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1
Wisch, Michael Henry. "Microemulsions : a new perspective in the treatment of paediatric and geriatric tuberculosis patients". Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1003283.
Testo completoAbstract (sommario):
Tuberculosis(TB) was declared to be a global emergency in 1993, with South Africa declaring it to be the country’s top health priority in 1996, but ineffective treatment strategies have led to fewer than half of all treated patients in South Africa being cured. At present,paediatric treatment remains a problem, as the antitubercular preparations of rifampicin, isoniazid and pyrazinamide, that are currently available, were not initially designed for the treatment of paediatric TB patients, providing a motivation for this project. The aim of this project is thus the development of a microemulsion dosage form for the oral delivery of RIF(Rifampicin), INH(Isoniazid) and PZA(Pyrazinamide) in combination. RIF, INH and PZA were adequately characterised with reference to the monograph standards referenced and were found to be sufficiently pure to be used in subsequent work. A chromatographic system and conditions were selected and validated as being optimal for HPLC analysis of RIF, INH and PZA in combination, with a drug partitioning method for miglyol 812 developed and validated. Ternary and pseudo-ternary phase diagrams were constructed and reported, all employing miglyol 812 as the lipid. It was undoubtedly the imwitor 308 and crillet 3 combination o/w microemulsion system that proved most successful, maintaining homogeneity on dilution. The microemulsion used in formulation comprised imwitor 308 (27.63%), crillet 3 (27.63%), miglyol 812 23.68%) and water (21.06%). The stability of RIF, INH and PZA was investigated in aqueous solution, miglyol 812, corn oil, 10%m/v cremophor RH, 5%m/v imwitor 308, 10%m/v crillet 3 and 70%m/v sorbitol solution. Trends in the stability assessments conducted on RIF, INH and PZA were noted, with slight variation depending on the formulation component being evaluated. RIF invariably demonstrated temperature and oxidation dependent degradation in all vehicles, with a definite distinction possible between samples stored at 25, 40 and 600C over a 7 day trial period. A definite advantage of storing RIF solutions under nitrogen was observed, with these solutions showing less degradation over the course of the trial, than those stored under air. INH produced a pronounced increase in the degree of degradation of RIF, whereas PZA had a negligible effect on it’s stability. INH proved to be most stable in the 70%m/v sorbitol solution with no significant oxidation or temperature dependent degradation indicated. Temperature dependent degradation was only noticable when INH was in combination with RIF, most significant in crillet 3 solution. PZA was the most stable of the three drugs, remaining relatively unaffected by temperature and the presence of air, independent of the vehicle employed, although the drug remaining did decrease slightly in the presence of RIF.Due to drug dose specifications and solubility limitations, the final formulation assessed, only contained RIF and INH, despite INH and PZA having no significant effect on the stability of each other. The solubility of PZA in the lipid and aqueous components of the microemulsion was not great enough to achieve the required 500 mg/10ml dose, while RIF and INH could achieve the respective 150mg/10ml and 100mg/10ml dose. RIF stability was improved, as anticipated, with the incorporation of RIF into the internal phase decreasing contact with INH which has been shown to affect it’s stability. RIF behaved as predicted, possessing greater stability than shown in the individual formulation components, however, INH did not, being less stable in formulation in the absence of antioxidant, than in it’s presence. A novel microemulsion formulation capable of delivering the incompatible RIF and INH in combination, with numerous microemulsion systems mapped,with the ability of being used for the delivery of other lipophilic drugs and drug combinations, was produced.The final formulation provided valuable information into possible future improvements of the microemulsion to improve drug stability.
2
He, Xiuqing. "The risk factors for tuberculosis in elderly in Guangzhou". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994743.
Testo completo
3
何綉卿 e Xiuqing He. "The risk factors for tuberculosis in elderly in Guangzhou". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994743.
Testo completo
4
Morris, Charles David Wilkie. "Pulmonary tuberculosis in the elderly : diagnostic criteria and its epidemiology in old age homes". Doctoral thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/26574.
