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Aging is defined as all of the irreversible structural and functional changes that result in a gradual decrease in physical and mental capacity, an increased risk of disease, and ultimately death, due to the effect of the accumulation of a wide variety of molecular and cellular damage over time. It is known that the world population is on an increase line. With the aging of the population, health protection policies come to the fore. Genetic and environmental factors are effective in maintaining health and preventing premature aging in the aging process. From a public health point of view, it is aimed to prevent diseases before they occur as a primary prevention method. It is known that with the aging process, adequate and balanced nutrition is important for reducing the negative effects of aging. Anti-aging compounds are also needed to reduce the negative effects of the aging process and to prolong the healthy life span. One of the most important of these compounds is resveratrol. Resveratrol (3,5,4 trihydroxystilbene) is a non-flavonoit polyphenolic compound found in many sources in the human diet, such as grapes (Vitis vinifera), mulberry (Morus rubra), peanuts (Arachis hypogaea), strawberries (Rosaceae fragaria). Resveratrol has been used for decades in European and Asian countries to reduce cardiological risks, as an anticarcinogenic compound, and in the treatment of allergies and skin diseases. Due to its antiinflammatory, antioxidant, antitumor, autophagy-enhancing properties, anti-proliferative, and cardioprotective effects, resveratrol is also widely used to reduce the negative changes in physical, biological and lifestyle that occur as a result of aging. In addition, with the aging of the world population, the effects of dietary intake of phytochemicals and their use as nutritional supplements in order to protect and improve the health of the elderly need to be investigated further clinically. With this study, it is aimed to examine the miracle of resveratrol in order to delay or prevent the negativities that will occur with the aging process. [ABSTRACT FROM AUTHOR]

The study sought to identify the profile of users assisted at a Reference Center for Health Care for the Elderly in Belo Horizonte, Minas Gerais. This is a quantitative, cross-sectional, exploratory and descriptive study in which 6,895 consultations at Centro Mais Vida were investigated between January and December 2017. A representative random sample of 289 personalized care plans was analyzed. The results showed that most users were female (72%), with a mean age of 76.4 years and low education. The prevalence of functional impairment was 16% for activities of daily living and 61% for instrumental activities of daily living. Differences are observed between the measured clinical-functional vulnerability and the degree of priority in referral for followup in primary or secondary care. Most of the elderly assisted were forwarded for follow-up in Primary Care. Gaps remain in care for frail elderly people in the SUS-BH network. [ABSTRACT FROM AUTHOR]

