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Sample records for older london residents

  1. Key Barriers to Community Cohesion: Views from Residents of 20 London Deprived Neighbourhoods.

    PubMed

    Bertotti, Marcello; Adams-Eaton, Faye; Sheridan, Kevin; Renton, Adrian

    2012-04-01

    The notion of community has been central to the political project of renewal of New Labour in the UK. The paper explores how the discourses of community are framed within New Labour and discusses these in the light of the results from research which focuses on how people within urban deprived areas construct their community. It draws upon the results of one part of a larger research project (the 'Well London' programme) which aimed to capture the views of residents from 20 disadvantaged neighbourhoods throughout London using an innovative qualitative method known as the 'World Café'. Our results show the centrality of young people to the development of cohesive communities, the importance of building informal relationships between residents alongside encouraging greater participation to policy making, and the need to see these places as fragile and temporary locations but with considerable social strengths. Government policies are only partially addressing these issues. They pay greater attention to formally encouraging citizens to become more involved in policy making, largely ignore the contribution young people could make to the community cohesion agenda, and weakly define the shared norms and values that are crucial in building cohesive communities. Thus, the conclusion is that whilst an emphasis of the government on 'community' is to be welcome, more needs to be done in terms of considering the 'voices' of the community as well as enabling communities to determine and act upon their priorities.

  2. Motivators for physical activity among ambulatory nursing home older residents.

    PubMed

    Chen, Yuh-Min; Li, Yueh-Ping

    2014-01-01

    The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

  3. Key Barriers to Community Cohesion: Views from Residents of 20 London Deprived Neighbourhoods

    PubMed Central

    Bertotti, Marcello; Adams-Eaton, Faye; Sheridan, Kevin; Renton, Adrian

    2016-01-01

    The notion of community has been central to the political project of renewal of New Labour in the UK. The paper explores how the discourses of community are framed within New Labour and discusses these in the light of the results from research which focuses on how people within urban deprived areas construct their community. It draws upon the results of one part of a larger research project (the ‘Well London’ programme) which aimed to capture the views of residents from 20 disadvantaged neighbourhoods throughout London using an innovative qualitative method known as the ‘World Café’. Our results show the centrality of young people to the development of cohesive communities, the importance of building informal relationships between residents alongside encouraging greater participation to policy making, and the need to see these places as fragile and temporary locations but with considerable social strengths. Government policies are only partially addressing these issues. They pay greater attention to formally encouraging citizens to become more involved in policy making, largely ignore the contribution young people could make to the community cohesion agenda, and weakly define the shared norms and values that are crucial in building cohesive communities. Thus, the conclusion is that whilst an emphasis of the government on ‘community’ is to be welcome, more needs to be done in terms of considering the ‘voices’ of the community as well as enabling communities to determine and act upon their priorities. PMID:27761059

  4. Building partnerships to continue older adults' residence in the community.

    PubMed

    Beeber, Anna Song

    2008-01-01

    Current care of older adults focuses on maintenance of independence and frames assessment and decision making about when to intervene. This conceptualization focuses on older adults' deficits and how to compensate for loss of function. Instead of considering independence to continue community residence, an alternative-interdependence-provides a conceptualization that focuses on older adults in the family context and on supportive services, which are the main components of community residence. This article presents the concept of interdependence by analyzing the current research, practice, and policy literature. The article concludes with a discussion of the application of interdependence in gerontological nursing practice and research.

  5. Worry in Older Community-Residing Adults

    ERIC Educational Resources Information Center

    Brock, Kaye; Clemson, Lindy; Cant, Rosemary; Ke, Liang; Cumming, Robert G.; Kendig, Hal; Mathews, Mark

    2011-01-01

    With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n =…

  6. Worry in Older Community-Residing Adults

    ERIC Educational Resources Information Center

    Brock, Kaye; Clemson, Lindy; Cant, Rosemary; Ke, Liang; Cumming, Robert G.; Kendig, Hal; Mathews, Mark

    2011-01-01

    With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n =…

  7. Aspirin for the older person: report of a meeting at the Royal Society of Medicine, London, 3rd November 2011

    PubMed Central

    Armitage, J; Cuzick, J; Elwood, P; Longley, M; Perkins, A; Spencer, K; Turner, H; Porch, S; Lyness, S; Kennedy, J; Henderson, GN

    2012-01-01

    On November 23rd 2011, the Aspirin Foundation held a meeting at the Royal Society of Medicine in London to review current thinking on the potential role of aspirin in preventing cardiovascular disease and reducing the risk of cancer in older people. The meeting was supported by Bayer Pharma AG and Novacyl. PMID:22423252