Testo completoAbstract (sommario):
The majority of today's elderly people were primarily infected with Mycobacterium tuberculosis at a time when no effective chemotherapeutic treatment was available. With the progressive decline in cell mediated immunity that accompanies aging, the potential to reactivate a dormant lesion, or to be re-infected increases. The latter particularly applies in areas of high density living e.g. homes for the elderly. The incidence of pulmonary tuberculosis in whites in South Africa is very similar to that in industrialized countries (approximately 16/100 000). In a survey of old age homes in East London (South Africa) involving 809 white subjects the prevalence rate was found to be 1403/100 000; clusters were found in individual homes where up to 10% of residents had tuberculosis. The age specific incidence in the community for whites was 86/100 000, and in homes for the aged the incidence in 648 elderly subjects followed for 2 years was 1080/100 000. It is concluded that the elderly living in high density accommodation constitute a high-risk group for the development of the disease. The diagnosis of pulmonary tuberculosis in the elderly may be complicated by the high prevalence of atypical radiographic changes, difficulty in obtaining sputum, and the high false-negative rate of the tuberculin skin test. Thus, the value of haematological and biochemical abnormalities in 93 elderly tuberculotics, 113 elderly non-tuberculotics and 264 young tuberculotics were investigated. The results in the elderly tuberculotic patients were: Normochromic normocytic anaemia (70%), leucocytosis (55%), thrombocytosis (33%), rapid ESR in 90%, lymphopenia (22%) and monocytopenia (37%); hyponatraemia (60%), hypokalaemia (42%) and hypoalbuminaemia (83%), serum bilirubin (20%) and alkaline phosphatase, aspartic transaminase and lactic dehydrogenase are elevated in approximately 2/3 of patients. In comparison with the younger group (mean age 48 years) with cavitating tuberculosis, the prevalence of elderly patients (with generally mild and non-cavitating disease) with elevated bilirubin, alkaline phosphatase and liver enzymes was approximately 50% higher. When the results of liver enzyme elevations in the elderly tuberculotics were compared retrospectively with elderly patients with non-tuberculotic destructive lung disease, the former group had significantly higher values. The sensitivity (76%), specificity (48%) and positive predictive value (60%) suggest that liver enzyme abnormalities may provide useful contributory data in the non-invasive diagnosis of pulmonary tuberculosis in the elderly. The chest radiographs in 93 consecutive cases of bacteriologically proven pulmonary tuberculosis showed infrequent apical involvement (7%), with the most frequent abnormality being opacification of the middle and lower zones of the lungs; half the cases had a pleural reaction. cavitation occurs in only 1/3 of patients, and was sited equally in the apical zones and in the mid and lower zones. These findings contrast with the pattern of cavitating apico-posterior disease commonly seen in reactivated tuberculosis in younger adults. A series of 21 patients was studied to compare the yield of sputum smear examination with sputum culture for M. tuberculosis. Sputum production in non-cavitating disease was found to be infrequent and unpredictable and the number of bacilli is usually scanty. Repeated Culture of sputum for M. tuberculosis is required to improve the likelihood of obtaining a positive bacteriological diagnosis. On the basis of this study at least 4 negative sputum cultures are required to exclude the disease. In a study of 10 patients the impact of 4-drug therapy on the viability of M. tubercle in their sputum was assessed. Viable tubercle bacilli continue to be excreted in patients with cavitating pulmonary disease on treatment for up to 9 weeks. It is suggested that patients with cavitating disease should probably not be allowed to return to high density accommodation for the elderly until their sputum is clear of acid fast bacilli on sputum smear examinations. The usefulness of using annual tuberculin skin reaction (Mantoux) tests as a screening procedure was evaluated in 648 residents in old age homes. The criteria for further investigation for pulmonary tuberculosis was either recent conversion to positive (reaction equal to 10 mm or more) or a year-on-year increase of greater than 12 mm, or any reaction> 20 mm. 206 subjects were identified as "possibly having the disease" and of these the diagnosis of pulmonary tuberculosis confirmed in 13 cases. 10/13 patients had Mantoux reactions of greater than 20 mm and 3/13 between 10 mm and 19 mm. As a result of this study the recommendation is made that a yearly Mantoux test is a useful screening procedure, and will help identify a population who should be further investigated with chest radiographs and sputum cultures.
