Search Results (98)

Introduction: Traumatic brain injury (TBI) is a significant global public health issue, with long-term impacts on patients. This study examines the relationship between TBI severity, as measured by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) at admission, and various sociodemographic, clinical, and injury-related factors. Methods: We conducted a retrospective analysis using data from 164 adult TBI patients. All were admitted between March 2020 and June 2023 to two Eastern European tertiary hospitals. Variables included sex, age, education, employment, marital status, injury type and cause, place of injury, and clinical measures such as the Marshall score, AIS, and ISS. Statistical methods included Pearson’s Chi-squared, Fisher’s exact, Spearman correlation, Wilcoxon, and Kruskal–Wallis tests. Results: Most patients were male (65.9%), retired (59.8%), and urban residents (73.8%), with a mean age of 64.98 years. The most frequent mechanism of injury was falls (76.2%), typically occurring at home (61%). The predominant injury type was closed head trauma (93.3%). Most patients had mild AIS scores (75%), and the mean ISS was 6.52 (SD: 4.55). Statistically significant group differences were found for AIS among categories of Modified Marshall Score, injury type, and education categories and for ISS among categories of the Modified Marshall Score, injury type, cause and place of injury, employment status, and sex. No significant correlations were found between AIS or ISS and age or hospital length of stay. Conclusions: AIS is more anatomically focused. ISS reflects broader systemic injury patterns and is more influenced by contextual factors. These findings are particularly relevant for the Eastern European population and can help develop better healthcare policies for the region. Full article

Globally, technologically integrated housing solutions are increasingly relevant in addressing the challenges of aging populations and sustainable urban development. Drawing on the Technology Acceptance Model (TAM), this research investigates how perceptions of usefulness, ease of use, and attitudes influence relocation intention to smart retirement villages (SRVs), while also examining any significant differences between the socio-demographic variables and such intention. A total of 305 individuals aged 55 and above participated in an online survey, with data analyzed using IBM SPSS Statistics version 27 and AMOS-SEM version 25. The findings reveal that elderly individuals of Chinese ethnicity, those who are married, and those aged between 66 and 70 are more inclined to relocate to SRVs. Attitude and perceived usefulness significantly predict relocation intention, while perceived ease of use exerts an indirect effect through usefulness. These results highlight the importance of integrating user-centered technological design with socio-cultural and demographic considerations in the development of age-friendly built environments. The study offers insights for urban planners, policymakers, and developers seeking to create inclusive and sustainable smart housing solutions for aging populations. Full article

Background: As the global population ages, there is an increasing focus on enhancing the psychological well-being of older adults. A key strategy is person-centred care, which emphasises recognising each individual as unique, with their values, needs, and preferences. This study explored older adults’ perceptions of person-centred care and its relationship with their general health and psychological well-being. Methods: A cross-sectional study involving 632 participants aged 65 to 96 years (mean age = 73.4 ± 6.7) was conducted, comprising 435 (69%) female and 197 (31%) male participants. Of these, 57% lived in home environments, while 43% resided in retirement homes. Data were collected using a self-report questionnaire that included the General Health Questionnaire (GHQ-12), the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS), and the Person-Centred Practice Inventory for Service Users (PCPI-SU). Data analysis was performed using SPSS Statistics 28.0, and non-parametric tests such as the Kruskal–Wallis test, Mann–Whitney U test, and Spearman’s correlation were used. Results: Older adults who reported more frequent contact with relatives or loved ones (daily or several times per week) and those residing in home environments perceived significantly higher levels of person-centred care compared to those with less frequent contact and those living in retirement homes (p < 0.001 for both variables). General health varied significantly according to gender (p = 0.009), level of education (p < 0.001), and living environment (p = 0.004), while psychological well-being among older adults showed significant differences based solely on their level of education (p < 0.001). Regression analysis revealed that person-centred care (p = 0.017) and monthly income (p < 0.001) were significantly associated with the psychological well-being of older adults, independent of their living environment. Conclusions: The findings suggest that person-centred care and monthly income significantly predict psychological well-being among older adults. Differences in perceived care and health outcomes were also observed based on gender, education level, and living environment. These results underscore the importance of promoting person-centred care practices, particularly in retirement home settings, to enhance psychological well-being in older adult populations. Full article