  8. Depressive Symptoms among Older Residents in Assisted Living Facilities

    ERIC Educational Resources Information Center

    Jang, Yuri; Bergman, Elizabeth; Schonfeld, Lawrence; Molinari, Victor

    2006-01-01

    Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and…

  9. Depressive Symptoms among Older Residents in Assisted Living Facilities

    ERIC Educational Resources Information Center

    Jang, Yuri; Bergman, Elizabeth; Schonfeld, Lawrence; Molinari, Victor

    2006-01-01

    Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and…

  10. Vision impairment and nutritional status among older assisted living residents.

    PubMed

    Muurinen, Seija M; Soini, Helena H; Suominen, Merja H; Saarela, Riitta K T; Savikko, Niina M; Pitkälä, Kaisu H

    2014-01-01

    Vision impairment is common among older persons. It is a risk factor for disability, and it may be associated with nutritional status via decline in functional status. However, only few studies have examined the relationship between vision impairment and nutritional status, which was investigated in this cross-sectional study. The study included all residents living in the assisted living facilities in Helsinki and Espoo in 2007. Residents in temporary respite care were excluded (5%). Of permanent residents (N=2214), 70% (N=1475) consented. Trained nurses performed a personal interview and assessment of each resident including the Mini Nutritional Assessment (MNA), functional and health status. Patient records were used to confirm demographic data and medical history. Mortality in 2010 was retrieved from central registers. Of the residents, 17.5% (N=245) had vision impairment and they were not able to read regular print. Those with vision impairment were older, more often females, and malnourished according to MNA. They had lower BMI, and suffered more often from dementia and chewing problems than those without vision impairment. In logistic regression analysis controlling for age, gender, chewing problems and dementia, vision impairment was independently associated with resident's malnutrition (OR 2.51, 95% CI 1.80-3.51). According to our results older residents in assisted living with vision impairment are at high risk for malnutrition. Therefore it is important to assess nutritional status of persons with vision impairment. It would be beneficial to repeat this kind of a study also in elderly community population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Environmental and genetic determinants of vitamin D status among older adults in London, UK.

    PubMed

    Jolliffe, David A; Hanifa, Yasmeen; Witt, Karolina D; Venton, Timothy R; Rowe, Marion; Timms, Peter M; Hyppönen, Elina; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R

    2016-11-01

    Despite the high prevalence of vitamin D deficiency among older adults in the UK, studies investigating the determinants of vitamin D status in this group are lacking. We conducted a cross-sectional study in 222 older adults living in sheltered accommodation in London, UK, who were screened for participation in a clinical trial of vitamin D supplementation for the prevention of acute respiratory infection. Details of potential demographic and lifestyle determinants of vitamin D status were collected by questionnaire and blood samples were taken for analysis of serum 25-hydroxyvitamin D (25[OH]D) concentration and DNA extraction. Fifteen single nucleotide polymorphisms (SNP) in 6 genes (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, VDR) previously reported to associate with circulating 25(OH)D concentration were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration. Mean serum 25(OH)D concentration was 42.7nmol/L (SD 22.0); 144/222 (64.9%) participants had serum 25(OH)D concentrations <50nmol/L. The following factors were independently associated with lower serum 25(OH)D concentration: non-white ethnicity (-8.6nmol/L, 95% CI -14.9 to -2.3, P=0.008); lack of vitamin D supplement consumption (-17.1nmol/L, 95% CI -23.3 to -10.9, P<0.001) vs. taking a daily supplement; sampling in Q1/January-March (-12.2nmol/L, 95% CI -21.5 to -2.9, P=0.01), and sampling in Q4/October-December (-10.3nmol/L, 95% CI -20.2 to -0.4, P=0.04) vs. sampling in Q3/July-September. None of the 15 SNP investigated independently associated with serum 25(OH)D concentration after correcting for multiple comparisons. In conclusion, vitamin D deficiency was highly prevalent among the older adults in this study; non-White ethnicity, lack of vitamin D supplement consumption and sampling in winter and spring independently associated with lower vitamin D status.