5
Sung, Kei Ka Emily. "Troup treatments for geriatric depression in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B29727510.
Testo completo
6
Kaur, Baljit. "Therapy of depressives symptoms among Chinese older adults: a meta-analysis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45169354.
Testo completo
7
Leung, Yee-man Emily, e 梁綺雯. "Systematic review : effectiveness of non-pharmacological interventions in managing depression in elderly". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193788.
Testo completoAbstract (sommario):
Introduction
Geriatric depression is one of the major public health issues around the world. Geriatric depression is often being misinterpreted as a normal aspect of aging process, but it is indeed a complex psychological problem that would result in significant increases in DALYs. With effective treatments, depressive symptoms and signs can be reduced. Nevertheless, pharmacological intervention is often used as the first-line treatment for geriatric depression. In recent years, different types of non-pharmacological intervention have been getting more attention in terms of theirs effectiveness in treating geriatric depression.
Objectives
Primary objective is to determine whether two categories of non-pharmacological intervention (physical activity and reminiscence therapy) are effective in relieving depression in elderly that are 60 years old or older. The other objectives are to examine enduring effects of physical activity and reminiscence therapy, and compare the effectiveness of reminiscence therapy and physical activity in alleviating depressive symptoms in elderly compared with no intervention and/or other intervention.
Methods
Relevant studies published between the year of 2000 and 2013 were searched and identified through several electronic databases, including the Cochrane Library, PubMed, Medline, PsycINFO and Google Scholar, with a combination of keywords. All randomized controlled trials that examine physical activity and reminiscence therapy on elderly that are 60 years old or older, being diagnosed or indicated as suffering from depression were included. The methodological quality of each study was assessed. The outcome measure of this review is the depression symptom level.
Main Result
A total of 12 randomized controlled trials met the inclusion criteria, in which seven were about physical activity and five of them were about reminiscence therapy. Significant immediate reduction in depressive symptoms was found in five out of seven physical activity studies and in four out of five reminiscence studies. Three and two studies respectively on physical activity and reminiscence therapy had assessed the effect at follow-up and looked at the lasting effect. In two physical activity studies that have assessed the short-term effect beyond the completion of intervention, incongruent findings were found. Only one physical activity study has examined the long-term effect and it reported significant positive result. On the other hand, there were two reminiscence therapy studies assessing the short-term effect on depressive symptoms. These two studies reported significant improvement in depressive symptoms. Since there were few studies reporting the medium and long-term effect of physical activity and reminiscence therapy, no conclusion can be made on their enduring effect of reducing depressive symptoms.
Conclusions
Physical activity and reminiscence therapy appear to be effective non-pharmacological interventions for relieving depressive symptoms in elderly. They may complement pharmacological intervention and/or may offer alternative treatment option for elderly with depression. However, the mode, intensity, duration, type, format of physical activity and reminiscence therapy on depressive symptoms in elderly remain unclear. Further testing is need before these interventions can be routinely used to alleviate depressive symptoms in elderly with depression.published_or_final_version
Public Health
Master
Master of Public Health
8
Cortez-Bazán, Nathaly, Jennifer R. Delgado, Omar Galdos e Luis Huicho. "Pott’s disease in upper thoracic vertebrae in atwo-year-old boy: Case report". Instituto Nacional de Salud, 2018. http://hdl.handle.net/10757/624633.
