (range 24-85). Patient experience has been favorable. On a scale of 1-5, 85.5% rated the experience as 3 or higher. Median patient engagement, calculated by dividing the number of forms completions by number of days enrolled was 34.2% (0.9-66.2 %). Symptom tracker captured 536 responses. Fatigue (153), no symptoms (152), shortness of breath (57), nausea/vomiting, diarrhea (46) and numbness/tingling (28) were the most common response categories. Of 1107 completed check ins, 75 triggered flags. There were 2 hospitalizations for neutropenic fever with the remainder managed as outpatients. Average time between patient generated response and provider intervention was 90.9 minutes. 88% follow-ups were completed within 1 business day. COVID-19 screening module captured 1096 responses. 988 were no symptoms. All positive responses (44 diarrhea, 39 cough, 23 shortness of breath and 2 fever) were false positives. Distress thermometer implemented a week before data cut-off captured 2 responses, 1 in the physical and 1 in the psychological domain. CONCLUSION We demonstrate feasibility of electronic capture of treatment toxicities and offer proof of concept that a mobile app can be used for infection screening. Additionally, the quick response time by care team indicated a high adoption rate. REFERENCES Doorduijn J, B.I., Holt B, Steijaert M, Uyl-de Groot C, Sonneveld P., Self-reported quality of life in elderly patients with aggressive non-Hodgkin's lymphoma treated with CHOP chemotherapy. . European Journal of Hemtology 2005. 75(2): p. 116-123.Troy JD, L.S., Samsa GP, Feliciano J, Richhariya A, LeBlanc TW., Patient-reported distress in Hodgkin lymphoma across the survivorship continuum. Supportive Care Cancer, 2019. 27(7): p. 2453-2462.Stover A M, H.S., Deal A M, Stricker C T, Bennett A V, Carr P M, Jansen J, Kottschade L A, Dueck A C, Basch E M, Methods for alerting clinicians to concerning symptom questionnaire responses during cancer care: Approaches from two randomized trials (STAR, AFT-39 PRO-TECT). Journal of Clinical Oncology 2018. 36(30 supplement): p. 158.Mooney KH, B.S., Wong B, Whisenant M, Donaldson G, Automated home monitoring and management of patient-reported symptoms during chemotherapy: results of the symptom care at home RCT. Cancer Medicine, 2017. 6(3): p. 537-546.Barkley R, S.M.-J., Wang J, Blau S, Page RD, Reducing Cancer Costs Through Symptom Management and Triage Pathways. Journal of Oncology Practice, 2019. 15(2): p. e91-e97.Denis F, B.E., Septans AL, Urban T, Dueck AC, Letellier C., Two-Year Survival Comparing Web-Based Symptom Monitoring vs Routine Surveillance Following Treatment for Lung Cancer. JAMA, 2019. 321(3): p. 306-307.ASCO Special Report: A guide to cancer care delivery during COVID-19 pandemic. 2020, ASCO: Alexandria, VA. Disclosures Janssen: wellbe Inc.: Current Employment.
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Saponara, Maristella, Laura Pala, Fabio Conforti, Marco Rubatto, Ivana De Risi, Francesco Spagnolo, Michele Guida, Paolo Bossi, Pietro Quaglino, and Paola Queirolo. "Patients with locally advanced and metastatic cutaneous squamous cell carcinoma treated with immunotherapy in the era of COVID-19: stop or go? Data from five Italian referral cancer centers." Therapeutic Advances in Medical Oncology 12 (January 2020): 175883592097700. http://dx.doi.org/10.1177/1758835920977002.
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Since the end of 2019, global healthcare systems have been dealing with the COVID-19 pandemic. In oncology, the biggest questions concern interaction of COVID-19 with pre-existing cancer disease and with systemic anticancer treatments. With regards to immunotherapy, there is uncertainty about its effect in the context of COVID-19 in terms of probability and course of viral infection. Herein, we retrospectively report data of patients with advanced cutaneous squamous cell carcinoma (cSCC) treated with immunotherapy at five Italian referral cancer centers during the pandemic. cSCC is a disease poorly represented in the literature, typically affecting fragile, elderly patients, with multiple comorbidities and often immunosuppressed. Overall, 54 patients were identified, most of them coming from Lombardy and Piedmont, the two regions hit hardest by COVID in Italy. In most cases, our choice was to continue treatment, reserving temporary interruptions only to patients considered particularly at risk for age and comorbidity. A total of 9% of patients developed new-onset symptoms or had chest radiological assessment potentially related to COVID-19. Nasopharyngeal swabs were collected in all suspicious cases and two hospitalized patients were found to be positive. In conclusion, the outbreak of COVID-19 is a major worldwide health concern. Our data indicate that COVID-19 mortality in patients with cancer may be principally driven by advancing age, the presence of other comorbidities, and other cancer-related conditions (i.e. hospitalization). Our data further suggests the safety of continued use of PD-1 blockade during the COVID-19 pandemic (obviously implementing all the safety measures in the hospital environment) also considering the possible negative effects of a prolonged suspension on the course of the tumor evolution. We think it is useful to collect and report case studies coming from reference centers, because they can represent helpful examples for the scientific community of clinical management of patients affected by cancer in this difficult period and guide further research.