  12. Dentition status, malnutrition and mortality among older service housing residents.

    PubMed

    Saarela, R K T; Soini, H; Hiltunen, K; Muurinen, S; Suominen, M; Pitkälä, K

    2014-01-01

    Oral health status and oral health problems can affect eating habits and thus consequently the nutritional status of frail older people. To assess older service house residents' dentition and its associations with nutritional status and eating habits, and as well as to explore the prognostic value of dentition status for mortality. A cross-sectional study with a three-year follow-up. In 2007, we assessed the nutritional status of all residents in service houses in the two cities of Helsinki and Espoo in Finland (N=2188). Altogether 1475 subjects (67%) participated in the study; dentition status data were available for 1369 of them. Using a personal interview and assessment, trained nurses familiar to the resident collected the subjects' demographic data, medical history, functional and cognitive status, information on dentition status, oral symptoms, eating habits and diets. We assessed nutritional status with the Mini Nutritional Assessment (MNA), and retrieved information on mortality from central registers on 6 July 2010. Edentulousness was common; more than half of the residents (52%) had lost all their teeth: 7% (n=94) were totally edentulous without prosthesis (Group 1), 45% (n=614) had removable dentures (Group 2), and 48% (n = 661) of the residents, had some natural teeth left (Group 3). Dentition status was associated with age, gender, education and disability. According to the MNA, 13% were malnourished, 65% were at risk for malnutrition, and 22% were well nourished. Edentulousness without prosthesis was associated with malnutrition, oral symptoms and infrequent use of oral care services. In Group 1, 52% were deceased during follow-up period. The respective figures for Groups 2 and 3 were 48% and 40% (p=0.004). However, in Cox regression analysis adjusted for age, gender, comorbidity and MNA score, dentition status no longer predicted mortality. Edentulousness is still common among older service housing residents. Edentulousness without prosthesis was

  13. Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

    PubMed

    Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E

    2013-06-01

    To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. A cross sectional postal questionnaire survey and follow-up semi-structured interviews. Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

  14. Advance Directives and Care Received by Older Nursing Home Residents.

    PubMed

    Manu, Erika R; Mody, Lona; McNamara, Sara E; Vitale, Caroline A

    2017-03-01

    Research shows variable success as to whether care provided aligns with individual patient preferences as reflected in their advance directives (AD). We aimed to study AD status and subsequent care received in older nursing home (NH) residents deemed at risk for infections and care transitions: those with a urinary catheter (UC), feeding tube (FT), or both. Design/participants/measurements: A subgroup analysis of a prospective cohort of 90 residents with a UC and/or FT from 15 NHs in southeast Michigan. Outcomes assessed at enrollment and at 30-day intervals were hospitalizations and antibiotic use. The ADs were divided as follows: (1) comfort oriented: comfort measures only, no hospital transfer; (2) palliative oriented: comfort focused, allowing hospital transfer (except intensive care unit), antibiotic use, but no cardiopulmonary resuscitation; (3) usual care: full code, no limitations to care. We calculated incidences for these outcomes. Seventy-eight (87%) residents had ADs: 18 (23%) comfort oriented, 32 (41%) palliative oriented, and 28 (36%) usual care. The groups did not differ regarding demographics, comorbidity, function, device presence, or time in study. Using the usual care group as comparison, the comfort-oriented group was hospitalized at a similar rate (Incidence rate [IR] = 15.6/1000 follow-up days vs IR = 8.8/1000 follow-up days, Incident rate ratio [IRR] 0.6 [95% confidence interval, CI, 0.3 -1.1], P value .09) but received fewer antibiotics (IR = 18.9/1000 follow-up days vs IR = 7.5/1000 follow-up days, IRR 0.4 [95% CI, 0.2-0.8], P value .005). Nursing home residents with comfort-oriented ADs were hospitalized at a rate similar to those with usual-care ADs but received fewer antibiotics, although the small sample size of this analysis suggests these findings deserve further study.

  15. Predictors of care home and hospital admissions and their costs for older people with Alzheimer's disease: findings from a large London case register

    PubMed Central

    Knapp, Martin; Chua, Kia-Chong; Broadbent, Matthew; Chang, Chin-Kuo; Fernandez, Jose-Luis; Milea, Dominique; Romeo, Renee; Lovestone, Simon; Spencer, Michael; Thompson, Gwilym; Stewart, Robert; Hayes, Richard D

    2016-01-01

    Objectives To examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs. Design Observational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations. Setting Catchment area for South London and Maudsley National Health Service Foundation Trust, provider for 1.2 million people in Southeast London. Participants Every individual with diagnosis of Alzheimer's disease seen and treated by mental health services in the catchment area, with at least one rating of cognition, not resident in care home at time of assessment (n=3075). Interventions Usual treatment. Main outcome measures Risk of admission to, and days spent in three settings during 6-month period following routine clinical assessment: care home, mental health inpatient care and general hospital inpatient care. Results Predictors of probability of care home or hospital admission and/or associated costs over 6 months include cognition, functional problems, agitation, depression, physical illness, previous hospitalisations, age, gender, ethnicity, living alone and having a partner. Patterns of association differed considerably by destination. Conclusions Most people with dementia prefer to remain in their own homes, and funding bodies see this as cheaper than institutionalisation. Better treatment in the community that reduces health and social care needs of Alzheimer's patients would reduce admission rates. Living alone, poor living circumstances and functional problems all raise admission rates, and so major cuts in social care budgets increase the risk of high-cost admissions which older