Testo completoAbstract (sommario):
Pott’s disease is a health problem in developing countries and its diagnosis in children is a challenge. Here we present the case of a two-year-old boy with Pott’s disease involving T1 to T3 thoracic vertebrae. The clinical presentation was characterized by difficulty walking, fever, cough, and dyspnea. At physical examination, kyphosis and bony prominence were observed in the cervicodorsal area. A positive tuberculin test was obtained, and Mycobacterium tuberculosis was isolated via culture of the gastric aspiration sample. The spine MRI showed a chronic abscess, destruction of two vertebrae, and bone marrow compression. The patient experienced some improvement with anti-TB therapy. Here, we emphasize the importance of giving consideration to the clinical suspicion for the early detection of this condition, as well as a quick TB-treatment start so as to avoid the disability and mortality associated to this disease.Revisión por pares
Revisión por pares
9
Barker-Read, Mary. "The treatment of the aged poor in five selected west Kent parishes from settlement to Speenhamland (1662-1797)". n.p, 1988. http://ethos.bl.uk/.
Testo completo
10
Koffman, Steven D. "Structured reminiscence and gestalt life review : group treatment of older adults for late life adjustment". Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1115724.
Testo completoAbstract (sommario):
The present analogue study compared the effects of 2 theoretically divergent Life Review group psychotherapies on aspects of late life adjustment and development. Thirty-six adult non-patients, ages 65 years and older, from the Muncie - Delaware County vicinity, were randomly selected from an available subject pool of screened volunteer respondents and randomly assigned to one of three analogue treatment conditions with two groups for each treatment condition. These three treatment conditions were the structured reminiscence life review group (SRLR), the Gestalt life review group (GLR) and a Wait List control group (WLC). Demographic, mental status, and Activities of Daily Living Scale (ADL) data were obtained from initial respondents by telephone interview and followed by written completion of the Symptom Checklist (SCL 90-R). The differential effects of treatment were measured by pre and post testing on four dependent variables: (1) depression, (2) congruence, (3) helplessness, and (4) ego integrity.Results indicated that neither of the two life review group psychotherapy treatments had any statistically significant effect upon the dependent variables. In a post hoc exploratory analysis, evidence emerged which suggested that the participants in the GLR treatment condition may have shown significant improvement on several state mental health variables. The dimensions of improvement for participants in the GLR were Interpersonal Sensitivity, Hostility, Depression, and Positive Symptom report as measured by the SCL 90-R. This contrasted with those in both the SRLR or WLC condition for whom no improvement was shown.Department of Counseling Psychology and Guidance Services
11
CORBISHLEY, MAUREEN ANN. "REM DENSITY, REM LATENCY AND THE DEXAMETHASONE SUPPRESSION TEST AS PREDICTORS OF TREATMENT RESPONSE IN DEPRESSED OLDER ADULTS". Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/183999.
Testo completoAbstract (sommario):
The purpose of this study was to investigate whether biological variables could predict how older adults would respond to different types of treatment for depression. Fifty-six adults over the age of sixty-five, diagnosed with major depression (DSM III criteria) were assigned to one of four treatment conditions: group Cognitive Behavior Therapy with alprazolam or placebo medications, and minimal support therapy with alprazolam or placebo medication. Before and after treatment, REM latency and REM density were measured by polysomnograph in the sleep laboratory and the Dexamethasone Suppression Test (DST) was administered. Depression was measured by weekly by the Hamilton Depression rating Scale and the Beck Depression Inventory. Subjects presented with normal (i.e. nondepressed) values on REM latency and REM density. Thirty five percent of subjects were DST nonsuppressors, a similar percentage to that found in other studies of depressed subjects, but mean DST for the whole group was below the selected cutoff of 4 mcg/dl. The expected correlations among the biological variables and between these variables and baseline depression levels were not found. It was concluded, therefore, that depression in this group of subjects was not characterized by biological abnormalities. Multiple regression analyses of baseline variables and depression scores at mid and end of treatment and at followup indicated that initial depression levels and DST predicted later depression levels for subjects who received Cognitive Behavior Therapy, regardless of medication assignment. Low baseline DST levels were associated with good response to psychotherapy, confirming the findings of previous studies. Sleep variables were not predictive of response to treatment at any time point.
12
Bartos, Paul Joseph. "Modified partial colpocleisis of Kahr in the treatment of various degrees of uterine prolapse in the elderly with prohibitive anaesthetic risk : an alternative to ring pessary". Thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/25904.