The population is aging, with frailty emerging as a significant risk factor for poor outcomes for older people who become acutely ill. We describe the development and implementation of the Frail Older Persons' Collaborative Program, which aims to optimise the care of frail older adults across healthcare systems in Queensland. Priority areas were identified at a co-design workshop involving key stakeholders, including consumers, multidisciplinary clinicians, senior Queensland Health staff and representatives from community providers and residential aged care facilities. Locally developed, evidence-based interventions were selected by workshop participants for each priority area: a Residential Aged Care Facility acute care Support Service (RaSS); improved early identification and management of frail older persons presenting to hospital emergency departments (GEDI); optimisation of inpatient care (Eat Walk Engage); and enhancement of advance care planning. These interventions have been implemented across metropolitan and regional areas, and their impact is currently being evaluated through process measures and system-level outcomes. In this narrative paper, we conceptualise the healthcare organisation as a complex adaptive system to explain some of the difficulties in achieving change within a diverse and dynamic healthcare environment. The Frail Older Persons' Collaborative Program demonstrates that translating research into practice and effecting change can occur rapidly and at scale if clinician commitment, high-level leadership, and adequate resources are forthcoming. What is known about the topic? Providing frailty-focused care can improve outcomes, particularly by avoiding unnecessary admissions to hospital and reducing hospital-acquired complications, such as delirium and functional decline. Several evidence-based interventions exist that apply to specific points in the trajectory of older frail patients from hospital presentation to discharge and beyond, but these are not generally well integrated across the entire patient journey. What does this paper add? This paper describes a whole-of-healthcare system approach to improving care and outcomes for frail older people in Queensland. Rather than developing new care initiatives, the approach was taken to invest in pre-existing evidence-based interventions developed and validated in Queensland clinical settings and scale them across the state over 3 years. What are the implications for practitioners? This state-wide scale-up of evidence-based interventions has profiled how the healthcare system can be redesigned to implement models that better support vulnerable older people. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Considering the specific requirements of the older adults in the use of drugs and the opportunity for the clinical pharmacist to contribute to these patients, this review aimed to identify studies that have evaluated the results of pharmaceutical care for older adults in Brazil. We conducted a systematic review of the studies that answered the following guiding question: “What pharmaceutical care outcomes in older adult patients are found in Brazil?”. The search strategy was applied to the following databases in February 2019: PubMed, CENTRAL, BVS, and LILACS. Observational or experimental studies describing the results of pharmaceutical care in older adults in Brazil at any level of healthcare and related to the monitoring of any health problem were included. The quality of the included publications was assessed using the Downs and Black checklist. Of the 5080 studies that were identified, 11 were included. The results could summarize evidences supporting pharmaceutical care for older adults, regardless of place of attendance, health problem, or level of health care. The experiences of the Brazilians have contributed to the improvement of clinical and humanistic outcomes, such as reduction in blood pressure, glycemic index, lipid levels, anthropometric measurements, and polypharmacy; resolution of drugs related problems; and improvement in adherence and quality of life. One publication also reported economic outcomes (ICER per QALY gained). Although the number of articles obtained was small, they reported unanimously beneficial results. Pharmacist’s training in healthcare service is essential for expanding pharmaceutical care for this population group.

Introduction: Postoperative delirium is one of the most common and dangerous psychiatric complications after hip surgery. The aim of this study was to investigate the incidence of postoperative delirium in elderly patients after hip fracture surgery and to identify risk factors for such, as part of developing a risk stratification index (RSI) system to predict a patient's risk of postoperative delirium. Methods: Elderly patients (aged 65 years or older) with hip fractures who had received surgical treatment in our hospital between March 2018 and December 2019 were retrospectively included. Clinical data were collected, and multivariate logistic regression analysis was performed to investigate the relevant risk factors of postoperative delirium. An RSI system was developed based on factors identified in the regression analysis. Results: Of 272 patients included, 52 (19.12%) experienced postoperative delirium. Drinking history (> 3/ week), the perioperative lactic acid level (Lac > 2 mmol/L), postoperative visual analog score (VAS) > 3, American Society of Anesthesiologists (ASA) physical status > II, application of the bispectral index, and preoperative diabetes were independent risk factors of postoperative delirium. When RSI ≥ 5, the rate of postoperative delirium significantly increased (p <.05). Conclusion: The RSI system developed here can safely guide postoperative outcomes of elderly patients with hip fractures, and RSI ≥ 5 may be able to predict the onset of postoperative delirium. [ABSTRACT FROM AUTHOR]

Abstract Introduction Postoperative delirium is one of the most common and dangerous psychiatric complications after hip surgery. The aim of this study was to investigate the incidence of postoperative delirium in elderly patients after hip fracture surgery and to identify risk factors for such, as part of developing a risk stratification index (RSI) system to predict a patient's risk of postoperative delirium. Methods Elderly patients (aged 65 years or older) with hip fractures who had received surgical treatment in our hospital between March 2018 and December 2019 were retrospectively included. Clinical data were collected, and multivariate logistic regression analysis was performed to investigate the relevant risk factors of postoperative delirium. An RSI system was developed based on factors identified in the regression analysis. Results Of 272 patients included, 52 (19.12%) experienced postoperative delirium. Drinking history (> 3/ week), the perioperative lactic acid level (Lac > 2 mmol/L), postoperative visual analog score (VAS) > 3, American Society of Anesthesiologists (ASA) physical status > II, application of the bispectral index, and preoperative diabetes were independent risk factors of postoperative delirium. When RSI ≥ 5, the rate of postoperative delirium significantly increased (p