  16. Chronic lead poisoning in an Iranian opium smoker resident in London.

    PubMed

    Azizi, Alex; Ferguson, Katie; Dluzewski, Sam; Hussain, Tajammul; Klein, Martin

    2016-11-01

    A 46-year-old man of Iranian origin presented with a 4-day history of colicky abdominal pain and absolute constipation on a background of several weeks of irritability and malaise. He had smoked 10 g of opium per week for a year and a half. On examination, he had diffuse abdominal tenderness and faecal loading. This was cleared, but the abdominal pain, nausea and vomiting persisted. He had extravascular haemolytic anaemia with punctate basophilic stippling on blood film. The patient's serum lead concentration was substantially elevated and he perhaps demonstrated Burton's line. The patient underwent chelation therapy and has recovered clinically and biochemically. Public health experts were notified and conducted an assessment of the risk to the patient and others; their lead exposure questionnaire was subsequently amended. This is an important case report of a UK resident describing lead toxicity secondary to the inhalation of opium.

  17. Barriers to exercise in younger and older non-exercising adult women: a cross sectional study in London, United Kingdom.

    PubMed

    El Ansari, Walid; Lovell, Geoff

    2009-04-01

    A survey of 100 women in the south of London, United Kingdom (UK) compared exercise barrier intensities between non-exercising younger (20-27 years) and older (28-35 years) adult women; and examined childcare duties as perceived barriers to exercise. Perceived barriers to exercise were examined using an Exercise Benefits/Barriers Scale (EBBS) comprising four subscales (exercise milieu; time expenditure; physical exertion; family discouragement). Participants' number of children was also noted. Non-exercising older women reported significantly higher total exercise barriers, as well as across three barrier subscales: exercise milieu, time expenditure, and family discouragement. For both age groups, significant correlation existed between number of children and women's total exercise barrier scores. Number of children explained approximately 25% and approximately 30% of the variance of younger and older women's total barrier scores respectively. For both women groups, the strongest correlation between exercise barrier and number of children was for the time expenditure subscale. Broad grouping of 20-35 year old non-exercising women does not reflect a homogenous sample. Age categories employing narrower age brackets are recommended. Issues surrounding family responsibilities e.g. childcare duties may be shared between these groups and require further research and policy attention.

  18. Entitlement to concessionary public transport and wellbeing: a qualitative study of young people and older citizens in London, UK.

    PubMed

    Jones, Alasdair; Goodman, Anna; Roberts, Helen; Steinbach, Rebecca; Green, Judith

    2013-08-01

    Access to transport is an important determinant of health, and concessionary fares for public transport are one way to reduce the 'transport exclusion' that can limit access. This paper draws on qualitative data from two groups typically at risk of transport exclusion: young people (12-18 years of age, n = 118) and older citizens (60+ years of age, n = 46). The data were collected in London, UK, where young people and older citizens are currently entitled to concessionary bus travel. We focus on how this entitlement is understood and enacted, and how different sources of entitlement mediate the relationship between transport and wellbeing. Both groups felt that their formal entitlement to travel for free reflected their social worth and was, particularly for older citizens, relatively unproblematic. The provision of a concessionary transport entitlement also helped to combat feelings of social exclusion by enhancing recipients' sense of belonging to the city and to a 'community'. However, informal entitlements to particular spaces on the bus reflected less valued social attributes such as need or frailty. Thus in the course of travelling by bus the enactment of entitlements to space and seats entailed the negotiation of social differences and personal vulnerabilities, and this carried with it potential threats to wellbeing. We conclude that the process, as well as the substance, of entitlement can mediate wellbeing; and that where the basis for providing a given entitlement is widely understood and accepted, the risks to wellbeing associated with enacting that entitlement will be reduced.

  19. Residential Pesticide Usage in Older Adults Residing in Central California

    PubMed Central

    Armes, Mary N.; Liew, Zeyan; Wang, Anthony; Wu, Xiangmei; Bennett, Deborah H.; Hertz-Picciotto, Irva; Ritz, Beate

    2011-01-01

    Information on residential pesticide usage and behaviors that may influence pesticide exposure was collected in three population-based studies of older adults residing in the three Central California counties of Fresno, Kern, and Tulare. We present data from participants in the Study of Use of Products and Exposure Related Behaviors (SUPERB) study (N = 153) and from community controls ascertained in two Parkinson’s disease studies, the Parkinson’s Environment and Gene (PEG) study (N = 359) and The Center for Gene-Environment Studies in Parkinson’s Disease (CGEP; N = 297). All participants were interviewed by telephone to obtain information on recent and lifetime indoor and outdoor residential pesticide use. Interviews ascertained type of product used, frequency of use, and behaviors that may influence exposure to pesticides during and after application. Well over half of all participants reported ever using indoor and outdoor pesticides; yet frequency of pesticide use was relatively low, and appeared to increase slightly with age. Few participants engaged in behaviors to protect themselves or family members and limit exposure to pesticides during and after treatment, such as ventilating and cleaning treated areas, or using protective equipment during application. Our findings on frequency of use over lifetime and exposure related behaviors will inform future efforts to develop population pesticide exposure models and risk assessment. PMID:21909294