Testo completo
13
Velasco, Enid Aida. "Discrepancies in social workers' self-perception in theoretical and treatment approaches to depressed late middle-age women". CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1325.
Testo completo
14
Mutevedzi, P. C. "Old age health and HIV in a rural area with high HIV prevalence and incidence : what is the impact of enhanced access to antiretroviral treatment?" Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1410788/.
Testo completoAbstract (sommario):
The widespread roll-out of antiretroviral therapy (ART) has resulted in a decline of HIV-related deaths; as a result the HIV positive population is rapidly ageing with improved survival of HIV positive adults on ART. In sub-Saharan Africa, including South Africa, where older adults comprise a significant proportion of the total population, health services face the complexities of an ageing population and HIV. The aim of this PhD study is to inform understanding of issues relating to older adults, aged 50 years or more, HIV infection and ART, who are resident in Northern KwaZulu-Natal, South Africa. Data from the cross-sectional Wellbeing of Older People Study (WOPS), including 422 older adults and nested within the demographic surveillance system, show that HIV positive older adults receiving ART for >1 year had less chronic morbidity than HIV negative older adults despite having higher IL6 and hsCRP levels. To quantify the cause-specific morbidity burden at the time of initiating ART, data on 1 409 adults aged ≥16 years obtained from the ART Clinical Cohort show that chronic morbidity at time of ART initiation burden and HIV-associated morbidity was more common in older than younger (16-49 years old) adults. Data from the HIV Treatment and Care programme, linked to an electronic Hospital Information database (n=8598 adults aged ≥16 years) show that older adults had a lower hospitalisation rate, but higher case fatality rates, than younger adults. In the HIV treatment and Care programme, including 8846 overall, in the first year of ART, mortality was higher in older than younger adults, but rates in the two groups were similar thereafter. Older adults had a blunted immunological but superior virological response. All-cause mortality risk increased with a decline in CD4 cell count and unsuppressed viral load. Further detailed data from the ART Clinical Cohort showed that, in both age groups, the contribution of multiple co-morbidity to early mortality was high. The results presented here contribute towards evidence required to understand issues surrounding the health of older adults in the context of high HIV prevalence and incidence with widespread availability and access to ART and provide knowledge required for evidence-based health planning for the ageing HIV cohort. The thesis concludes with a discussion of the implications for health service development and future research.
15
Chan, Wai-mai May, e 陳慧媚. "Relationship between poor compliance with antihypertensive medication and factors associated with inadequate blood pressure control inChinese community-dwelling elderly". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45010651.
Testo completo
16
Spring, Noah Z. "Effects of Dialectical Behavior Therapy Mindfulness Skills Training on Older Adults with Chronic Pain". Xavier University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1396715022.
Testo completo
17
Redl, Donnie. "Factors in older adults' resistance to substance abuse treatment". CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2342.
Testo completo
18
Van, Soelen Nelda. "An evaluation of the cost-effectiveness of the introduction of an isoniazid prophylaxis treatment (IPT) register for tuberculosis contact management in children less than five years of age in a high-burden community healthcare clinic (CHC) setting in the Western Cape, South Africa". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/97286.