Aim: With the increase in the geriatric population, admissions to emergency units are increasing each day. This study aims to determine the perspective and attitudes of emergency specialists towards geriatric patients, and to form a training program for emergency medicine to improve the quality of patient care. Materials and Methods: We conducted a complementary study designed as a survey. At the end of the study period, the data collected were recorded in SPSS for Windows 15.0 (SPSS Inc.®, Chicago, ABD) program package and statistically analyzed. The Chi-square, Yates corrected chi-square and the Fisher's exact tests were used in order to defne the relationship between the parameters. The level of signifcance was accepted as p<0.05. Results: 335 physicians working in the emergency units responded to the survey questionnaire and participated in the study. Overall, 74.7% of the participants worked in the institutes where a geriatric division or department was not present. No specifc division of geriatrics was present in the institute where 60.5% of the participants worked. 79.4% of the participants mentioned that hospitalization of geriatric patients was avoided compared with that of younger patients where they worked. Furthermore, 37.3% of research assistants and 13.1% of the specialists mentioned that they had no training in geriatrics. 68.2% of the participants stated that they felt suffcient in approaching geriatric patients and 67% stated that they felt suffcient in communication with them. The participants desired training mostly in drug interactions, elder abuse and communication. 226 (68.9%) the emergency unit doctors stated that they had patients who had been subjected to elder abuse. Finally, 72.8% of the pariticipants felt no unwillingness in case of a need for resuscitation to elderly patients with no oncological disease or those who were not accepted to be in their terminal period. Conclusion: Training of emergency unit specialists for the management of geriatric patients is insuffcient and needs to be revised. [ABSTRACT FROM AUTHOR]

The aging process involves physical, psychological, and social changes. The elderly, who have to adapt to psychosocial problems brought by the aging process, can get into difficult life with the addition of cancer to the process. The unique and complex needs of elderly cancer patients may arise in this process, which has turned into a difficult struggle for both the elderly cancer patient and their relatives. The concept of "supportive care", which takes a great place in patients' care, gains importance in meeting these needs. Supportive care aims to provide holistic care by centering the patient and the family. Thus, the physical comfort and functionality of cancer patients, as well as their social, cognitive, economic, psychological, and spiritual well-being are increased. Supportive care is in a tight relationship with the adaptation process, care satisfaction, and quality of life. Supportive care needs, including the dimensions of healthcare and communication, daily life activities, sexual and psychological, may vary with the medical service and individual and cultural features. This special group with multidimensional, unique, and complex needs will receive the care they need if the nurses who provide care adopt systematic and evidencebased approaches and approach the patient and his/her family with a collaborative attitude. This review aims to examine the supportive care needs of elderly cancer patients and bring a text to Turkish literature that healthcare providers can use to recognize and address the unmet care needs of elderly cancer patients. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To identify factors associated with leisure activities of elderly residents in rural areas. Method: Quantitative cross-sectional study carried out with 258 elderly living in the rural area of Paraná. The collection instrument addressed sociodemographic, economic, and self-reported leisure activities. The association between variables and leisure activities was verified by means of bivariate and multivariate analysis. Results: Among the elderly interviewed, 63.9% were female, and 36.1% were male, with an average of 68.3 years old (± 5.8 years). Participation in leisure activities was high (79.8%), and the factors associated with their practice were: marital status, gender, and education. Conclusion: Considering that the practice of leisure activities promotes better living and health conditions, we reinforce the need to implement actions and instruments that provide individual and collective leisure in rural areas.

