gerontology

老年学
  • 文章类型: Journal Article
    由于全球人口老龄化及其对卫生系统的影响,老年学和公共卫生的交叉越来越重要。这项范围审查旨在绘制公共卫生中关于老年学的现有文献,确定当前的观点,并评估适合老年人需求的干预措施。在多个数据库中使用预定义的关键字进行了系统的搜索,包括PubMed,谷歌学者,Scopus,和WebofScience。审查包括42项采用各种设计的研究,所有这些都侧重于针对老龄人口的公共卫生干预措施。主要研究结果表明,迫切需要将老年学原则纳入公共卫生实践,认识到老年人的异质性和健康的社会决定因素的重要性。干预措施包括预防性健康措施和慢性病管理计划,健康促进活动和护理人员支持,包括应用技术来改善健康结果。然而,明显缺乏对不同人群和心理健康干预措施的研究.这篇评论还发现了文献中的关键差距,如获得护理的经济障碍和应对老龄化人口多样化需求的全面政策的必要性。总之,这篇综述强调了多维度方法对有效满足老年人健康需求的重要性.虽然存在一些有效的干预措施,迫切需要解决已确定的差距,特别是关于不同的人群和心理健康,加强老龄化人口的整体健康战略。
    The intersection of gerontology and public health is increasingly vital due to the global aging population and its implications for health systems. This scoping review aims to map existing literature on gerontology within public health, identify current perspectives, and evaluate interventions tailored to the needs of older adults. A systematic search was performed using predefined keywords across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science. The review included 42 studies that employed various designs, all focusing on public health interventions targeting the aging population.  Key findings indicate a pressing need to integrate gerontological principles into public health practice, recognizing the heterogeneous nature of older adults and the significance of social determinants of health. Interventions ranged from preventive health measures and chronic disease management programs to health promotion activities and caregiver support, including the application of technology to improve health outcomes. However, there was a notable lack of research on diverse populations and mental health interventions. The review also uncovered critical gaps in the literature, such as economic barriers to care access and the necessity for comprehensive policies addressing the aging population\'s diverse needs. In conclusion, this review emphasizes the importance of a multidimensional approach to effectively addressing older adults\' health needs. While several effective interventions exist, there is an urgent need to tackle identified gaps, particularly concerning diverse populations and mental health, to enhance overall health strategies for the aging demographic.
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  • 文章类型: Journal Article
    背景:多领域干预对促进健康衰老具有明显的益处,但维持长期收益的自我授权战略仍然遥不可及。
    目的:本研究评估了参与数字体感舞蹈游戏对作为主要结果的大脑意象变化和作为与健康衰老相关的次要结果的其他身体和心理健康指标的影响。
    方法:在2020年8月31日至2021年6月27日之间,这项随机对照试验招募了60名55岁以上且最近没有参与数字舞蹈游戏的合格参与者。使用计算机生成的随机化序列以1:1分配参与者,不进行分层,接受数字体感舞蹈游戏训练的干预组(n=30)或对照组(n=30)。匿名代码掩盖了调查人员的干预分配,分配干预措施的个体不参与分析研究数据.干预需要在6个月内每周进行两次30分钟的舞蹈游戏,对照组接受健康老龄化教育。主要结果是大脑意象变化。在基线和6个月随访时测量所有变量,使用t检验和意向治疗分析估计干预效果。
    结果:与对照组相比,干预参与者在左壳核的灰质体积(GMV)中具有显着差异的大脑图像(估计值0.016,95%CI0.008至0.024;P<.001),左苍白球的GMV(估计值0.02,95%CI0.006至0.034;P=.004),和左苍白球低频波动的小振幅(估计0.262,95%CI0.084至0.439;P=.004)。此外,干预组小脑VIGMV图像不同(估计值0.011,95%CI0.003~0.02;P=.01).干预组的蒙特利尔认知评估总分也有所改善(估计1.2,95%CI0.27至-2.13;P<0.01),生活质量(估计7.08,95%CI2.35至11.82;P=.004),和工作日坐着的时间(估计-1.96,95%CI-3.33至-0.60;P=0.005)。此外,舞蹈表现与认知表现显著相关(P=0.003),健康状况(P=0.14),弹性(P=0.007),和士气低落(P<.001)。
    结论:参与6个月的数字体感舞蹈游戏与涉及体感的多个区域的大脑意象变化有关,电机,视觉,和注意功能,这与健康衰老相关的表型改善是一致的。
    背景:ClinicalTrials.govNCT05411042;https://clinicaltrials.gov/study/NCT05411042。
    BACKGROUND: Multidomain interventions have demonstrable benefits for promoting healthy aging, but self-empowerment strategies to sustain long-term gains remain elusive.