China’s population is aging rapidly, with a large proportion of elderly individuals “aging in place”. In central areas of large cities, the amount of community and home-based elderly care services provided by the government and for-profit organizations are insufficient to meet the demands of these “aging in place” elderly. Taking the core area of Beijing as the spatial scope, this empirical study collects the demand on services of the main types of elderly residents in community and home-based dwelling through questionnaires (n = 242) and employs a mixed-methods approach for analysis. Descriptive statistics and exploratory factor analysis are used to determine the categories and levels of those demands, and machine learning methods (random forest regression model) are used to calculate the importance of various influencing factors (features of the elderly and subdistricts’ built environment) on them. It is shown that elderly residents have a higher demand for psychological and physical condition maintenance services (mean = 3.40), and a lower demand for reconciliation and rights defense services (mean = 3.08). The results also show that the built environment factors are very important for the elderly on choosing demands, especially mean distance of CECSs (community elderly care stations) to downtown landmarks and main roads in subdistricts, and characteristics of CECS. The elderly’s own features also have a relatively important impact, especially their living arrangements, caregivers, and occupations before retirement. This study applies machine learning techniques to sociological survey analysis, helping to understand the intensity of elderly people’s demand for various community and home-based elderly care services. It provides a reference for the allocation of such service resources. Full article

The need for psychological treatment in the community, specifically in times of crisis and for those in isolation, calls for finding suitable interventions, especially for older adults. The present study examined the effect of a short mindfulness-based intervention emphasizing a ’decentering’ component and an equivalent guided-imagery intervention on cognitive and emotional measures in seniors living in the community. Thirty community seniors (M_age = 74.7) performed either ’decentering’ or matched guided-imagery intervention, or care as usual as a control. The 8-week interventions included weekly 20 min sessions and daily 10 min home practice. Participants underwent a cognitive and emotional assessment before and after the interventions, which included filling out questionnaires and performing the cognitive Simon task. The results showed improvements only for intervention groups: cognitively, reduced response time and improved accuracy rate were found in the Simon task. Emotionally, reported depression levels were decreased and an increase in reported positive relationships was found. Our study, hence, introduces two intervention protocols, with promising positive effects on psychological and cognitive status. This contributes evidence-based treatments, easy to deliver in nursing homes or retirement communities, for improving the life quality of older adults. Full article

Background: Alzheimer’s disease (AD) is a chronic neurodegenerative disease, ranking as the seventh leading cause of death in both sexes. There is increasing awareness of the role of chronic periodontal disease and severe tooth loss as a modifiable risk factor for developing AD. The aim of the present observational study was to assess AD patients with non-affected healthy controls in the context of their dental and periodontal health outcomes; additionally, the potential impact of anamnestic factors and lifestyle habits on oral health outcomes was also studied. Methods: A total of n = 41 AD patients receiving treatment at the Department of Psychiatry, University of Szeged, were compared with n = 41 age- and gender-matched controls from individuals seeking dental treatment and from retirement homes (mean age was 83.32 ± 7.82 years). Dental and periodontal status indices were assessed according to World Health Organization (WHO) criteria. Results: Overall, 51.2%, 68.3%, and 87.8% of AD patients received mood stabilizers, drugs for their non-cognitive symptoms and cognitive symptoms, respectively. Severe tooth loss was observed in 43.9% of AD patients and 56.1% of controls, respectively. There were no significant differences among AD patients and controls regarding the dental status indices studied (p > 0.05 for all indicators). AD patients had significantly higher plaque indices (%) (59.06 ± 15.45 vs. 41.35 ± 7.97; p < 0.001), bleeding on probing (BOP%) (62.65 ± 12.00 vs. 40.12 ± 10.86; p < 0.001), pocket depth [PD] (2.63 ± 0.56 vs. 2.29 ± 0.13; p = 0.002) and attachment loss [AL] (2.85 ± 0.79 vs. 2.39 ± 0.41; p = 0.026) values, compared to controls. Smoking (vs. non-smokers; 56.28 ± 12.36 vs. 51.40 ± 13.23, p = 0.038) and consumption of alcohol (vs. non-drinkers; 58.68 ± 9.86 vs. 54.78 ± 14.86, p = 0.040) were associated with higher plaque indices [%], while no similar effects were shown for dental status parameters (p > 0.05). In contrast, coffee intake and vitamin supplement use had no significant effect on dental or periodontal status parameters (p > 0.05 in all cases). Conclusions: The results of our study underscore the substantial treatment needs of AD patients, calling for heightened awareness among dental healthcare professionals. Full article