Introduction: The reality of aging has caught up with the field of plastic surgery, shown by the growth in the number of elderly patients who undergo cosmetic surgery (CS). To evaluate its importance in elderly women, this study examined differences in quality of life and self-esteem among those who did or did not undergo CS. Methods: This casecontrol study included 25 elderly women who underwent CS and a control group of 25 elderly women who did not undergo CS; the groups were matched by socioeconomic data. Assessment methods included the Mini-Mental State Examination, a quality of life (QOL) questionnaire (World Health Organization Quality of Life-Bref), the Rosenberg Self-Esteem Scale, and a questionnaire developed for the study of sociodemographic data, motivation, and satisfaction with CS. Results: The mean age was 67.26 years, with a mean of 9.96 years of education. The most common surgeries were abdominoplasty and blepharoplasty. The most common motivations were physical discomfort, desire to improve QOL, and dissatisfaction with self-image. No subjects were found to have low self-esteem and the level of satisfaction with personal or social life was high. There was no difference in QOL or self-esteem between the 2 groups. Conclusion: Physical and psychological motivations cause the elderly to undergo CS. There was no difference in QOL or self-esteem among elderly women who did or did not have CS. Elderly women who underwent CS showed high levels of satisfaction with their personal and social life.

To analyse the state of scientific production on ageing and therapeutic interventions for older adults from a psychological perspective. Methodology: Quantitative research, bibliometric design, theoretical sample, data collection with a photometric technique. Bibliographic search was made consulting databases such as Pubmed, Scopus, ScienceDirect, PsycInfo, Pro- Quest, Dialnet among others. The search words were Old age, Positive Psychology, Active aging, quality of life in older adults, PERMA model. The inclusion criteria were publications corresponding to the period from 2015 to 2020, scientific quality criteria, publications based on research processes. The analysis of results was developed from a background matrix, according to the different descriptors and discarding the documents that did not meet the inclusion criteria. Results: the theoretical and methodological models were recognized in the collected researches, being the main authors from the psychological perspective: with Healthy, Positive and Successful Aging, transversal determinants of active aging, with psychological well-being and finally from health promotion, Daily Activities and Theory of Activity. Methodologically the studies reviewed were non-experimental, with some quasi-experimental studies present, however, in the scientific information selected longitudinal research was absent. It is concluded that the psychological perspective contributes to the understanding of aging in variables susceptible to intervention such as quality of life, psychological well-being, happiness, daily activity, therefore, opportunities for research and intervention are perceived in the field of psycho-gerontology. [ABSTRACT FROM AUTHOR]

The negative self-perception of health is a relevant construct for the analysis of the elderly population health conditions and should be recognized as a guiding tool for health promotion actions. We aimed to verify the prevalence and the associated factors to a negative self-perception of health by elderly assisted in a reference center. This is an analytical cross-sectional study with convenience sampling conducted in 2015. The negative self-perception association with health-related sociodemographic variables was investigated. Bivariate analysis followed by multiple analysis by Poisson regression was performed to verify the variables associated with the outcome. Three hundred sixty elderly were evaluated. The negative self-perception of health prevalence was 60.5%. The following associated factors were identified in the final model: age range 65-79 years (PR=1; CI95%=0.648-0.974; p=0.027); frailty (PR=1.28; CI95%=1.07-1.54; p=0.007); depressive symptoms (PR=1.40; CI95%=1.19- 1.67; p=0.000); and providing care to someone (PR=1.49; CI95%=1.18-1.88; p=0.001). The elevated prevalence of negative self-perception of health and the associated factors point to the need for effective health promotion actions and more specific care for the elderly assisted in the reference center. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim was to explore the outcome, on a local level, of steering, organisation and practices of elderly care foodservice by Swedish municipalities, and changes relative to national actions. Methods: A survey using a web‐based questionnaire about elderly care foodservice targeting all Swedish municipalities (n = 290) was conducted in 2006 and 2013/2014. The questionnaire included the topics: organisation of foodservice, its practice in elderly care and steering devices such as guidelines and policies. Based on the share of a rural population, municipalities were divided into groups: rural (≥50%), urban (<50%) and city (≤20%). Results: The response rate from municipalities was 80% in 2006 and 56% in 2013/2014; 45% participated in both surveys. The results showed increased use of local food policies (P = 0.03) and meal choice (P < 0.001), while access to clinical/community dietitians declined (P = 0.01) between the surveys. In home‐help services, daily delivered cook‐serve meals declined (P < 0.001) and chilled meals delivered three times a week increased (P = 0.002) between the surveys. City municipalities used private foodservice organisations the most (P < 0.001), and reported reduced use of cook‐serve systems in favour of chilled. In rural municipalities, the use of public providers (98%) and a cook‐serve system (94%) were firmly established. Urban municipalities were placed between the other groups. Conclusions: National actions such as soft governance and benchmarking appear largely to determine local level outcomes. However, conditions for adapting these measures vary between municipality groups. While efficiency enhancing trends were prominent, questions remain whether national actions should be expanded beyond performance to also examine their consequences. [ABSTRACT FROM AUTHOR]