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Pereira, Francisco Gilberto Fernandes, Maria De Jesus Pereira Araújo, Claudia Regina Pereira, Danelle Da Silva Nascimento, Francisca Tereza de Galiza, and Claudia Daniella Avalino Vasconcelos Benício. "Automedicação em idosos ativos." Revista de Enfermagem UFPE on line 11, no. 12 (December 4, 2017): 4919. http://dx.doi.org/10.5205/1981-8963-v11i12a22289p4919-4928-2017.
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RESUMOObjetivo: analisar a prática de automedicação em idosos ativos. Método: estudo quantitativo, exploratório e descritivo, realizado com 74 idosos ativos, em dois Centros de Referência da Assistência Social (CRAS). A coleta de dados ocorreu em encontros semanais por meio de um formulário com perguntas de características sociodemográficas e relacionadas ao consumo de medicamentos aplicado por meio de encontros semanais ofertados pelo CRAS. Os dados foram analisados pelo Programa estatístico SPSS versão 20.0 com distribuição das frequências absoluta e relativa, em que se realizou inferência numérica de descrição das variáveis organizados em tabelas. Resultados: o grupo estudado demonstrou predomínio de participantes do sexo feminino, 43 (58,1%), analfabetos, 40 (54,1%), e portadores de doenças crônicas, 62 (83,8%). A prática da automedicação foi comum para 57 (77%), com analgésicos e antitérmicos, 32 (56,2%), e desencadeada pela cefaleia, 38 (66,7%), tendo a propaganda forte influência para essa prática em 43 (58,1%). Conclusão: a prática de automedicação é frequente nos idosos, o que repercute na necessidade de trabalhar com grupos de promoção à saúde de modo a reduzir possíveis danos provocados pelo uso inadequado de medicamentos. Descritores: Envelhecimento; Automedicação; Saúde do Idoso. ABSTRACTObjective: to analyze the practice of self-medication in the elderly population. Method: this is a quantitative, exploratory and descriptive study carried out with 74 active elderly people in two Social Assistance Reference Centers (CRAS). The data collection took place in weekly meetings through a form with questions of socio-demographic characteristics and related to the consumption of medicines applied through weekly meetings offered by CRAS. The data were analyzed by the SPSS statistical software version 20.0, with absolute and relative frequency distribution, in which numerical inference was performed on the description of the variables organized in tables. Results: the group studied showed a predominance of 43 (58.1%) female, 40 illiterate (54.1%) and 62 patients with chronic diseases (83.8%). The practice of self-medication was common for 57 (77%), analgesic and antipyretic with 32 (56.2%), and triggered by a headache with 38 (66.7%), with strong advertising influencing this practice in 43 patients (58, 1%). Conclusion: the practice of self-medication is frequent in the elderly population, which has repercussions on the need to work with health promotion groups to reduce the possible harm caused by inappropriate medication use. Descriptors: Aging; Self-Medication; Health of the Elderly.RESUMENObjetivo: analizar la práctica de automedicación en ancianos activos. Método: estudio cuantitativo, exploratorio y descriptivo, realizado con 74 ancianos activos, en dos Centros de Referencia de la Asistencia Social (CRAS). La recolección de datos fue en encuentros semanales por medio de un formulario con preguntas de características sociodemográficas y relacionadas al consumo de medicamentos aplicado por medio de encuentros semanales ofertados por el CRAS. Los datos fueron analizados por el Programa estadístico SPSS versión 20.0, con distribución de las frecuencias absoluta y relativa, en que se realizó inferencia numérica de descripción de las variables organizadas en tablas. Resultados: el grupo estudiado demostró predominio de participantes del sexo femenino 43 (58,1%), analfabetos 40 (54,1%) y portador de enfermedades crónicas 62 (83,8%). La práctica de la automedicación fue común para 57 (77%), con analgésicos y antitérmicos 32 (56,2%), y desencadenada por la cefaléa 38 (66,7%), teniendo la propaganda fuerte influencia para esa práctica en 43 (58,1%). Conclusión: la práctica de automedicación es frecuente en los ancianos, lo que repercute en la necesidad de trabajar con grupos de promoción a la salud de modo a reducir posibles daños provocados por el uso inadecuado de medicamentos. Descriptores: Envejecimiento; Automedicación; Salud del Anciano.