Background/Objectives: The global nursing shortage encompasses issues such as the uneven nurse distribution in low- and middle-income countries, nurse outflow to other countries, and nurse retirement in developed countries, necessitating effective retention strategies. Our objective was to clarify the changes in facility selection reasons among Japanese nurses after changing jobs and the personal attributes influencing facility selection. Methods: In January 2023, an online survey was conducted among licensed practical nurses, registered nurses, midwives, and public health nurses in Japan. The survey items included personal attributes (age and sex), information on ≤five employment facilities, and facility selection reasons. The variations in facility selection reasons by facility number were analyzed using a generalized linear model with a binomial distribution. A logistic regression analysis was conducted with personal attributes and reasons for workplace selection as the independent and dependent variables, respectively. Results: In total, 721 participants were included; 90.8% selected hospitals as their first place of employment. As nurses changed jobs, they increasingly selected non-hospital facilities, including nursing homes, nursery schools, and government agencies. With multiple job changes, the facility selection reasons included “good location for commuting”, “good salary”, and “convenient working style”. Among personal attributes, “age”, “sex”, “age at employment at the facility”, “educational background”, “number of children”, and “living alone” influenced workplace choice reasons. Conclusions: Considering the study results, country-specific demographic trends, medical policy changes, and nursing-shortage-related causes, medical facility managers and policymakers should devise appropriate employment conditions and develop recruitment strategies, especially for situations with severe nursing shortages. Nurses can learn from the career choices of others to manage their own careers. Full article

This paper introduces an innovative sell-type home reversion product aimed at monetizing Singapore’s public flats, serving as a new alternative to the existing Singapore Lease Buyback Scheme (LBS). This new product not only retains the LBS’s guaranteed period of residence in the property along with life annuity incomes but also enhances the product features to meet specific homeowner needs, including the ability to age in place, flexibility in retaining part of the property, options for bequests, and guaranteed principal return. By incorporating these additional features, the new product seeks to stimulate greater demand for monetizing public flats among asset-rich but cash-poor homeowners. An actuarial pricing model is developed to establish a transparent and fair framework for justifying the cost of each product feature. Additionally, we present a cost–benefit analysis from both the provider and consumer perspectives to highlight the major contributions of the new product when compared to the LBS. Full article