this study aimed to describe the characteristics related to access to and use of health services, and verify factors associated with the use of services among the elderly. This is a cross-sectional analytical study conducted with 705 urban elderly in Uberaba/Minas Gerais. Were used: structured instrument related to socioeconomic data, Katz, Lawton and Brody scales and Fried Fragility Phenotype; and questionnaire from the National Survey by Domicile Sample for access and use of health services. The procedure was the descriptive and logistic regression analysis (p

Perception of elderly people resident in small towns are analyzed with regard to their satisfaction with public services such as public transport, recreation and health attendance. The study was undertaken in five towns in the state of Minas Gerais, Brazil, and included 32 male and female elderly people, living in the rural and urban areas. They were interviewed according to a structured protocol guided by the environmental and social dominion of the questionnaires WHOQOL-BREF and WHOQOL-OLD. The interviews were later transcribed and the themes were catalogued. Most elderly people were satisfied with the services but suggested several improvements, such as, extending offers, information and access to health services, investing priority attendance, reduction in time in queues for visits to the doctor's, professional capacitation, extend transport for recreation and social living. The implementation of priorities was an important resource for better life quality and health. [ABSTRACT FROM AUTHOR]

Private geriatricians report heterogeneous practices, while the specialty as a whole is questioning its model. We conducted semi-structured interviews to understand how private geriatricians viewed their role in the health care system. They report a certain homogeneity in their conception of their role, which corresponds to that of geriatricians as a whole: there seems to be a professional identity for geriatrics., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Peripheral areas are often overlooked in health-care research but they in fact deserve specific attention. Such areas struggle to maintain access to good quality health-care services due to their geographical context. At the same time, new interventions or promising innovations often emerge in places where creativity is urgently needed. In this paper, we explore this creativity at the margins in older persons care organizations in peripheral areas, which other healthcare providers and policymakers can learn from., Methods: This exploratory study is based on two large research projects on the quality of care for older persons in Norway and the Netherlands. We performed secondary analysis of interviews with quality managers and other quality workers and used additional document analysis and expert interviews to deepen our analysis., Results: The results show that older persons care organizations working in peripheral areas must deal with a number of challenges caused by their geographical context, e.g. geographical distances (between services and to the geographical center), workforce shortages, and landscape characteristics. We found that organizations use different strategies to tackle these challenges, such as scaling up, brightening up and opening up. These strategies, conceptualized as creativity at the margins, impact quality work in different ways, for example by enabling more person-centered care., Conclusion: We conclude that both policymakers and research should overcome their peripheral blindness by learning from and supporting creativity at the margins in future policies and research., Competing Interests: Declaration of Competing Interest We have no conflict of interest to declare., (Copyright © 2022. Published by Elsevier B.V.)