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Watson, Renae. "Social Work Reference Center." Charleston Advisor 21, no. 4 (April 1, 2020): 49–53. http://dx.doi.org/10.5260/chara.21.4.49.
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Social Work Reference Center is a point-of-care reference tool for social workers and mental health professionals available via annual subscription. This tool provides easy access to evidence-based care sheets, social work practices and skills, skill competency checklists, quick lessons, patient education, and more, including CEU modules at no additional cost to the user. Credentialed social workers and relevant professionals produce and review much of the content available in Social Work Reference Center on a regular basis. Content is easy to navigate and read, barring a few issues with searching and limiting results. Institutions supporting current or soon-to-be social work practitioners should consider subscribing.
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Fraser, Hannah, Daniel Gallacher, Felix Achana, Rachel Court, Sian Taylor-Phillips, Chidozie Nduka, Chris Stinton, Rebecca Willans, Paramjit Gill, and Hema Mistry. "Rapid antigen detection and molecular tests for group A streptococcal infections for acute sore throat: systematic reviews and economic evaluation." Health Technology Assessment 24, no. 31 (June 2020): 1–232. http://dx.doi.org/10.3310/hta24310.
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Background Sore throat is a common condition caused by an infection of the airway. Most cases are of a viral nature; however, a number of these infections may be caused by the group A Streptococcus bacterium. Most viral and bacterial sore throat infections resolve spontaneously within a few weeks. Point-of-care testing in primary care has been recognised as an emerging technology for aiding targeted antibiotic prescribing for sore throat in cases that do not spontaneously resolve. Objective Systematically review the evidence for 21 point-of-care tests for detecting group A Streptococcus bacteria and develop a de novo economic model to compare the cost-effectiveness of point-of-care tests alongside clinical scoring tools with the cost-effectiveness of clinical scoring tools alone for patients managed in primary care and hospital settings. Data sources Multiple electronic databases were searched from inception to March 2019. The following databases were searched in November and December 2018 and searches were updated in March 2019: MEDLINE [via OvidSP (Health First, Rockledge, FL, USA)], MEDLINE In-Process & Other Non-Indexed Citations (via OvidSP), MEDLINE Epub Ahead of Print (via OvidSP), MEDLINE Daily Update (via OvidSP), EMBASE (via OvidSP), Cochrane Database of Systematic Reviews [via Wiley Online Library (John Wiley & Sons, Inc., Hoboken, NJ, USA)], Cochrane Central Register of Controlled Trials (CENTRAL) (via Wiley Online Library), Database of Abstracts of Reviews of Effects (DARE) (via Centre for Reviews and Dissemination), Health Technology Assessment database (via the Centre for Reviews and Dissemination), Science Citation Index and Conference Proceedings [via the Web of Science™ (Clarivate Analytics, Philadelphia, PA, USA)] and the PROSPERO International Prospective Register of Systematic Reviews (via the Centre for Reviews and Dissemination). Review methods Eligible studies included those of people aged ≥ 5 years presenting with sore throat symptoms, studies comparing point-of-care testing with antibiotic-prescribing decisions, studies of test accuracy and studies of cost-effectiveness. Quality assessment of eligible studies was undertaken. Meta-analysis of sensitivity and specificity was carried out for tests with sufficient data. A decision tree model estimated costs and quality-adjusted life-years from an NHS and Personal Social Services perspective. Results The searches identified 38 studies of clinical effectiveness and three studies of cost-effectiveness. Twenty-six full-text articles and abstracts reported on the test accuracy of point-of-care tests and/or clinical scores with biological culture as a reference standard. In the population of interest (patients with Centor/McIsaac scores of ≥ 3 points or FeverPAIN scores of ≥ 4 points), point estimates were 0.829 to 0.946 for sensitivity and 0.849 to 0.991 for specificity. There was considerable heterogeneity, even for studies using the same point-of-care test, suggesting that is unlikely that any single study will have accurately captured a test’s true performance. There is some randomised controlled trial evidence to suggest that the use of rapid antigen detection tests may help to reduce antibiotic-prescribing rates. Sensitivity and specificity estimates for each test in each age group and care setting combination were obtained using meta-analyses where appropriate. Any apparent differences in test accuracy may not be attributable to the tests, and may have been caused by known differences in the studies, latent characteristics or chance. Fourteen of the 21 tests reviewed were included in the economic modelling, and these tests were not cost-effective within the current National Institute for Health and Care Excellence’s cost-effectiveness thresholds. Uncertainties in the cost-effectiveness estimates included model parameter inputs and assumptions that increase the cost of testing, and the penalty for antibiotic overprescriptions. Limitations No information was identified for the elderly population or pharmacy setting. It was not possible to identify which test is the most accurate owing to the paucity of evidence. Conclusions The systematic review and the cost-effectiveness models identified uncertainties around the adoption of point-of-care tests in primary and secondary care settings. Although sensitivity and specificity estimates are promising, we have little information to establish the most accurate point-of-care test. Further research is needed to understand the test accuracy of point-of-care tests in the proposed NHS pathway and in comparable settings and patient groups. Study registration The protocol of the review is registered as PROSPERO CRD42018118653. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 31. See the NIHR Journals Library website for further project information.