Background: Chronic disease significantly influences mental health, identity, and self-esteem. It is deeply interconnected with loneliness, frailty, stress, mental health, and the ageing process, forming a complex and interrelated dynamic. The aim was to find an association between loneliness, frailty, mental health, and the patient’s self-management. Methods: A cross-sectional study was conducted between October 2023 and May 2024. A total of 605 patients with chronic disease took part in the research, of whom 67% were female and 33% were male. In total, 71% of participating patients lived in a home environment, and 19% lived in retirement homes. Results: 605 respondents with chronic disease participated in the study and were recruited using a purposive sampling method. Participants were drawn from healthcare settings, including primary care centres, outpatient clinics, and nursing homes, to increase representativeness. The study achieved a response rate of 55% after distributing 1100 questionnaires. Data were analysed with SPSS Statistics 25.0 using descriptive and inferential statistical methods, including non-parametric tests (Kruskal–Wallis test, Mann–Whitney U test) and Spearman’s correlation. The main results showed that patients who self-rated their chronic disease as well- or very well-managed (81%) were less frail (p < 0.001), less lonely (p < 0.001), and had better mental health (p = 0.015). Significant associations were found between frailty, loneliness (r_s = 0.428, p < 0.001), and lower mental health (r_s = 0.185, p < 0.001). In addition, frequent social contact was associated with lower frailty and loneliness (p < 0.001). Conclusions: Without adequate assessment and support from the healthcare system, patients may face challenges in meeting their needs, which can contribute to loneliness, frailty, and mental health decline. It is crucial to acknowledge that every individual with a chronic disease, regardless of age, education level, or condition, must actively participate in managing their chronic disease. Recognising the importance of self-management and its impact on mental health is essential to mitigating the negative effects of chronic disease on a patient’s quality of life. Full article

Around three million pensioners receive the Indonesian civil service pension benefit. This benefit is the main source of income for the majority of civil service pensioners. This paper examines the adequacy of this pension benefit from the perspective of pensioners in Kapuas Regency. Through qualitative research, fifteen semi-structured interviews were conducted to investigate the role of pension benefits in maintaining the interviewees’ lifestyles and standards of living. All the interviewees perceived that the pension benefit could cover their basic needs, but for most of them, it only covered 25% of their total expenditures. Despite this, the replacement rate of the take-home pay from the pension benefit is still acceptable based on the ILO standard. While some can adjust to life with basic needs, others choose to find another source of income after retirement. Therefore, although the amount is still higher than the poverty line and the minimum wage, the findings suggest the retirement rate is considered meager. Full article

Background/Objectives: Inadequate fluid intake is prevalent among older adults living in care settings and can lead to dehydration-related events such as falls and hospitalization. Staff knowledge and confidence using diverse strategies is needed to provide adequate hydration to residents. PROMOTE is a multicomponent intervention designed to support staff to increase resident fluid intake between meals. This study evaluated the educational components of PROMOTE. Methods: Participants (n = 87) working in long-term care or retirement homes completed an online pre-/post-test evaluation of a 7 min educational video. Key informant participants (n = 13) reviewed all educational materials, evaluated their usefulness and feasibility, and were interviewed to identify how to improve the materials. Results: The educational video improved knowledge (e.g., self-rating of knowledge pre-test median 8, standard error of the mean (SEM) 0.18; post-test median 9, SEM 0.13) and confidence. Participants intended to use PROMOTE strategies in their work with residents (1 [very likely] to 10 [very unlikely] median 2.0 SEM 0.27). Key informants rated the hydration of residents as an organizational priority (median 9.0 SEM 0.42) and all indicated that they would use the educational video in their future training. Less feasible educational components as rated by key informants included huddle discussions and email pushes. Posters were seen as feasible (54%) but only somewhat useful (77%). Conclusions: Brief educational videos can improve staff knowledge and confidence regarding providing adequate hydration to residents. Having several educational components that can be used with this video was viewed positively. Recommendations were made to improve the materials. Full article