Testo completoAbstract (sommario):
Thesis (MBA)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Childhood tuberculosis is an infectious disease that can cause serious illness and mortality in especially young children. Following contact with an infectious adult tuberculosis case, the disease is easily preventable through preventive isoniazid treatment, yet very few exposed and at-risk children currently access this healthcare service in most high-burden settings. Previous research pointed out the multifactorial and complex nature of the barriers to accessing preventive care. Specifically, the lack of a formalised recording and reporting tool, such as the universally used tuberculosis treatment registers, possibly contribute to the operational barriers of preventive care delivery to these children. The purpose of this research was to evaluate the cost-effectiveness of an isoniazid preventive treatment register tool used at community level. The study utilised previously reported data from the study population and other high-burden settings to construct a decision analysis model that included varying probabilities of isoniazid preventive treatment across three high risk age groups (<1 year of age, 1 – 2 years of age, 3 – 5 years of age), coupled with disease probabilities and associated treatment costs. The scenarios simulated included 1) the routine isoniazid preventive treatment service (3% started on treatment, 17% identified as eligible); and 2) an isoniazid preventive treatment service supported by a recording register (15% (adherent to six months of treatment) and 38% (started on IPT treatment)). In addition, two hypothetical simulations were included for 76% and 100% isoniazid preventive treatment uptake; these hypothetical simulations required additional community based healthcare worker resources in addition to the register tool. The observations from the literature indicated that more children were identified (24(17%) vs. 54(38%)) and started (4(3%, base case) vs. 54) on isoniazid preventive treatment following the implementation of the register. As expected, the mean number of tuberculosis cases prevented, increased as the proportion of eligible children that received isoniazid preventive treatment, improved; the change in the number of cases prevented per simulation showed incremental improvements which were all significantly better (p<0.01) than the base case.. The incremental cost-effectiveness ratios incurred savings for each of the scenarios simulated since the mean costs for each of the simulations were significantly less (p<0.01) than the costs associated with the base case. The current evidence suggests that the proposed isoniazid preventive treatment register tool is a cost-effective alternative to the current standard of care in place at community level for at-risk children exposed to tuberculosis. It is therefore recommended that the tool be used incrementally on a bigger scale, until such time that sufficient evidence has been generated to support widespread implementation.
19
Razé, Laetitia. "L'âge en droit social : étude en droit européen, français et allemand". Thesis, Rennes 1, 2013. http://www.theses.fr/2013REN1G025/document.
Testo completoAbstract (sommario):
L’allongement de la durée de la vie humaine et le déficit du rapport démographique constituent de véritables défis pour les systèmes sociaux des États membres. Pour y faire face, les législateurs doivent à la fois développer une politique de protection des plus jeunes dans le cadre des relations professionnelles, tout en revisitant les logiques des seuils d’âge notamment au regard de la fin de ces relations. Cette étude a vocation à s’interroger sur l’existence d’un concept de l’âge. Fort d’une histoire culturelle, confortée par une analyse du phénomène physiologique du vieillissement par le législateur, le critère de l’âge entretient des liens particuliers avec les principes généraux du droit de l’Union, tel que le principe de la dignité humaine et le principe de l’égalité de traitement. Malgré tout, le critère de l’âge conserve une ambivalence certaine, mise en exergue à travers le principe général du droit de l’Union de non-discrimination à raison de l’âge. Cette ambivalence se manifeste plus fortement encore à l’issue des relations professionnelles, posant ainsi la question de la place de l’âge à la fin de la vie active. Ce curseur au soutien du pacte intergénérationnel, conditionnant le bénéfice de la liquidation de la pension, connaît actuellement un renouveau, dépassant les frontières des États membres. Une convergence dans le traitement de la vieillesse se crée, tendant au développement de nouvelles solidarités dans le cadre de l’entreprise (régimes professionnels d’entreprise). Il s’agit en outre de favoriser la poursuite de l’activité à un âge élevé (relèvement de l’âge légal de la retraite, décote, surcote, encadrement des régimes dérogatoires, prohibition des ruptures de la relation de travail fondée sur l’âge…) et de repenser les rapports entre les relations de travail et l’âge (cumul emploi - retraite, retraite progressive…). Ce faisant, les législateurs promeuvent un traitement de l’âge qui s’inscrit dans la problématique générale de la longévité humaine en EuropeDealing with longer life expectancy and demographic deficit is currently a huge challenge for the social system of European member states. To face this challenge, it is necessary for legislators to develop a dedicated protection policy for the young people in a business relationship context and, at the same time, to redefine age limits policy especially in business relationship termination situation.. The presented study focuses on the factuality of the « age » concept. Based on cultural history, confirmed by the legislator analysis of the physiological aging, « age » criterion is closely linked to general principles in E.U. legislation like, for example, the human dignity and the equal treatment. However, the « age » criterion still remains ambivalent which is underlined by the non-discrimination principle. This ambiguity is emphasized in business relationships which leads to the influence of the « age » in an ending working life situation. This intergenerational pact support, which influence the proceed of the pension liquidation, is currently experiencing a revival beyond E.U. member state boundaries. A converging point is achieved in old-age treatment which leads to new solidarity development schemes inside companies (like for example the company occupational scheme). An important objective is to promote the pursuance of a professional activity in order to retire later (increasing in the statutory retirement age, increment or reduce of the retirement pension, restriction of derogations, proscription of business relationship breaches if they are based on age, …) and to redefine the connection between age and business relationships (combined work and retirement, phased retirement, …). By this way, legislators promote a human longevity based age treatment in Europe
20
Everett, Carrey. "The efficacy of Scleron® in the treatment of age-related memory loss". Thesis, 2010. http://hdl.handle.net/10210/3135.