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Borger, L. L., S. L. Whitney, M. S. Redfern, and J. M. Furman. "The influence of dynamic visual environments on postural sway in the elderly." Journal of Vestibular Research 9, no. 3 (June 1, 1999): 197–205. http://dx.doi.org/10.3233/ves-1999-9307.
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Postural sway during stance has been found to be sensitive to moving visual scenes in young adults, children, and those with vestibular disease. The effect of visual environments on balance in elderly individuals is relatively unknown. The purpose of this study was to compare postural sway responses of healthy elderly to those of young subjects when both groups were exposed to a moving visual scene. Peak to peak, root mean squared, and mean velocity of the center of pressure were analyzed under conditions combining four moving scene amplitudes ( 2 . 5 ∘ , 5 ∘ , 7 . 5 ∘ , 10 ∘ ) and two frequencies of scene movement (0.1 Hz, 0.25 Hz). Each visual condition was tested with a fixed floor and sway referenced platform. Results showed that elderly subjects swayed more than younger subjects when experiencing a moving visual scene under all conditions. The elderly were affected more than the young by sway referencing the platform. The differences between the two age groups were greater at increased amplitudes of scene movement. These results suggest that elderly are more influenced by dynamic visual information for balance than the young, particularly when cues from the ankles are altered.
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Pomerantz, Rhoda S. "The Johnston R. Bowman Health Center for the Elderly." Topics in Geriatric Rehabilitation 4, no. 2 (January 1989): 71–78. http://dx.doi.org/10.1097/00013614-198901000-00009.
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Vera Posligua, Cristina Luisana, and Gabriel Rodolfo García Murillo. "ORIENTACIÓN EN NUTRICIÓN FAMILIAR DIRIGIDA A PACIENTES HIPERTENSOS DEL CENTRO DE SALUD DE JARAMIJÓ." Revista Cognosis. ISSN 2588-0578 4, no. 1 (February 27, 2019): 53. http://dx.doi.org/10.33936/cognosis.v4i1.1675.
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El estudio llevado a cabo abordo como tema “Orientación en Nutrición Familiar dirigido a Pacientes Hipertensos del Centro de Salud de Jaramijo”, la hipertensión arterial es una problemática que afronta en su gran mayoría los ecuatorianos, constituyéndose de esta manera en un problema social. Considerándose una de las principales causas de muerte en el mundo, representando el 30% de muertes en toda América Latina; ubicándose el Ecuador en el sexto puesto con una tasa de 17.1% con relación a los hombres y en el quinto puesto con referencia a las mujeres, en lo concerniente a las diez principales causas de muerte en nuestro país. En la actualidad es común ver a personas jóvenes que sufren problemas e hipertensión Estudios epidemiológicos concluyen que varios factores de riesgo guardan relación con la hipertensión arterial, dentro de estos se citan la edad, el sexo, color de la piel, la herencia, las dietas ricas en sodio, los oligoelementos, los factores socioculturales, el alcoholismo, el hábito de fumar, la hiperlipidemia y las enfermedades como la cardiopatía isquémica, la enfermedad cerebro vascular, y la diabetes mellitus. El objetivo fue conocer los hábitos alimentarios de los adultos mayores con diagnóstico de Hipertensión Arterial y brindar información a este grupo sobre el contenido de sodio de los diferentes grupos de alimentos, ya que en su mayoría desconocen el contenido de sodio presente en los alimentos y en el día sobrepasa las cantidades básicas que el organismo requiere. Cabe recalcar que como aporte de este artículo; y en base a resultados establecidos que resulta primordial e importante mantener la asistencia de un profesional especializado en dietética y nutrición, conjuntamente con atención médica provocarán en la persona que padecen de hipertensión controlen la enfermedad mediante la ingesta de una adecuada dieta. Se consideran muchos factores como los derivantes de esta enfermedad, ocasionados por la sociedad globalizada en la que vivimos que lleva al consumismo deliberante, lo que influye de manera negativa con el desarrollo de esta enfermedad.
PALABRAS CLAVE: Alimentación; Hipertensión; autocuidado; nutrición.