    OBJECTIVE: This study evaluated the effects of digital somatosensory dance game participation on brain imagery changes as primary outcomes and other physical and mental health measures as secondary outcomes related to healthy aging.
    METHODS: Between August 31, 2020, and June 27, 2021, this randomized controlled trial recruited 60 eligible participants older than 55 years with no recent engagement in digital dance games. A computer-generated randomization sequence was used to allocate participants 1:1, without stratification, to an intervention group (n=30) who underwent digital somatosensory dance game training or a control group (n=30). An anonymized code masked the intervention allocations from the investigators, and individuals who assigned the interventions were not involved in analyzing the study data. The intervention entailed two 30-minute dance game sessions per week for 6 months, and the control group received healthy aging education. Primary outcomes were brain imagery changes. All variables were measured at baseline and the 6-month follow-up, and intervention effects were estimated using t tests with intention-to-treat analyses.
    RESULTS: Compared with the control group, intervention participants had significantly different brain imagery in the gray matter volume (GMV) of the left putamen (estimate 0.016, 95% CI 0.008 to 0.024; P<.001), GMV of the left pallidum (estimate 0.02, 95% CI 0.006 to 0.034; P=.004), and fractional amplitude of low frequency fluctuations of the left pallidum (estimate 0.262, 95% CI 0.084 to 0.439; P=.004). Additionally, the intervention group had different imagery in the cerebellum VI GMV (estimate 0.011, 95% CI 0.003 to 0.02; P=.01). The intervention group also had improved total Montreal Cognitive Assessment scores (estimate 1.2, 95% CI 0.27 to -2.13; P<.01), quality of life (estimate 7.08, 95% CI 2.35 to 11.82; P=.004), and time spent sitting on weekdays (estimate -1.96, 95% CI -3.33 to -0.60; P=.005). Furthermore, dance performance was significantly associated with cognitive performance (P=.003), health status (P=.14), resilience (P=.007), and demoralization (P<.001).
    CONCLUSIONS: Digital somatosensory dance game participation for 6 months was associated with brain imagery changes in multiple regions involving somatosensory, motor, visual, and attention functions, which were consistent with phenotypic improvements associated with healthy aging.
