Background: In at-risk older adults, gait speed is an important factor associated with quality of life and falling risk. In this study, we assessed whether therapeutic exercise could improve gait speed. Methods: We conducted a meta-analysis to evaluate the 'best' therapeutic exercise method by analyzing each exercise in terms of intensity, type, and several gait speed indices. For the analysis, we gathered 122 papers through a database search and selected 9 (n=627) that were appropriate for the meta-analysis. Results: In 8 of the 9 included papers, gait speed improved with therapeutic exercise. Usual gait speed (n=246) improved more than maximal gait speed (n=574). A resistance program was more effective than a nonresistance program for improving maximal, but not usual, gait speed. We also found that the effects of therapeutic exercise were greater in noncommunity than in community-dwelling elderly people. Conclusion: In conclusion, therapeutic exercise was effective in improving gait speed.
Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.
The present study aimed at evaluating serum immunoglobulin G (IgG) avidity to Porphyromonas gingivalis in elderly patients with mild and severe chronic periodontitis. The avidity of antibodies against P. gingivalis present in the sera of 18 patients with mild chronic periodontitis and 18 patients with severe chronic periodontitis was evaluated using an ammonium thiocyanate-dissociated enzyme-linked immunosorbent assay (ELISA). The results showed that the mean absorbance value in serum IgG antibody titers was significantly higher in the severe chronic periodontitis group than in the mild chronic periodontitis group ($198{\pm}35ELISA$ unit [EU] vs. $142{\pm}32EU$, p < 0.01). However, there was no significant difference between the two groups in antibody avidity ($65{\pm}57EU$ vs. $54{\pm}27EU$). These findings suggest that humoral immune responses to P. gingivalis between mild and severe chronic periodontitis in elderly patients are characterized by the differences in the quantity rather than the quality of the antibodies.
Silay, Kamile;Akinci, Sema;Silay, Yavuz Selim;Guney, Tekin;Ulas, Arife;Akinci, Muhammed Bulent;Ozturk, Esin;Canbaz, Merve;Yalcin, Bulent;Dilek, Imdat
Asian Pacific Journal of Cancer Prevention
/
제16권2호
/
pp.783-786
/
2015
Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.
Background: In order to design effective educational intervention for cancer survivors, it is necessary to identify most-trusted sources for health-related information and the amount of attention paid to each source. Objective: The objective of our study was to explore the sources of health information used by cancer survivors according to their access to the internet and levels of trust in and attention to those information sources. Materials and Methods: We analyzed sources of health information among cancer survivors using selected questions adapted from the 2012 Health Information National Trends Survey (HINTS). Results: Of 357 participants, 239 (67%) had internet access (online survivors) while 118 (33%) did not (offline survivors). Online survivors were younger (p<0.001), more educated (p<0.001), more non-Hispanic whites (p<0.001), had higher income (p<0.001), had more populated households (p<0.001) and better quality of life (p<0.001) compared to offline survivors. Prevalence of some disabilities was higher among offline survivors including serious difficulties with walking or climbing stairs (p<0.001), being blind or having severe visual impairment (p=0.001), problems with making decisions (p<0.001), doing errands alone (p=0.001) and dressing or bathing (p=0.001). After adjusting for socio-demographic status, cancer survivors who were non-Hispanic whites (OR= 3.49, p<0.01), younger (OR=4.10, p<0.01), more educated (OR= 2.29, p=0.02), with greater income (OR=4.43, p<0.01), and with very good to excellent quality of life (OR=2.60, p=0.01) had higher probability of having access to the internet, while those living in Midwest were less likely to have access (OR= 0.177, p<0.01). Doctors (95.5%) were the most and radio (27.8%) was the least trusted health related information source among all cancer survivors. Online survivors trusted internet much more compared to those without access (p<0.001) while offline cancer survivors trusted health-related information from religious groups and radio more than those with internet access (p<0.001 and p=0.008). Cancer survivors paid the most attention to health information on newsletters (63.8%) and internet (60.2%) and the least to radio (19.6%). More online survivors paid attention to internet than those without access (68.5% vs 39.1%, p<0.001) while more offline survivors paid attention to radio compared to those with access (26.8% vs 16.5%, p=0.03). Conclusions: Our findings emphasize the importance of improving the access and empowering the different sources of information. Considering that the internet and web technologies are continuing to develop, more attention should be paid to improve access to the internet, provide guidance and maintain the quality of accredited health information websites. Those without internet access should continue to receive health-related information via their most trusted sources.