ORIENTATION IN FAMILY NUTRITION ADDRESSED TO HYPERTENSIVE PATIENTS OF THE HEALTH CENTER OF JARAMIJÓ
ABSTRACT
The study carried out on board as a topic "Guidance in Family Nutrition for Hypertensive Patients of the Health Center of Jaramijo", hypertension is a problem that faces the vast majority of Ecuadorians, thus becoming a social problem. Considered one of the leading causes of death in the world, accounting for 30% of deaths throughout Latin America; Ecuador was placed in the sixth place with a rate of 17.1% in relation to men and in fifth place with reference to women, with regard to the ten leading causes of death in our country. Currently it is common to see young people suffering from problems and hypertension Epidemiological studies conclude that several risk factors are related to high blood pressure, within these are cited age, sex, skin color, inheritance, diets rich in sodium, trace elements, sociocultural factors, alcoholism, smoking, hyperlipidemia and diseases such as ischemic heart disease, cerebrovascular disease, and diabetes mellitus. The objective was to know the dietary habits of the elderly with a diagnosis of arterial hypertension and to provide information to this group about the sodium content of the different food groups, since most of them do not know the content of sodium present in food and the day exceeds the basic quantities that the organism requires. It should be noted that as a contribution of this article; and based on established results that is essential and important to maintain the assistance of a professional specializing in dietetics and nutrition, together with medical care will cause the person suffering from hypertension to control the disease by ingesting an adequate diet. Many factors are considered as the derivatives of this disease, caused by the globalized society in which we live that leads to deliberative consumerism, which negatively influences the development of this disease.
KEYWORDS: Food; Hypertension; self-care; nutrition.
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Effendi, Santoso Ujang, Nurul Khairani, and Susi Hartina. "Knowledge, Attitude, Family Support, and Integrated Health Service Post for Elderly in Working Area of Penurunan Public Health Center Bengkulu." Jurnal Sains Kesehatan 25, no. 2 (August 5, 2018): 10–19. http://dx.doi.org/10.37638/jsk.25.2.10-19.
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The basis for the establishment of integrated health service post for elderly (elderly Posyandu) was to improve the welfare of the community, especially the elderly. This study aimed to determine the factors that were related to the utilization of elderly Posyandu in the working area of Penurunan Public Health Center Bengkulu. This research was conducted in elderly Posyandu in the working area of Public Health Center Bengkulu in August 2017. This type of research was an analytical survey using a cross sectional design. The population in this study were elderly working area of Penurunan Public Health Center Bengkulu. The sampling technique in this study used proportional random sampling and obtained a sample of 88 elderly people. Data collection in this study used primary data obtained from direct interviews with respondents. Data analysis techniques were carried out by univariate and bivariate analysis with Chi-Square test through the SPSS program. The results were obtained : there were 51 people (58.0%) who did not utilize the elderly posyandu. There were 43 people (48.9%) elderly with good knowledge. There were 45 people (51.1%) elderly who had a Favorable attitude and there were 49 people (55.7%) elderly who received family support. This study showed that there was a significant relationship between knowledge, attitudes, and family support with the utilization of elderly Posyandu in working area of Penurunan Public Health Center Bengkulu. It is expected that the elderly can play an active role in following the elderly posyandu activities so that the elderly are more independent and productive and the health status of the elderly can be monitored. Keywords: attitude, elderly posyandu, family support, knowledge,
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Goyal, Gaurav, Lata Nawal, Kailash Mosalpuria, and Peter T. Silberstein. "Impact of Socioeconomic, Demographic and Health System Factors on Therapy in Acute Myeloid Leukemia." Blood 126, no. 23 (December 3, 2015): 3316. http://dx.doi.org/10.1182/blood.v126.23.3316.3316.