    BACKGROUND: ClinicalTrials.gov NCT05411042; https://clinicaltrials.gov/study/NCT05411042.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:老年人吃腐烂的水果和食物中毒的风险更大,因为他们的认知功能随着年龄的增长而下降,很难区分腐烂的水果。为了解决这个问题,研究人员开发并评估了各种工具,以各种方式检测腐烂的食物。然而,很少有人知道如何创建一个应用程序来检测腐烂的食物,以支持老年人吃腐烂的食物有健康问题的风险。
    目的:这项研究旨在(1)创建一个智能手机应用程序,使老年人能够用相机拍摄食物,并将水果分类为腐烂或不腐烂的老年人和(2)评估应用程序的可用性和老年人对应用程序的看法。
    方法:我们开发了一个智能手机应用程序,该应用程序支持老年人确定本研究选择的3种水果(苹果,香蕉,和橙色)足够新鲜吃。我们使用了几个剩余深度网络来检查收集到的水果照片是否为新鲜水果。我们招募了65岁以上的健康老年人(n=15,57.7%,男性,n=11,42.3%,女性)作为参与者。我们通过调查和访谈评估了应用程序的可用性和参与者对应用程序的看法。我们分析了调查结果,包括事后调查问卷,作为应用程序可用性的评价指标,并从受访者那里收集定性数据,对调查答复进行深入分析。
    结果:参与者对使用应用程序通过拍摄水果照片来确定水果是否新鲜感到满意,但不愿意使用付费版本的应用程序。调查结果显示,参与者倾向于有效地使用该应用程序拍摄水果并确定其新鲜度。对应用程序可用性和参与者对应用程序的看法的定性数据分析表明,他们发现应用程序简单易用,他们拍照没有困难,他们发现应用程序界面在视觉上令人满意。
    结论:这项研究表明开发一款支持老年人有效和高效地识别腐烂食品的应用程序的可能性。未来的工作,使应用程序区分各种食品的新鲜度,而不是选择的3个水果仍然存在。
    BACKGROUND: Older adults are at greater risk of eating rotten fruits and of getting food poisoning because cognitive function declines as they age, making it difficult to distinguish rotten fruits. To address this problem, researchers have developed and evaluated various tools to detect rotten food items in various ways. Nevertheless, little is known about how to create an app to detect rotten food items to support older adults at a risk of health problems from eating rotten food items.
    OBJECTIVE: This study aimed to (1) create a smartphone app that enables older adults to take a picture of food items with a camera and classifies the fruit as rotten or not rotten for older adults and (2) evaluate the usability of the app and the perceptions of older adults about the app.
    METHODS: We developed a smartphone app that supports older adults in determining whether the 3 fruits selected for this study (apple, banana, and orange) were fresh enough to eat. We used several residual deep networks to check whether the fruit photos collected were of fresh fruit. We recruited healthy older adults aged over 65 years (n=15, 57.7%, males and n=11, 42.3%, females) as participants. We evaluated the usability of the app and the participants\' perceptions about the app through surveys and interviews. We analyzed the survey responses, including an after-scenario questionnaire, as evaluation indicators of the usability of the app and collected qualitative data from the interviewees for in-depth analysis of the survey responses.
    RESULTS: The participants were satisfied with using an app to determine whether a fruit is fresh by taking a picture of the fruit but are reluctant to use the paid version of the app. The survey results revealed that the participants tended to use the app efficiently to take pictures of fruits and determine their freshness. The qualitative data analysis on app usability and participants\' perceptions about the app revealed that they found the app simple and easy to use, they had no difficulty taking pictures, and they found the app interface visually satisfactory.
    CONCLUSIONS: This study suggests the possibility of developing an app that supports older adults in identifying rotten food items effectively and efficiently. Future work to make the app distinguish the freshness of various food items other than the 3 fruits selected still remains.
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  • 文章类型: Journal Article
    在过去的十年中,虚拟病房的采用激增。虚拟病房旨在防止不必要的入院,加快家庭出院,提高患者满意度,这对面临住院相关风险的老年人口特别有利。因此,虚拟康复病房(VRW)正在进行大量投资,尽管有证据表明它们的实施取得了不同程度的成功。然而,虚拟病房工作人员为快速实施这些创新护理模式所经历的促进者和障碍仍然知之甚少。
    本文介绍了在澳大利亚VRW上工作的医院工作人员的见解,以应对对旨在防止住院的计划日益增长的需求。我们探讨了员工对VRW的促进者和障碍的看法,在服务设置和交付上发光。
    使用非收养对21名VRW员工进行了定性访谈,放弃,放大,传播,可持续发展(NASSS)框架。使用框架分析和NASSS框架的7个领域进行数据分析。
    结果被映射到NASSS框架的7个领域。(1)条件:管理一定的条件,特别是那些涉及合并症和社会文化因素的,可以是具有挑战性的。(2)技术:VRW证明适合无认知障碍的技术患者,通过远程监控和视频通话在临床决策中提供优势。然而,互操作性问题和设备故障导致员工沮丧,强调迅速应对技术挑战的重要性。(3)价值主张:VRW授权患者选择他们的护理地点,扩大农村社区获得护理的机会,并为老年人提供家庭治疗。(4)采用者和(5)组织:尽管有这些好处,从面对面治疗到远程治疗的文化转变引入了工作流程的不确定性,专业责任,资源分配,和摄入过程。(6)更广泛的系统和(7)嵌入:随着服务的不断发展,以解决医院能力的差距,必须优先考虑正在进行的适应。这包括完善患者顺利转移回医院的过程,解决技术方面的问题,确保护理的无缝连续性,并深思熟虑地考虑护理负担如何转移到患者及其家人身上。