Embora a atenção ao idoso seja uma prioridade emergente no Brasil, pouca ênfase tem sido dada a modelos de organização de serviços hospitalares para pacientes geriátricos. São revisados modelos de serviços hospitalares para admissão e manuseio de casos agudos em idosos, com ênfase na discussão sobre o papel e o posicionamento da medicina geriátrica (incluindo sua interface com especialidades e com a clínica médica) no âmbito da atenção hospitalar. Foi realizada pesquisa na base de dados Medline (1989-1999), bem como nos principais livros-texto de geriatria e de gerontologia, buscando identificar descrições de serviços hospitalares para cuidado agudo de pacientes idosos. As características dos modelos identificados foram compiladas e descritas à luz de sua adequação à realidade dos serviços de saúde no Brasil. Exemplos de intervenções em geriatria, com efetividade demonstrada através de revisões sistemáticas, foram também citadas. Os modelos mais freqüentemente relatados foram cuidado prolongado, tradicional, baseado na idade cronológica, não especializado e integrado. Adaptações e variantes de alguns desses modelos foram freqüentemente relatadas, assim como seu impacto potencial na efetividade do cuidado geriátrico. Evidências sobre o melhor modelo a seguir não foram identificadas, mas aqueles modelos favorecendo a integração da geriatria com a clínica geral pareceram mais adequados à nossa realidade. Ressalta a necessidade de reestruturação de serviços de saúde para responder às novas demandas que surgem com o envelhecimento da população, bem como do delineamento de serviços hospitalares para casos agudos, importantes para a efetividade do cuidado geriátrico e que devem ser objeto de maior debate e pesquisa no Brasil.Although the implementation of geriatric services is an emerging priority in Brazil, little emphasis has been put on the type of acute care that should be provided for elderly patients in the hospital setting. The objective was to review some models of acute hospital care for elderly people, focusing on the role of geriatric medicine and its relationship with other specialities. Medline database (1989-1999), textbooks of geriatrics and gerontology, and other health publications were consulted in an attempt to identify all relevant publications about hospital services providing acute care to elderly people. The features of each model were compiled and discussed taking into account their suitability to the Brazilian health system. Some examples of interventions, with their effectiveness demonstrated by systematic reviews, were also mentioned. The models more frequently described were: long-time traditional, age-defined, unspecialized and integrated care. Variants of such models were frequently reported. There is no evidence pointing to one as the best model, but models favoring the integration of geriatrics with general medicine seemed to be particularly suitable to the Brazilian setting. With the aging of the population, there is a need to restructure the health services to face the increasing demands of elderly people. Given that the design of hospital services is an important factor for the effectiveness of geriatric care, this issue should be studied as priority in Brazil.