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Abstract Introduction Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Once diagnosed, AML is usually treated aggressively with the goal of improving survival. In this study, we aim to evaluate the factors affecting delivery of treatment in patients with AML. Methods This is a retrospective study of patients diagnosed with AML from 2003 to 2013 from the National Cancer Database (NCDB). NCDB consists of demographic variables and survival outcomes of approximately 70% of all new cancer diagnoses in the United States and Puerto Rico. Univariate logistic regression was performed to calculate crude odds ratio for different variables. Results A total of 98,293 patients were diagnosed with AML from 2003-2013, of which 24% (23,328) did not receive any systemic therapy (ST). On univariate analysis, the odds of receiving treatment were lower among females (Odds Ratio [OR] =0.97; 0.94-0.99), elderly (OR=0.15; 0.15-0.16), and Medicare patients (OR=0.23; 0.22- 0.23). Patients with one or more comorbidities had lower odds of receiving treatment compared to patients without any comorbidities (OR for 1 comorbidity=0.65; 0.63- 0.67, and OR for ≥ 2 comorbidities=0.42; 0.40-0.44). The odds of receiving ST were lower in community hospitals as compared to academic centers (OR=0.34; 0.32-0.35). African Americans had higher odds of receiving ST compared to Whites (OR=1.20; 1.13- 1.26). The patients belonging to households with higher income (>$49K) had higher odds of receiving ST (OR=1.14; 1.08-1.20). The histologic subtype associated with highest odds of receiving treatment was acute promyelocytic leukemia (OR=2.43; 2.27- 2.59). Compared to the reference period 2003-2006, patients diagnosed with AML during the later time period had higher odds for receiving therapy: 2007-2010 (OR =1.11; 1.08- 1.15), and 2011-2013 (OR=1.27; 1.22- 1.31) respectively (Table 1). Conclusions Although the number of people receiving therapy for AML has increased over time, factors like older age, comorbidities, lower household income, having Medicare, and being diagnosed at a community hospital were associated with lesser odds of receiving ST. More studies are needed to assess the impact of these factors on patient survival. Table 1. Systemic therapy in AML Variable Systemic Therapy (% of total) n = 74965 No Systemic Therapy (% of total) n = 23328 Odds ratio (95% CI) Gender Male 41 13 1.00 Female 35 11 0.97 (0.94, 0.99) Age ≤ 70 y 54 6 1.00 > 70 y 23 17 0.15 (0.15, 0.16) Race White 59 20 1.00 Black 7 2 1.20 (1.13, 1.26) Others 10 2 1.53 (1.45, 1.61) Year of diagnosis 2003-2006 24 8 1.00 2007-2010 27 9 1.11(1.08,1.15) 2011-2013 25 7 1.27 (1.22, 1.31) Insurance Private 32 4 1.00 Medicaid 7 1 1.16 (1.07, 1.26) Medicare 29 17 0.23 (0.22, 0.23) No Insurance 3 1 0.61 (0.55, 0.66) Others 5 1 0.61 (0.57, 0.66) Household income < $28K 7 2 1.00 $28K -$32,999 10 3 1.04 (0.98, 1.11) $33K - $38,999 14 5 1.01 (0.95, 1.08) $39K - $48,999 18 6 1.05 (0.99, 1.11) $49K + 27 8 1.14 (1.08, 1.20) Comorbidity None 58 15 1.00 Only 1 comorbid condition 14 5 0.65 (0.63, 0.67) Two or more comorbid conditions 5 3 0.42 (0.40, 0.44) Histology Acute Myeloid Leukemia (AML) 42 16 1.00 Acute Promyelocytic Leukemia (APL) 8 1 2.43 (2.27, 2.59) Acute Myelomonocytic Leukemia (AMyL) 6 2 1.25 (1.18, 1.32) Acute Myeloid Leukemia with Multilineage Dysplasia (AMLMD) 5 2 1.11 (1.05, 1.18) Acute Myeloid Leukemia with Maturation (AMLM) 4 1 1.56 (1.44, 1.68) Acute Myeloid Leukemia without Maturation (AMLWM) 3 1 2.02 (1.85, 2.21) Acute Myeloid Leukemia, Minimal Differentation 2 1 0.98 (0.91, 1.06) Other Specified Types (OST) 2 1 1.23 (1.11, 1.36) Erythroleukemia 2 1 1.07 (0.97, 1.18) Facility Type (n= 83431) Academic 50 8 1.00 Community 29 13 0.34 (0.32, 0.35) AML: Acute myeloid leukemia Disclosures No relevant conflicts of interest to declare.
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Bukur, Marko, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, and Fahim Habib. "The G60 Trauma Center: A Future Consideration?" American Surgeon 83, no. 6 (June 2017): 547–53. http://dx.doi.org/10.1177/000313481708300617.
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With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison. Primary outcomes were overall postinjury complication and mortality rates, as well as death after major complication (failure to rescue). ETC patients were older (78.6 vs 70.5), more likely to be admitted with severe head injuries (head abbreviated injury score ≥ 3, 50.0% vs 32%), had a greater overall injury burden (injury severity score > 16 41.4% vs 21.1%), and required intensive care unit admission (81.3% vs 64%) than the TC group. Need for operative intervention, mechanism of injury, and comorbidities were similar between the two groups. Overall complications were higher in trauma patients admitted to the TC (21.9% vs 14.3%), as well as failure to rescue (4.0% vs 1.8%). Adjusting for confounding factors, ETC had significantly lower chance of developing a postinjury complication (adjusted odds ratios [AOR] = 0.4, 95% confidence interval [CI] = [0.3, 0.5]), failure to rescue (AOR = 0.3, 95% CI = [0.1, 0.5]), and overall mortality (AOR = 0.3, 95% CI = [0.2, 0.4]). Improved outcomes were demonstrated in the Level I center treating a higher proportion of elderly patients. Exact etiology of these benefits should be determined for quality improvement in care of the injured geriatric patient.