    在这项定性研究中,探索医护人员对创新VRW的体验,我们确定了实施和可接受性的几个驱动因素和挑战。这些发现对考虑在服务设置和交付方面为老年人实施VRW的未来服务具有影响。未来的工作将集中在评估VRW的患者和护理人员体验。
    UNASSIGNED: Over the past decade, the adoption of virtual wards has surged. Virtual wards aim to prevent unnecessary hospital admissions, expedite home discharge, and enhance patient satisfaction, which are particularly beneficial for the older adult population who faces risks associated with hospitalization. Consequently, substantial investments are being made in virtual rehabilitation wards (VRWs), despite evidence of varying levels of success in their implementation. However, the facilitators and barriers experienced by virtual ward staff for the rapid implementation of these innovative care models remain poorly understood.
    UNASSIGNED: This paper presents insights from hospital staff working on an Australian VRW in response to the growing demand for programs aimed at preventing hospital admissions. We explore staff\'s perspectives on the facilitators and barriers of the VRW, shedding light on service setup and delivery.
    UNASSIGNED: Qualitative interviews were conducted with 21 VRW staff using the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. The analysis of data was performed using framework analysis and the 7 domains of the NASSS framework.
    UNASSIGNED: The results were mapped onto the 7 domains of the NASSS framework. (1) Condition: Managing certain conditions, especially those involving comorbidities and sociocultural factors, can be challenging. (2) Technology: The VRW demonstrated suitability for technologically engaged patients without cognitive impairment, offering advantages in clinical decision-making through remote monitoring and video calls. However, interoperability issues and equipment malfunctions caused staff frustration, highlighting the importance of promptly addressing technical challenges. (3) Value proposition: The VRW empowered patients to choose their care location, extending access to care for rural communities and enabling home-based treatment for older adults. (4) Adopters and (5) organizations: Despite these benefits, the cultural shift from in-person to remote treatment introduced uncertainties in workflows, professional responsibilities, resource allocation, and intake processes. (6) Wider system and (7) embedding: As the service continues to develop to address gaps in hospital capacity, it is imperative to prioritize ongoing adaptation. This includes refining the process of smoothly transferring patients back to the hospital, addressing technical aspects, ensuring seamless continuity of care, and thoughtfully considering how the burden of care may shift to patients and their families.
    UNASSIGNED: In this qualitative study exploring health care staff\'s experience of an innovative VRW, we identified several drivers and challenges to implementation and acceptability. The findings have implications for future services considering implementing VRWs for older adults in terms of service setup and delivery. Future work will focus on assessing patient and carer experiences of the VRW.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:血液恶性肿瘤大部分是老年人的疾病。造血干细胞移植(HSCT)仍然是许多患者的唯一潜在治愈策略,但具有很大的发病率和死亡率风险。特别是在虚弱或共病的患者中。通过康复对关键目标进行移植前优化可能会产生重大的临床影响。
    方法:我们利用定性方法(半结构化访谈)来获得对医学观念的见解和理解,护理和专职卫生专业人员在造血细胞移植前进行康复治疗,以优化老年人的候选资格。主题分析是使用由两名研究人员重复完成的定性描述性方法进行的。
    结果:在2023年8月至10月之间,来自爱尔兰岛四个大型癌症中心的11名卫生专业人员参加了会议(n=3名血液学家顾问,n=7名血液学专科护士和n=1名高级血液学物理治疗师)。确定了四个主要主题。全面的生物心理社会护理和老年患者移植需求的增加突出了影响接受HSCT的老年人的独特挑战。护理主题的多模态途径强调了不同临床部位和疾病类型之间治疗途径的异质性。这对康复有影响:后勤和福利主题,这表明了对康复的大力支持,但强调实施必须考虑国家范围和背景。
    结论:在为考虑移植的患者制定康复计划方面存在广泛的国家多学科兴趣。我们的结果将为这一领域服务的发展提供信息,考虑到国家范围,恶性肿瘤特异性途径和与年龄相关的独特因素。
    OBJECTIVE: Haematologic malignancies for the most part are diseases of the elderly. Haematopoietic stem cell transplantation (HSCT) remains the only potentially curative strategy for many patients but carries substantial morbidity and mortality risks, particularly in frail or co-morbid patients. Pre-transplant optimisation of key targets through prehabilitation may have significant clinical impact.