Testo completoAbstract (sommario):
M. Tech.Memory loss refers to the loss of ability to learn new information and the inability to retrieve information previously learnt (Karlawish & Clark, 2003). It is estimated that more than 40% of individuals over the age of 60 are affected by memory loss (Jackson, 2004). There are no recommended treatment options available for mild forms of memory loss (D‟Esposito & Weksler, 2000). The aim of the study was to determine the effects of the anthroposophical medicine, Scleron® in the treatment of memory loss associated with ageing, assessed by digit span; verbal and visual recall and recognition and a memory questionnaire. The trial was a double-blind placebo controlled study using matched pairs. Participants selected to take part in the study were between the ages of 60 and 75 and presented with subjective symptoms of memory loss. Participants were excluded from the study if they scored less than 24 out of 30 on the Mini-Mental State Exam; were previously diagnosed with memory or cognitive disorders; had a previous history of stroke, epilepsy, head injury, psychiatric disease and drug or alcohol dependence. Participants were divided into two groups in matched pairs according to age, education level, occupation and Mini-Mental State Exam scores. At the start of the study, participants completed a memory test and memory questionnaire. Participants in the experimental group received Scleron®, while participants in the placebo group received unmedicated tablets. Participants were required to take 2 tablets in the morning for a period of six weeks. The memory test and memory questionnaire was once again completed by participants at the end of the study. Thirty six participants completed the study. The results of the study were analysed and frequencies and descriptives were calculated for the sample group. The Wilcoxon test was used to compare the data within groups, while the Mann-Whitney test was used to compare the results between the two groups. iv After analysis of the results of the study, it was concluded that Scleron® did not appear to improve the symptoms of memory loss when using tests of digit span, verbal and visual recall or verbal and visual recognition. Furthermore, it did not appear to improve subjective symptoms of memory loss assessed by the use of a memory questionnaire.
21
McKechnie, Bronwen. "A study on the influence of homoeopathically prepared Ginkgo Biloba 6X potency compared with that of phytotherapeutically prepared Ginkgo Biloba on the results of psychometric tests used to ascertain short term memory loss in the geriatric subject". Thesis, 2014. http://hdl.handle.net/10210/11797.
Testo completoAbstract (sommario):
M.Tech (Homoeopathy)The aim of this study is to determine the influence of homoeopathically prepared Ginkgo Biloba 6X potency compared with that of phytotherapeutically prepared Ginkgo Biloba Extract; on the results of psychometric tests used to ascertain short-term memory loss in the geriatric subject. 21 elderly volunteers received; Ginkgo Biloba Extract (500mg), a homoeopathic 6X potency of Ginkgo Biloba and a placebo according to a double blind design. One hour after administration of the treatment, volunteers were subjected to psychometric testing namely the Reading Comprehension Test, which serves to assess the status of the short-term memory. No statistically significant changes from the placebo were observed in either of the groups. Adjusted scores for education and Mini Mental Status Exam scores however revealed a positive trend in favour of the homoeopathic 6X potency of Ginkgo Biloba Further evaluation with a larger study sample could provide more conclusive evidence as to its efficacy
22
Brits, Janet. "A description of the hearing profile in gold miners with tuberculosis". Diss., 2011. http://hdl.handle.net/2263/30329.