  20. Residential pesticide usage in older adults residing in Central California.

    PubMed

    Armes, Mary N; Liew, Zeyan; Wang, Anthony; Wu, Xiangmei; Bennett, Deborah H; Hertz-Picciotto, Irva; Ritz, Beate

    2011-08-01

    Information on residential pesticide usage and behaviors that may influence pesticide exposure was collected in three population-based studies of older adults residing in the three Central California counties of Fresno, Kern, and Tulare. We present data from participants in the Study of Use of Products and Exposure Related Behaviors (SUPERB) study (N = 153) and from community controls ascertained in two Parkinson's disease studies, the Parkinson's Environment and Gene (PEG) study (N = 359) and The Center for Gene-Environment Studies in Parkinson's Disease (CGEP; N = 297). All participants were interviewed by telephone to obtain information on recent and lifetime indoor and outdoor residential pesticide use. Interviews ascertained type of product used, frequency of use, and behaviors that may influence exposure to pesticides during and after application. Well over half of all participants reported ever using indoor and outdoor pesticides; yet frequency of pesticide use was relatively low, and appeared to increase slightly with age. Few participants engaged in behaviors to protect themselves or family members and limit exposure to pesticides during and after treatment, such as ventilating and cleaning treated areas, or using protective equipment during application. Our findings on frequency of use over lifetime and exposure related behaviors will inform future efforts to develop population pesticide exposure models and risk assessment.

  1. What are older people prepared to do to avoid falling? A qualitative study in London.

    PubMed

    Simpson, Janet M; Darwin, Cressida; Marsh, Nicola

    2003-04-01

    Falls prevention strategies form a significant part of recent government policy relating to older people. In this article we report a qualitative study to examine the extent to which older people are willing to adopt any of the following strategies in order to avoid falling; balance and lower limb strengthening exercises, home safety advice, and 'taking care'. A sample of community-dwelling inpatients who were more or less afraid of falling were interviewed. Some older people blamed their own unsafe behaviour rather than hazards in their home for falls, so taking care (moving slowly, holding on, being vigilant to and avoiding danger) was a widespread strategy. The benefits of exercise in falls prevention were poorly understood and there was little enthusiasm for exercising especially if it was perceived to be inappropriate in old age or painful. Awareness of home hazards and taking measures against them was common but home visits tended to be regarded as intrusive. Inadequate negotiation about adaptations was widespread and led to resentment and unwillingness to cooperate. Building on the widespread 'taking care' strategy may help educated older people in safe behaviour. Health professionals should encourage older people to exercise and when making home safety visits should confer with their clients, taking their preferences about adaptations into account.

  2. Madness and Rulers: Events in Coorg and London in 1810, as observed by the Hon. Arthur Cole, the resident at Mysore

    PubMed Central

    Jain, Sanjeev; Sarin, Alok

    2015-01-01

    What happens if a King becomes mentally ill? Excerpts from the personal papers of Arthur Henry Cole, Resident to the Kingdom of Mysore in 1809, open up fascinating insights into the madness of rulers, in neighboring Coorg and faraway London, and ways in which different societies responded to this. Musings on legal capacity and restrictions imposed on account of insanity, as well as migration and ennui in imperial colonies inevitably follow. PMID:26124533

  3. Madness and Rulers: Events in Coorg and London in 1810, as observed by the Hon. Arthur Cole, the resident at Mysore.

    PubMed

    Jain, Sanjeev; Sarin, Alok

    2015-01-01

    What happens if a King becomes mentally ill? Excerpts from the personal papers of Arthur Henry Cole, Resident to the Kingdom of Mysore in 1809, open up fascinating insights into the madness of rulers, in neighboring Coorg and faraway London, and ways in which different societies responded to this. Musings on legal capacity and restrictions imposed on account of insanity, as well as migration and ennui in imperial colonies inevitably follow.

  4. Are inner-cities bad for your health? Comparisons of residents' and third parties' perceptions of the urban neighbourhood of Gospel Oak, London.