Purpose: Recently, the population of elderly people has been increasing rapidly all over the world. The social activities of the aging population have increased, which has also increased the number of elderly patients injured in traffic accidents. Thus, we analyzed the characteristics of elderly patients involved in traffic accidents. Methods: This study was conducted retrospectively from July 2008 to March 2009 among trauma patients involved in traffic accidents who visited Wonju Severance Christian Hospital. Patients under 18 years of age and pregnant patients were excluded. We divided the patients in two groups, a geriatrics group and an adult group on the basis of an age of 65. We compared the types of traffic accidents, the locations of the accidents, the behaviors of the patients at the times of the accidents, the use of seat-belts, and alcohol consumption between the two groups. We calculated the Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) for each group. Results: Total number of the included patients was 903, and the number of elderly patients was 181 (mean age: $71.7{\pm}4.9$ years old). There were no significant differences in the initial vital signs, GCS (Glasgow Coma Scale), and RTS between the two groups. There were differences in the types and the locations of the crashes, the behaviors of the patients at the times of the accidents, the use of seat belts, and alcohol consumption between the two groups (p<0.05). The average ISS of the geriatric group was higher than that of the adult group ($9.66{\pm}10.11$ vs. $6.59{\pm}8.99$, p=0.004). The mortality was higher in the geriatric group (n=17,9%) than in the adult group (n=23,2%) (p=0.004). Conclusion: The numbers of mortalities and surgical procedures were greater within the elderly group than the adult group. The average ISS was higher in the geriatric group than in the adult group. The severity of injuries due to traffic accidents was higher in the geriatric group than it was in the adult group.
Purpose: The purpose of this study was to survey the present status of the gerontological nursing course in Baccalaureate degree programs(BSN) in Korea, so as to provide basic data for developing a standard model for a gerontological nursing curriculum. Method: Data on the contents of a gerontological nursing curriculum was collected from those programs that had a gerontological nursing course. Result: The results show that 48 schools(87.3%) offered a gerontological nursing course. Twenty-five schools(45.5%) had both lectures and clinical practicum, while 23 schools(41.8%) had only lectures. Twenty-seven schools(56%) offered a gerontological nursing course as an elective. Students earned the most number of credits in their senior year. The most common credit system for lecture subjects was 2 credits with 38 schools(79.2%) and a clinical practicum was 1 credit with 20 schools(80%). The issues identified were that gerontological nursing was an elective and not a mandatory course, a lack of clinical lab hours, and a lack of common learning objectives. Conclusion: Recommendations are made for better defined curricula in gerontological nursing. In addition, further investigations of the learners or students entering gerontological nursing to facilitate curriculum development and appropriate instructional strategies are needed.
This research was conducted to define the different conventional meanings of face painting, we can come across easily in recent days, in different times and different cultures. The conclusions of the research are as followed. First, the face painting was mainly done for the symbolic function. Second, in un-cultivated groups, face painting was one way of body art expression and in some cases, the color and the pattern was the tool to give a symbolic massage that was more powerful than a language. The characteristics of the patterning was that they adopted wide range of patterns include geriatrics, abstract, animals, plants and especially the abstract patterns have the groups unique symbolic meanings such as specific pattern appears guard god which was the effort of having a wholeness with the pattern. Third, it is known that in un-cultivated cultures, face painting has a symbolic function whereas in modern society, there is an emphasis on a decorative function. Lastly, the various expressions of modern body decorations are seen as a result of social/cultural states of the settlement ethnic culture and the modern life style of the people who want to have direct and active opinions and individualize and differentiate themselves.
This study, an examination of the plan for effective resource management for national university hospitals, was performed to determine the relationship between the effectiveness of patient output by considering input personnel using the DEA model and Management Performance, in which 4 years of data from 12 national university hospitals were analyzed. Among the components of the effectiveness, utilizing properly imput components from the application of VRS(Variable Returns to Scale), the Management Performance of national university hospitals was found to be affirmatively influenced by PTE(Pure Technical Efficiency). Regarding the Management Performance of national university hospitals in their attempts to establish a plan for effective human resource management, the management of patient numbers on the basis of calculation level with input is more recommendable than the controlling of personnel input using patient numbers. Thus, the establishment of a strategy plan for the proper allocation of administrative staff and sickbeds, considering the variation of patient numbers, is suggested.
Purpose : This study was to investigate vascular dementia elders's activities of daily living, quality of life index and to determine how much vascular dementia elders is influenced by the 12 weeks combined exercise program with aerobic training and resistance exercise. Methods : Thirty patients with vascular dementia over 65 in B geriatrics hospital were recruited this study. Activities of daily living were measured by I-ADL(instrumental-activities of daily living) and B-ADL(basic-Activities of daily living) and quality of life index was measured by GQOL-D(geriatric quality of life scaledementia). Statistical analysis was used repeated one-way ANOVA to test mean difference by using SPSS 12.0 for windows. Results : After comparing the activities of daily living of experimental group that of control group according to the period of exercise, there were statistically significant differences in I-ADL, B-ADL score test and GQOL-D index test of both experimental and control groups. There was also a significant difference in comparing the results of 12 weeks exercise of the groups. Conclusion : 12 weeks combined exercise program had a good influence on vascular dementia elders's activities of daily living and quality of life index.
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