Testo completoAbstract (sommario):
Two of the primary occupational health threats to employees in the mining industry are noise-induced hearing loss (NIHL) and occupational lung diseases (OLD) with Tuberculosis (TB) included in the latter. The objective of this study was to investigate the hearing profile of a group of gold miners with and without TB to determine the effect of TB and its associated risk profile on hearing. Workers in AngloGold Ashanti mine in South Africa were recruited due to the fact that they present with these two health threats namely NIHL and TB. The audiological and medical surveillance data of 2698 subjects (between the years 2001 and 2009) were used in analyses. Hearing thresholds for the air conduction frequencies (0.5, 1, 2, 3, 4, 6, 8 KHz) in both ears were analysed in conjunction with biographic and occupational data. Subjects were divided into three groups, two experimental groups (Single TB treatment, n= 911 and Multiple TB treatment, n= 376) and one control group (n= 1411). A highly significant difference (p<0.01) was noted between the control group and both TB treatment groups across most frequencies and hearing parameters analysed, although the higher frequencies were more affected. Pair wise comparisons revealed the largest differences in hearing thresholds throughout between the control group and the multiple TB treatment groups. The smallest differences in hearing thresholds were evident between the two TB groups with the multiple TB treatment group presenting with the poorest thresholds. TB and its related risk profile had a pronounced influence on the decline of hearing thresholds. Thresholds for the multiple TB treatment group indicated more deterioration than the hearing thresholds of the single TB treatment group. This may point to the possibility that the influence of repeated TB on the subjects’ hearing thresholds over time was more pronounced than a single incidence of TB. It is still necessary however to separate the effects of the disease from the effects of the treatment on hearing.Dissertation (MCommunication Pathology)--University of Pretoria, 2012.
Speech-Language Pathology and Audiology
Unrestricted
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Khambaty, Tasneem. "Depression treatment and diabetes risk: a 9-year follow-up study of the impact trial". Thesis, 2015. http://hdl.handle.net/1805/7905.
Testo completoAbstract (sommario):
Indiana University-Purdue University Indianapolis (IUPUI)Objectives: To examine the effect of a collaborative care program for late-life depression on risk of diabetes among depressed, older adults. Method: We conducted a 9-year follow-up study of 160 older, primary care patients with a depressive disorder but without diabetes enrolled at the Indiana sites of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial. Results: Surprisingly, the rate of incident diabetes in the collaborative care group (22/80 = 27.5%) was twice the rate observed in the usual care group (11/80 = 13.7%). Cox proportional hazards models adjusted for randomization status (HR = 1.94, p = .076), demographic factors (HR = 1.94, p = .075), and additionally for diabetes risk factors (HR = 1.73, p = .157) indicated that the risk of incident diabetes did not differ between the collaborative care and usual care groups, with collaborative care patients remaining at a nonsignificant increased risk. Conclusions: Our novel findings suggest that depression may not be a casual risk factor for diabetes and that depression treatment may be insufficient to reduce the excess diabetes risk of depressed, older adults.
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Crawford, Gregory Brian. "Depression in palliative care patients in Australia identification and assessment /". 2007. http://catalogue.flinders.edu.au/local/adt/public/adt-SFU20090127.133003/index.html.
Testo completoAbstract (sommario):
Thesis (MD (Doctor of Medicine))--Flinders University, School of Medicine, Dept. of Palliative and Supportive Care.Typescript bound. Includes bibliographical references: (leaves 147-177) Also available online.
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Ali, Solomon Ahmed. "Outcomes of TB treatment in HIV co-infected TB patients in Ethiopia". Diss., 2015. http://hdl.handle.net/10500/18858.
Testo completoAbstract (sommario):
The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB diseaseHealth Studies
M.A. (Public Health)
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů". Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
Testo completoAbstract (sommario):
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.