    PubMed

    Whitley, Rob; Prince, Martin

    2005-01-01

    This paper analyses representations of the neighbourhood of Gospel Oak (London, UK), by contrasting views of residents with views expressed by third parties. Data from residents were gathered through in-depth qualitative methods. Data from third parties were gathered through documentary analysis. Third parties' descriptions of Gospel Oak were significantly more negative than residents'. In contrast, residents were overwhelmingly positive about the neighbourhood, often taking a diametrically opposed view to third parties on the same factor, for example, quality of housing. We argue that third parties' negative social construction of Gospel Oak is functional rather than descriptive; a pathological orientation is usually taken to assist efforts to win regeneration funding. Though this is sometimes successful, we discuss possible negative affects of this social construction, for example, stigmatisation. Finally, we warn against making assumptions of collective social and physical pathology in urban neighbourhoods, urging a more critical approach to the study of the inner-city in the health sciences.

  5. Fasting Periods in Older Patients Attending a South London Emergency Department

    PubMed Central

    2013-01-01

    There is increasing recognition of the deleterious effects of poor nutrition on health care outcomes. Older patients appear particularly vulnerable to the effects of undernutrition. This includes both low intake as patients and chronic preadmission undernutrition. This study investigates nutrition during a critical intervening period when patients present to a hospital emergency department (ED) in the first half of the day. One third of observed patients sustained periadmission fasts in excess of 18 hours. This fasting period showed significant positive correlation to age (correlation coefficient = 0.34, P < 0.05). Analysis of the results by gender showed that men who were older than the average cohort age of 53.6 years fasted for a significantly longer period in the hospital than their younger counterparts (P < 0.02). This comparison did not reach significant levels for female patients (P > 0.05). This study raises the question as to whether food should be routinely provided in the ED unless there is reason to withhold it. Particular care should be taken to avoid unnecessary delays in offering food to older patients. There may also be a need to ensure that geriatric care indicators are considered individually for each gender. PMID:23451846

  6. Fasting periods in older patients attending a South London emergency department.

    PubMed

    McDonald, Annabel J

    2013-01-01

    There is increasing recognition of the deleterious effects of poor nutrition on health care outcomes. Older patients appear particularly vulnerable to the effects of undernutrition. This includes both low intake as patients and chronic preadmission undernutrition. This study investigates nutrition during a critical intervening period when patients present to a hospital emergency department (ED) in the first half of the day. One third of observed patients sustained periadmission fasts in excess of 18 hours. This fasting period showed significant positive correlation to age (correlation coefficient = 0.34, P < 0.05). Analysis of the results by gender showed that men who were older than the average cohort age of 53.6 years fasted for a significantly longer period in the hospital than their younger counterparts (P < 0.02). This comparison did not reach significant levels for female patients (P > 0.05). This study raises the question as to whether food should be routinely provided in the ED unless there is reason to withhold it. Particular care should be taken to avoid unnecessary delays in offering food to older patients. There may also be a need to ensure that geriatric care indicators are considered individually for each gender.

  7. A temporary home to nurture health: lived experiences of older nursing home residents in Taiwan.

    PubMed

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang

    2008-07-01

    This study explored the lived experiences of older nursing home residents in Taiwan. With more long-term care institutions in Taiwan, older people are more often placed in nursing homes than in the past. Increased understanding of their lived experience is essential to assess residents' needs and determine the effectiveness of nursing interventions. A qualitative design was used to gain a deeper understanding of the lived experiences of older nursing home residents in Taiwan. Focus groups, followed by in-depth interviews, were used to gather information from 33 older residents at eight nursing homes in northern Taiwan. Participants were asked to describe what was important to them and what impressed them most in their daily lives in the nursing home. Participants (24 females and nine males) were on an average 75.3 years old. Verbatim transcripts of audiotaped focus groups and interviews were analysed by thematic analysis via ATLAS.ti software. The core theme of older residents' nursing home experience was 'a temporary home to nurture health'. This core theme was reflected in participants' descriptions of their overall life in the nursing home as a temporary experience to nurture their health. Their everyday experience was characterised by four subthemes: highly structured lifestyle, restricted activities, safety concerns and social interactions. Our findings may enhance policy makers' and healthcare providers' understanding of the lived experience of older nursing home residents, thus guiding the evaluation and development of nursing home services to improve residents' lives. For example, residents with the same characteristics could be placed in the same room or same floor, thus increasing their interactions with other residents. Residents' interactions with family members could also be developed using the Internet or mobile telephones.

  8. Perceptions of heatwave risks to health: interview-based study of older people in London and Norwich, UK.

    PubMed

    Abrahamson, Vanessa; Wolf, Johanna; Lorenzoni, Irene; Fenn, Bridget; Kovats, Sari; Wilkinson, Paul; Adger, W Neil; Raine, Rosalind

    2009-03-01

    Most projections of climate change suggest an increased frequency of heatwaves in England over coming decades; older people are at particular risk. This could result in substantial mortality and morbidity. To determine elderly people's knowledge and perceptions of heat-related risks to health, and of protective behaviours. Semi-structured interviews: 73 men and women, 72-94 years, living in their own homes in London and Norwich, UK. Few respondents considered themselves either old or at risk from the effects of heat, even though many had some form of relevant chronic illness; they did recognize that some medical conditions might increase risks in others. Most reported that they had taken appropriate steps to reduce the effects of heat. Some respondents considered it appropriate for the government to take responsibility for protecting vulnerable people, but many thought state intervention was unnecessary, intrusive and unlikely to be effective. Respondents were more positive about the value of appropriately disseminated advice and solutions by communities themselves. The Heatwave Plan should consider giving greater emphasis to a population-based information strategy, using innovative information dissemination methods to increase awareness of vulnerability to heat among the elderly and to ensure clarity about behaviour modification measures.