    METHODS: We utilised qualitative methodology (semi-structured interviews) to gain insights and understanding of the perceptions of medical, nursing and allied health professionals towards prehabilitation before haematopoietic cell transplantation to optimise candidacy in older adults. Thematic analysis was performed using a qualitative descriptive approach completed in duplicate by two researchers.
    RESULTS: Between August and October 2023, eleven health professionals participated from four large cancer centres across the island of Ireland (n = 3 consultant haematologists, n = 7 specialist haematology nurses and n = 1 senior haematology physiotherapist). Four major themes were identified. The themes comprehensive biopsychosocial care and increasing demand for transplant in older patients highlight the unique challenges impacting older adults who receive HSCT. The multimodality pathways of care theme highlights the heterogeneity of treatment pathways across different clinical sites and disease types. This has implications for the prehabilitation: logistics and benefits theme, which indicated strong support for prehabilitation but emphasised that implementation must consider national reach and context.
    CONCLUSIONS: There is broad national multidisciplinary interest in the development of prehabilitation programmes for patients being considered for transplant. Our results will inform the development of services in this area in consideration of national reach, malignancy-specific pathways and the unique factors associated with older age.
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  • 文章类型: Journal Article
    背景:社会创新和老年学制定了旨在支持和改善长寿人群需求的广泛行动。高等教育机构(HEI)是变革的驱动力,以及他们通过教授学生社会创新技能来开发解决方案的潜力,应该在长寿领域予以考虑。本文报告了高级创新实验室(SIL)培训计划获得的结果。
    方法:基于挑战的学习,设计思维,在培训26名参与者时实施了精益创业方法,最终目标是为先前确定的长期人口需求开发创新解决方案。
    结果:最终产品是通过学生之间的合作开发的创新想法,学术人员,和企业员工,表明在学术教学中采用创业方法的重要性。参与者认为动机和毅力是最相关的创业技能,他们中的大多数人也认为他们拥有它。参与者还认为发现机会(增加价值的机会)是整个体验中最需要的技能。
    结论:SIL的评估表明,社会创新方法有助于学习策略的发展,为老龄化挑战提供潜在的解决方案。
    BACKGROUND: Social innovation and gerontology develop a wide range of actions aimed at supporting and improving the needs of long-lived populations. Higher education institutions (HEIs) are drivers of change, and their potential to develop solutions through teaching students\' social innovation skills should be considered in the field of longevity. This article reports the results obtained by the Senior Innovation Lab (SIL) training initiative.
    METHODS: Challenge-based learning, design thinking, and lean startup approaches were implemented in training 26 participants with the final aim of developing innovative solutions to previously identified long-lived population needs.
    RESULTS: Final products were innovative ideas developed through collaboration between students, academic staff, and business employees, indicating the importance of adopting entrepreneurial approaches in academic teaching. The participants identified motivation and perseverance as the most relevant entrepreneurial skills and most of them also perceived that they possessed it. The participants also considered spotting opportunities (chance to add value) as the most desired skill throughout the whole experience.