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Murwani, Arita. "the correlation between health behavior in the elderly and public policy, nursing function and health education." Jurnal Formil (Forum Ilmiah) Kesmas Respati 5, no. 2 (November 13, 2020): 103. http://dx.doi.org/10.35842/formil.v5i2.324.
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Population projection data in Indonesia in 2017 says that the elderly population is 23.660.000 people. Yogyakarta has the highest number of elderly, especially those domiciled in Sleman Regency with a total of about 105.955 people. Health behaviors in the elderly can be influenced by public policy, nursing functions, and health education. To find out the correlation between health behaviors in the elderly and public policy, nursing functions, and health education. This study uses a cross-sectional design with a quantitative research type. This research used the survey method with a questionnaire sheet as a research instrument and then the data will be processed using Stata test. Analysis of data conducted with chi-square analysis. The technique used is purposive sampling due to sampling with certain criteria. The criteria of this study include elderly who come to the health center to conduct examinations, have families, and live in the working area of Sleman District health center. The research will take place from March 2020 until completion. The elderly who were domiciled in the working area of Sleman District health center became the population in this study as many as 103.686 elderly.There is a correlation between public policy and elderly health behavior with a Pearson chi-square value of 0,472. There is a correlation nursing function with elderly health behavior with a Pearson Chi-Square value of 0,210. There is a correlation between health education and elderly health behavior, with Pearson Chi-Square value -0,210.Conclusion: There is a significant correlation between health behaviors in the elderly and public policy, nursing function, and health education.
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Edvardsson, Maria, Märtha Sund Levander, Jan Ernerudh, Elvar Theodorsson, and Ewa Grodzinsky. "Clinical use of conventional reference intervals in the frail elderly." Journal of Evaluation in Clinical Practice 21, no. 2 (December 11, 2014): 229–35. http://dx.doi.org/10.1111/jep.12294.
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Shobarina, Agiesta Sephya, Aat Sriati, and Iwan Shalahuddin. "HEALTH PROBLEMS AMONG THE ELDERLY AT MAJALAYA PUBLIC HEALTH CENTERS (PUSKESMAS) WEST JAVA-INDONESIA." Malahayati International Journal of Nursing and Health Science 2, no. 1 (April 11, 2019): 6–13. http://dx.doi.org/10.33024/minh.v2i1.1164.
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ABSTRACT Background: Elderly Health problems can lead to decline in elderly body functions and become a factor that improves health problems. As a result, many elderly people come to public health services every day with the same complaints and different complaints.Purpose: to recognize the description of health problems among the elderly at Majalaya public health centers (Puskesmas) West Java-IndonesiaMethods: A descriptive research with documentation study. The object of research is medical records of elderly who went to public health center during the last 1 year from April 2017 until March 2018. The number of samples is 3899 elderly based on elderly visit number gained by total sampling technique. The technique of data collection is through elderly medical records at Majalaya Public Health Centre during the last 1 year. This research uses frequency distribution and proportion analysis.Results: Showed that almost all elderly came independently without being escorted by their families and hypertension was the highest-ranking health problems experienced by elderly (40,9%) others were rheumatoid atritis (14,9%), cough and flu (8.2%) , gastritis (7,9%) and chepalgia (7.6%) , they were the 5th highest health problems experienced by the elderly at Majalaya Public Health center during the last 1 year.Conclusion: Among 22 health problems that are experienced by elderly, hypertension is the most common problem complained by elderly. It is recommended that health care workers optimize services regarding the handling and treatment of chronic health problems among elderly.
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Suarmini, Kadek Ayu, Putu Agus Windu Yasa Bukian, Putu Sukma Megaputri, and Ni Kadek Nadia Sintia Dewi. "PKM: improving the posyandu elderly capacity to improve the degree of elderly health." ABDIMAS TALENTA: Jurnal Pengabdian Kepada Masyarakat 4, no. 2 (June 1, 2020): 281–88. http://dx.doi.org/10.32734/abdimastalenta.v4i2.3925.