  9. Older care-home residents as collaborators or advisors in research: a systematic review

    PubMed Central

    Backhouse, Tamara; Kenkmann, Andrea; Lane, Kathleen; Penhale, Bridget; Poland, Fiona; Killett, Anne

    2016-01-01

    Background: patient and public involvement (PPI) in research can enhance its relevance. Older care-home residents are often not involved in research processes even when studies are care-home focused. Objective: to conduct a systematic review to find out to what extent and how older care-home residents have been involved in research as collaborators or advisors. Methods: a systematic literature search of 12 databases, covering the period from 1990 to September 2014 was conducted. A lateral search was also carried out. Standardised inclusion criteria were used and checked independently by two researchers. Results: nineteen reports and papers were identified relating to 11 different studies. Care-home residents had been involved in the research process in multiple ways. Two key themes were identified: (i) the differences in residents' involvement in small-scale and large-scale studies and (ii) the barriers to and facilitators of involvement. Conclusions: small-scale studies involved residents as collaborators in participatory action research, whereas larger studies involved residents as consultants in advisory roles. There are multiple facilitators of and barriers to involving residents as PPI members. The reporting of PPI varies. While it is difficult to evaluate the impact of involving care-home residents on the research outcomes, impact has been demonstrated from more inclusive research processes with care-home residents. The review shows that older care-home residents can be successfully involved in the research process. PMID:26790454

  10. Quality of Life in the Nursing Home: Perspectives of Younger and Older Residents

    ERIC Educational Resources Information Center

    Watt, Ashli; Konnert, Candace

    2007-01-01

    Adults aged 65 and younger make up a significant proportion of nursing-home residents. To date, however, there is no research examining their quality of life (QOL), including how their perceptions of QOL compare to those of older nursing-home residents. This study used a multidimensional approach to (a) assess the QOL of younger nursing-home…

  11. Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

    ERIC Educational Resources Information Center

    Segal, Daniel

    2005-01-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

  12. Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

    ERIC Educational Resources Information Center

    Segal, Daniel

    2005-01-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

  13. "Everyone was looking at you smiling": East London residents' experiences of the 2012 Olympics and its legacy on the social determinants of health.

    PubMed

    Thompson, C; Lewis, D J; Greenhalgh, T; Smith, N R; Fahy, A E; Cummins, S

    2015-11-01

    Mega-sporting event regeneration, as a specific approach to urban renewal, uses impending host-city status as a catalyst for revitalisation and has the potential to improve health both through addressing deprivation and by promoting increased sport and physical activity among the host-city's population. This qualitative study explored how hosting of the London 2012 Games impacted upon the way East London residents perceived and experienced the social determinants of health in their local neighbourhood. We conducted narrative family interviews, go-along interviews and video focus group workshops with 66 Newham residents, aged 12-55 years, immediately after the Games. A narrative analytic approach examined accounts of health and wellbeing experiences in terms of neighbourhood change and the spectacle of the Games. Participants of this qualitative study generally welcomed the respite and the unexpected chance to live in a cleaner, safer and more unified environment. However, this positivity was underscored by an acute awareness that this was a very temporary situation and one that was intended to support the event rather than residents.

  14. Suicides among Older United States Residents: Epidemiologic Characteristics and Trends.

    ERIC Educational Resources Information Center

    Meehan, Patrick J.; And Others

    1991-01-01

    Suicide mortality rates are analyzed for older adults (Blacks, Whites, males, and females) using national mortality data for 1980 through 1986. Elderly White males have the highest rates and have experienced an increase of 23 percent. The rate for Black males rose by 42 percent. Implications for social policy are discussed. (SLD)

  15. Predictors of regular exercise among older residents of long-term care institutions.

    PubMed

    Chen, Yuh-Min; Li, Yueh-Ping; Yen, Min-Ling

    2016-06-01

    The purpose of this study was to apply self-efficacy theory to explore predictors of regular exercise among older residents of long-term care institutions. Convenience sampling was used to collect data from 151 older adults residing in three residential care homes in Taiwan. Data collection instruments included a background data sheet, Self Efficacy for Exercise Scale, Outcome Expectations for Exercise Scale and self-reported regular exercise. Results indicated that older residents who exercised regularly had fewer chronic diseases, better perceived health status and functional status, and higher self-efficacy expectations and outcome expectations related to exercise. Older residents with a regular exercise habit prior to institutionalization were more likely to engage in regular exercise. Logistic regression analysis indicated past exercise participation and self-efficacy expectations to be significant positive predictors of regular exercise. To promote regular exercise within this population, these can be potential target areas for interventions. These factors should be targeted in the development and implementation of interventions to promote regular exercise among older residents of long-term care institutions.