The profile of a sample population of elderly receiving treatment under the Family Health Strategy in the municipality of Teófilo Otoni, State of Minas Gerais, Brazil, is described, and the factors associated with diseases prevalence examined. Using simple random sampling, 385 elderly were interviewed using Form A and Elderly Form from the Primary Health Care Information System. The majority of the sample (83.1%) self-reported at least one disease, 69.9% had hypertension, and 17.7% had diabetes. Poisson regression analysis showed that the main factors associated with hypertension and other diseases were being non-white, having a low level of education, medication use, dental prosthesis use, and lack of a private health plan. The prevalence of diabetes was greater among women and individuals who depended on other people to live. It can be concluded that this sample population of elderly has a generally low socioeconomic status and are more susceptible to developing diseases, particularly hypertension. Diabetes should be controlled although had relatively low prevalence. It is suggested investments in structuring the health system network to provide adequate care for the elderly and in training health professionals to play an effective role in improving the quality of life of the elderly in Brazil. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The demographic transition in industrialized countries leads to a growth of elderly population. This population is more prone to chronic diseases and puts an increasing pressure on the healthcare system. One way to reduce the cost associated to the support of this population is to improve its autonomy to keep it independent as long as possible. Many assistive technologies and environmental interventions can be implemented to achieve this goal. In this paper, we are looking at the advantages and drawbacks of smartwatches as a platform to support elderly at home. By doing a literature search and by performing expert interview, we have identified the advantages of this technology to insure the success of promising applications as well as the obstacles that should be gone beyond. Among the advantages, the ubiquity of smartwatches makes possible a continuous medical surveillance, harder to achieve with other devices. Moreover, the versatility of smartwatches provides an appropriate ground to implement a centralized platform providing multiples services facilitating elderly homecare. However, the physical constraints of the watches such as the tiny screen size, the small connectors and the limited power autonomy can be significant barriers to the adoption of these tools. In conclusion, beside the actual homecare system, improving the autonomy and the independence of elderly at home can be leveraged by a combination of environmental and assistive technologies. Smartwatches have definitively the potential to become close assistants to help elderly in their daily life. However, this will not be achieved without dedicating a significant effort in designing appropriate user interfaces and certainly dedicated hardware to respond to the constraints associated with potential physical and cognitive impairments. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Due to the narrow therapeutic range and high drug-to-drug interactions (DDIs), improving the adequate use of warfarin for the elderly is crucial in clinical practice. This study examines whether the effectiveness of using warfarin among elderly inpatients can be improved when machine learning techniques and data from the laboratory information system are incorporated. Methods: Having employed 288 validated clinical cases in the DDI group and 89 cases in the non-DDI group, we evaluate the prediction performance of seven classification techniques, with and without an Adaptive Boosting (AdaBoost) algorithm. Measures including accuracy, sensitivity, specificity and area under the curve are used to evaluate model performance. Results: Decision tree-based classifiers outperform other investigated classifiers in all evaluation measures. The classifiers supplemented with AdaBoost can generally improve the performance. In addition, weight, congestive heart failure, and gender are among the top three critical variables affecting prediction accuracy for the non-DDI group, while age, ALT, and warfarin doses are the most influential factors for the DDI group. Conclusion: Medical decision support systems incorporating decision tree-based approaches improve predicting performance and thus may serve as a supplementary toolin clinical practice. Information from laboratory tests and inpatients' history should notbe ignored because related variables are shown to be decisive in our prediction models, especially when the DDIs exist. [ABSTRACT FROM AUTHOR]

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Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Gay and lesbian seniors are more likely to be single, live alone, and be childless. The current evidence base suggests that limited social supports are associated with a variety of health disparities among all older adults. Research regarding the aging issues of lesbian seniors is scarce. This instrumental collective case study of 4 older lesbians (ages 59 and older) illustrates unique aging support concerns, issues, and needs. The purpose of the case study is to increase provider sensitivity and provide supportive evidence of the need for more research. Findings suggest that limited biological family support, childlessness, and 'families of choice' may be important factors in support service and health care decisions for older lesbians. Implications for care providers in working with the older lesbian population include exploring existing supports and assisting with the formation of culturally acceptable support systems and services. Given the current evidence base regarding the impact of social support on elder health, it is critical for providers to have a better understanding of elder lesbians' unique concerns and needs relating to support and health care services in order to prevent health disparities among this vulnerable population. [ABSTRACT FROM AUTHOR]