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Kubutambahan and Bulian Village are two villages that are included in the working area of the Primary health care in Kubutambahan. Integrated Healthcare Center (IHC) elderly in these two villages still have lower coverage than other villages. In addition, the elderly IHC cadre are also not very active in promoting activities and inviting all elderly elements in the villages of Bulian and Kubutamabahan to come to the IHC. The elderly exercise becomes innovative as an improvement in the quality of life of the elderly. In view of the need for active cadres so that elderly gymnastic instructors are not only trained by health workers but also by elderly IHC cadres themselves. The method used is application technology with three patern (promotion, information and education). The stages of implementation are preparation, implementation and evaluation. The target is for all the elderly in the working area of the health center. The results of this service include the provision of IHC information through loudspeakers car, cadre training, provision of additional food as a reward for the arrival of the elderly to the IHC, providing health information and elderly exercise. This service is effectively carried out so that there is an increase in elderly visits and elderly cadres become trained. In addition, the elderly cadre also developed themselves by becoming an elderly gymnastic instructor. The conclusion is that there is an increase in elderly visits and cadres are increasingly trained.
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Mosher-Ashley, Pearl M. "Referral Patterns of Elderly Clients to a Community Mental Health Center." Journal of Gerontological Social Work 20, no. 3-4 (February 4, 1994): 5–23. http://dx.doi.org/10.1300/j083v20n03_02.
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Daou, Samira, Laure Federici, Jacques Zimmer, Frédéric Maloisel, Khalid Serraj, and Emmanuel Andrès. "Idiopathic thrombocytopenic purpura in elderly patients: A study of 47 cases from a single reference center." European Journal of Internal Medicine 19, no. 6 (October 2008): 447–51. http://dx.doi.org/10.1016/j.ejim.2007.07.006.
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Khairani, Nurul, Santoso Ujang Effendi, and Desi Kurnia Putri. "Education, Knowledge and Nutritional Status of Elderly in Elderly Integrated Service Post Working Area of Bentiring Community Health Center Bengkulu." Jurnal Sains Kesehatan 25, no. 1 (April 2, 2018): 9–17. http://dx.doi.org/10.37638/jsk.25.1.9-17.
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This study was based on the still high nutrient deficiency of elderly in the working area of Bentiring Community Health Center Bengkulu. This study aimed to study the relationship between education and knowledge with nutritional status of elderly in Elderly Integrated Service Post working area of Bentiring Community Health Center Bengkulu. The research type was Analytical Survey and the desain of research was Cross Sectional. The population of this study was all elderly who visited Elderly Integrated Service Post in the working area of Bentiring Community Health Center Bengkulu in January to April 2017 which amounted to 52 elderly. Sampling technique in this research used Total Sampling. The data collected in this study used primary data and secondary data with data analysis technique done by univariate and bivariate analysis with Chi-Square test (c²) through SPSS 16 program. The result of this research were : from 52 elderly, there were 35 elderly (67,3%) with basic education, 27 elderly (51,9%) who had less knowledge, 20 elderly (38,5%) had less nutritional status, there was significant relationship between education with nutritional status of elderly with medium category, and there was a significant relationship between knowledge with nutritional status of elderly with close category. It was expected to Bentiring Community Health Center Bengkulu to improve health services to the elderly by providing nutrition education and medical examination for elderly. Keywords : education, elderly, knowledge, nutritional status, elderly
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Yanti, Ni Putu Riska. "Effect Gymnastics Elderly Against Decreased Stress Levels in the Elderly in Jinengdalem: Buleleng III Health Center." MIDWINERSLION : Jurnal Kesehatan STIKes Buleleng 5, no. 2 (September 30, 2020): 265. http://dx.doi.org/10.52073/midwinerslion.v5i2.172.
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Abstrak: Senam lansia merupakan aktifitas fisik yang dapat menjadi sebuah mekanisme untuk meningkatkan kesejahtraan yang berkaitan dengan stres yang dihadapi lansia. Respon tubuh yang bersifat spesifik terhadap setiap tuntutan ataupun beban akan menimbulkan stres. Tujuan penelitian ini yaitu untuk menganalisis Pengaruh Senam Lansia Terhadap Penurunan Tingkat Stres Pada Lansia Di Desa Jinengdalem:Wilayah Kerja Puskesmas Buleleng III. Desain Penelitian ini yaitu Quasi Experimental dengan rancangan one group pre- post test design. Besar sampel yang digunakan yaitu 35 responden yang telah dipilih dengan tehnik sampling jenuh. Pengumpulan data dilakukan menggunakan lembar kuesioner DASS. Penelitian ini menggunakan uji paired T-test dengan taraf signifikan α = 0,05. Didapatkan hasil data nilai rata-rata pre 23.34 dan nilai rata-rata post 15.46. Hasil uji mengunakan uji Paired T-test didapatkan nilai p (0,000) < α (0,05), artinya (H0) ditolak dan (Ha) diterima. Dalam penelitian ini ada Pengaruh Senam Lansia Terhadap Penurunan Tingkat Stres Pada Lansia Di Desa Jinengdalem:Wilayah Kerja Puskesmas Buleleng III.