Chimp Haven is a private, nonprofit organization that serves as the largest chimpanzee sanctuary in the world. The National Institutes of Health supports the federal sanctuary system, which is operated by Chimp Haven, to provide lifetime care for chimpanzees who have retired from biomedical research. Chimp Haven is home to over 300 chimpanzees, with a wide variety of individual health needs including infectious diseases. The chimpanzees live in large, mixed-sex social groups within corrals, multi-dimensional enclosures, and naturally forested habitats, which presents challenges for monitoring and balancing individual versus group needs. Primate veterinarians and animal behavior directors have an obligation to collaborate for the best possible health and welfare outcomes for the species in their care. This manuscript details how veterinarians and behavioral staff at Chimp Haven interface to enhance clinical management and improve chimpanzee welfare using two clinical cases to illustrate this relationship. This is accomplished through the development of individual care plans that include the utilization of welfare assessment metrics and positive reinforcement training programs collaboratively developed between the veterinarians and behaviorists to facilitate voluntary medical procedures without the need for social isolation. Specifically, welfare metrics such as monitoring chimpanzee wounding levels and severity, as well as targeted assessments, involve the input of both the veterinarians and behaviorists. Positive reinforcement training initiatives such as weight loss, heart health, and wound care also require the interface between the two disciplines. The authors aim to demonstrate that working together provides optimal levels of expert care for both the physical and mental health of the chimpanzees in our care. Full article

This study investigates the spatial patterns of residential migration among older adults in the city center of Yancheng and the influencing factors using data on the home purchases of individuals aged 65 and older from 2016 to 2018, along with peripheral point of interest (POI) data, analyzed with ArcGIS and a decision tree model. The results indicated that persons aged 60–65 accounted for 42.8% of the total sample and primarily chose to migrate in the early stages of retirement. The intra-city migration of older adults exhibits both centripetal and centrifugal patterns, with a greater tendency toward the city center. House prices, floor levels, and commercial facilities significantly impact their choice of migration destinations. Among these, house prices were the most critical determinant, with the majority of older adults migrating to neighborhoods with lower house prices. This study contributes by integrating residential migration and location choice research and constructing an analytical framework based on facility accessibility. The findings provide insights into the key determinants of location choice for intra-city residential migration among older adults and the construction of livable neighborhoods for them. Full article

Southern European countries have shown indicators of accelerated aging. In Portugal, a particularly worrying aspect of this reality lies in the relationship between the aging process and the incidence of violence in older adults, as the degree of dependence and/or health status becomes a significant risk factor for the occurrence of violence. The objectives of the present study were (1) to assess the risk of violence and indicators of neglect in Portuguese older adults; (2) to examine the differences in neglect indicators according to sociodemographic characteristics and health habits. The final sample consisted of 1012 Portuguese older adults aged 65 or over. Participants were asked about sociodemographic characteristics and health habits. The risk of violence was measured using the Vulnerability to Abuse Screening Scale, and the neglect subscale of the Elder Abuse: A Multinational Prevalence Survey was used to evaluate indicators of exposure to neglect in the past year. The results show that approximately 27% of the population presents values of risk to violence. One-tenth of participants were exposed to low levels of neglect indicators and slightly fewer people (5%) were exposed to higher levels of neglect indicators. There are significant differences regarding exposure to neglect according to the age groups, gender, and marital status, depending on the living situation, years of retirement, practice of physical exercise, existence of chronic disease, alcohol consumption, and frequency of leaving home. Full article

This archival study explores the life and work of Dr. Carrie Weaver Smith (1885–1942), a Progressive Era social worker and prison warden. Specifically, I explore the first phase of her career as a House Physician at the Virginia K. Johnson Home in Dallas, Texas (1911–1915) and as the first Superintendent of the Texas State Training School for Girls in Gainesville, Texas (1916–1925). Using archival research, I detail three conflicts that defined Dr. Smith’s superintendency: her fight to reclassify a youth prison as a school, her challenges to a Ku Klux Klan-dominated legislature, and her refusal to cede authority to a State Board of Control. Together, these conflicts led the Board to terminate Dr. Smith’s position, an outcome that would replay twice more before she retired from prisonwork. I argue that when most reformers made significant concessions, compromising their visions to maintain state funding and political allyship, Dr. Smith stood out for her record of refusal. And yet, like other reformers, she left Texas with the capacity to imprison more women and girls than ever before. Full article