The Medicare Current Beneficiary Survey (MCBS) is a longitudinal, multipurpose panel survey of a nationally representative sample of Medicare beneficiaries sponsored by the Centers for Medicare and Medicaid Services (CMS). The MCBS serves as a comprehensive data source on self-reported health and socioeconomic status, health insurance, healthcare utilization and costs, and patient satisfaction. CMS uses Medicare claims data to validate self-reported Medicare Fee-For-Service (FFS) utilization. Because the Veterans Health Administration (VHA) does not bill for services, CMS imputes VHA costs. This article addresses the quality of the MCBS dataset for conducting research on Medicare-eligible veterans by addressing the sample's representativeness, quality of self-reported data, and accuracy of imputed VHA cost estimates. We compared demographic data from the 1992 and 2001 National Survey of Veterans (NSV) with the MCBS 1992 and 2001 Cost and Use files. We compared self-reported VHA utilization and CMS's imputed costs with VHA administrative datasets. The VHA's Pharmacy Benefits Management (PBM) database is available from fiscal year (FY) 1999 onward, and the VHA Health Economics Resource Center's (HERC) Average Cost datasets are available from FY1998 onward. While the samples were comparable in terms of age, sex, and race, the MCBS respondents were in better health, less likely to be married, and more likely to be widowed than NSV respondents. MCBS underreporting rates were higher for VHA than Medicare outpatient events. Underreporting and differences between CMS's and HERC's costing methodologies contributed to lower MCBS versus VHA administrative person- and event-level costs. Alternatively, average annual VHA prescription costs per capita were higher in the MCBS than in the PBM data. Differences in socioeconomic characteristics of the NSV and MCBS samples may be attributable to differences in sampling methodologies. Higher underreporting rates for VHA versus Medicare FFS outpatient events are likely due to systemic differences between the VHA and private healthcare sectors. While VHA formulary discounts may not be reflected in MCBS's VHA prescriptions costs, lower PBM prescriptions costs are also due to deficient indirect cost data. Since reliable VHA utilization and cost data existed in either FY1998 or FY1999 onward, study goals include estimating the relative share and/or cost of care provided by Medicare and the VHA. Researchers with access to VHA datasets should consider merging them into the MCBS and replacing self-reported utilization and CMS's imputed costs with VHA administrative data. This replacement would significantly improve the accuracy, quality, and usefulness of the MCBS dataset for policy research. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to apply the best practices for the elderly's oral health care through the theoretical-methodological framework "Interactive Domain Model of Best Practices in Health Promotion", which considers the interaction of domains (Underpinnings, Understanding of the Environment and Practice), as an action-research. An intervention at the Best Practice referential in a local health system was carried out through a systematic and critical reflection by the actors involved with local governance, examining its potential to transform current practices according to the principles of Health Promotion. Data were collected from focal groups formed by managers, health professionals and the elderly (20 subjects). The best practices were suggested built on the principles of the National Health Service, Family Health Strategy and Health Promotion. The process of development of Best Practices is based on the expectation that a higher oral health standard for the elderly could be reached by means of a change in organizational practices, as well as in health, research and evaluation practices. The possible change depends on the willingness of the actors involved as regards the careful consideration and analysis of current behaviors, procedures and scenarios. The driving force for the continuous improvement of practices is the commitment of the local governance with the principles of Health Promotion. It was possible to build an indicative set of practices on oral health of the elderly and to generate useful knowledge to afford the approach of the theoretical models to the reality, with a view to the transformation of such practices. [ABSTRACT FROM AUTHOR]

The influence of the Open University of the Third Age (São Carlos Educational Foundation) (UATI-FESC) and the Geriatric Revitalization Program (REVT) on the quality of life of middle-aged and elderly adults was evaluated. Method: Seventy individuals in their first year at UATI and REVT participated in this study. The inclusion criteria were that the subjects had to be at least 50 years old and be capable of filling out questionnaires. UATI had an interdisciplinary program comprising six lectures (once a week each). Three were on physical activities: Tai Chi Chi Kung, Body Expression and Physical Therapy and Health Promotion; three on social and cultural promotion: Musical Education, Art and Citizenship in the Third Age; and there were also commemorative activities and cultural tourism. REVT had 48 physical activity sessions, three times a week, lasting 50-55 minutes each. All the participants were evaluated using the World Health Organization Quality-of-Life (WHOQOL-bret) and Short-Form 36 Medical Outcomes Study (SF36) questionnaires at baseline and at the end of the 16-week intervention. The data were analyzed using ANOVA with repeated measurements. Results: There were no differences between the groups. Both groups showed significant improvement in quality of life according to the overall result from WHOQOL-bref and also in the Psychological and Environmental domains and the initial questions: "How would you rate your quality of life?" and "How satisfied are you with your health?", in WHOQOL-bref. There was also a significant improvement in the General Health domain of SF36. For the Physical and Social Relations domains of WHOQOL-bref and other domains of SF36, there was no significant improvement. Conclusions: These programs improved quality of life according to WHOQOL-bref and the General Health domain of SF36. [ABSTRACT FROM AUTHOR]