    CONCLUSIONS: SIL\'s assessment showed that social innovation methodologies contributed to the development of learning strategies, enabling potential solutions for the ageing challenges.
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  • 文章类型: Journal Article
    这项研究探讨了患有高血压和/或糖尿病的老年人的家庭护理人员在访问医院时为其亲属提供的护理的观点。使用定性研究方法进行研究,该研究使用家庭成员在加纳的一家教学医院为患有高血压和/或糖尿病的老年人提供非正式护理。共有20名参与者被故意取样,采访,数据采用反身性专题分析法进行分析。家庭照顾者主要认为,由于一些医护人员的消极态度,他们的年长亲属与医疗系统的互动不佳,诊所设施不足,设施缺乏老年护理服务。尽管如此,家庭照顾者也从陪同他们的亲属去医院中获得了一些好处。必须采用老年护理的实践和教育,以务实地满足加纳老年人的独特医疗保健需求,重点是老年病科和独立的研究计划,以准备专业的医疗保健专业人员为老年人提供全面的服务。为了彻底了解该国老年人护理问题,他们对这一主题的观点也应该在未来的研究中探索。
    This study explored the perspectives of family caregivers of older adults with hypertension and/or diabetes mellitus on the care provided to their kin when they visit the hospital. A qualitative research approach was used to conduct the study using family members providing informal care for older adults with hypertension and/or diabetes mellitus at a teaching hospital in Ghana. A total of 20 participants were purposively sampled, interviewed, and data was analyzed using reflexive thematic analysis. Family caregivers mainly had perceptions that their older adult kin had poor interactions with the healthcare system because of some healthcare workers\' negative attitudes, inadequate facilities at the clinics, and lack of geriatric care services at the facility. This notwithstanding, family caregivers also derived some benefits from accompanying their kin to the hospital. Practice and education in gerontological nursing must be employed to pragmatically meet the unique healthcare needs of older adults in Ghana with a focus on geriatrics units and standalone programs of study to prepare specialized healthcare professionals to provide comprehensive services to older adults. For a thorough understanding of issues of older adult care in the country, their perspectives on this subject should also be explored in future studies.
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  • 文章类型: Journal Article
    快速检测具有情感价值的中性面孔在年轻人和老年人的社会关系中起着重要作用。最近的心理学研究表明,年轻人对中性面孔和“与价值相关的面孔”的检测表现出有效的价值学习,“而老年人在价值学习和基于价值的中性面孔检测方面表现出略有不同的模式。然而,这些过程背后的机制仍然未知。为了调查这一点,我们将分层强化学习和扩散模型应用于涉及中性面孔的价值学习任务和价值驱动检测任务;这些任务由年轻人和老年人完成.学习任务的结果表明,学习反馈的敏感性可能会随着年龄的增长而降低。在检测任务中,年轻人比老年人更有效地积累信息,在年轻人中,导致运动发作的感知时间较短。仅在年轻人中,联想学习过程中的奖励敏感性可能会增强在奖励任务中对中性面孔的视觉搜索过程中信息的积累。这些结果提供了与有效检测与情绪值相关的面部相关的处理的洞察力,以及其中与年龄相关的变化。
    The rapid detection of neutral faces with emotional value plays an important role in social relationships for both young and older adults. Recent psychological studies have indicated that young adults show efficient value learning for neutral faces and the detection of \"value-associated faces,\" while older adults show slightly different patterns of value learning and value-based detection of neutral faces. However, the mechanisms underlying these processes remain unknown. To investigate this, we applied hierarchical reinforcement learning and diffusion models to a value learning task and value-driven detection task that involved neutral faces; the tasks were completed by young and older adults. The results for the learning task suggested that the sensitivity of learning feedback might decrease with age. In the detection task, the younger adults accumulated information more efficiently than the older adults, and the perceptual time leading to motion onset was shorter in the younger adults. In younger adults only, the reward sensitivity during associative learning might enhance the accumulation of information during a visual search for neutral faces in a rewarded task. These results provide insight into the processing linked to efficient detection of faces associated with emotional values, and the age-related changes therein.
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