  16. Operationalizing frailty among older residents of assisted living facilities

    PubMed Central

    2011-01-01

    Background Frailty in later life is viewed as a state of heightened vulnerability to poor outcomes. The utility of frailty as a measure of vulnerability in the assisted living (AL) population remains unexplored. We examined the feasibility and predictive accuracy of two different interpretations of the Cardiovascular Health Study (CHS) frailty criteria in a population-based sample of AL residents. Methods CHS frailty criteria were operationalized using two different approaches in 928 AL residents from the Alberta Continuing Care Epidemiological Studies (ACCES). Risks of one-year mortality and hospitalization were estimated for those categorized as frail or pre-frail (compared with non-frail). The prognostic significance of individual criteria was explored, and the area under the ROC curve (AUC) was calculated for select models to assess the utility of frailty in predicting one-year outcomes. Results Regarding feasibility, complete CHS criteria could not be assessed for 40% of the initial 1,067 residents. Consideration of supplementary items for select criteria reduced this to 12%. Using absolute (CHS-specified) cut-points, 48% of residents were categorized as frail and were at greater risk for death (adjusted risk ratio [RR] 1.75, 95% CI 1.08-2.83) and hospitalization (adjusted RR 1.54, 95% CI 1.20-1.96). Pre-frail residents defined by absolute cut-points (48.6%) showed no increased risk for mortality or hospitalization compared with non-frail residents. Using relative cut-points (derived from AL sample), 19% were defined as frail and 55% as pre-frail and the associated risks for mortality and hospitalization varied by sex. Frail (but not pre-frail) women were more likely to die (RR 1.58 95% CI 1.02-2.44) and be hospitalized (RR 1.53 95% CI 1.25-1.87). Frail and pre-frail men showed an increased mortality risk (RR 3.21 95% CI 1.71-6.00 and RR 2.61 95% CI 1.40-4.85, respectively) while only pre-frail men had an increased risk of hospitalization (RR 1.58 95% CI 1

  17. Listening to older adults: elderly patients' experience of care in residency and practicing physician outpatient clinics.

    PubMed

    Hess, Brian J; Lynn, Lorna A; Conforti, Lisa N; Holmboe, Eric S

    2011-05-01

    The population of people aged 65 and older is rapidly growing. Research has demonstrated significant quality gaps in the clinical care of older patients in the United States, especially in training programs. Little is known about how older patients' experience with care delivered in residency clinics compares with that delivered by practicing physicians. Using patient surveys from the American Board of Internal Medicine Care of the Vulnerable Elderly Practice Improvement Module, the quality of care provided to adults aged 65 and older by 52 internal medicine and family medicine residency clinics and by a group of 144 practicing physicians was studied. The residency clinics received 2,213 patient surveys, and the practicing physicians received 4,204. Controlling for age and overall health status, patients from the residency clinic sample were less likely to report receiving guidance and interventions for important aspects of care for older adults than patients from the practicing physician sample. The largest difference was observed in providing ways to help patients prevent falls or treat problems with balance or walking (42.1% vs 61.8%, P<.001). Patients from the residency clinic sample were less likely to rate their overall care as high (77.5% vs 88.8%, P<.001). Patient surveys reveal important deficiencies in processes of care that are more pronounced for patients cared for in residency clinics. Quality of patient experience and communication are vital aspects of overall quality of care, especially for older adults. Physician education at all levels, faculty development, and practice system redesign are needed to ensure that the care needs of older adults are met. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  18. A mapper's reflection on Dementia Care Mapping with older residents living in a nursing home.

    PubMed

    Mansah, Martha; Coulon, Lyn; Brown, Peter

    2008-06-01

    Aim and objective.  This paper explores reflection stemming from a Dementia Care Mapper's own learning and development concerning person-centred care with older residents living in a dementia specific nursing home. Background.  Dementia Care Mapping has been employed in few Australian residential care facilities to promote person-centred care and the well-being of residents. Reflection has also been used selectively in some practices to improve and evaluate the care process. However, contemporary nursing literature has failed to highlight the usefulness of applying reflection following Dementia Care Mapping with older residents. Method.  The mapper's reflections arose from the Dementia Care Mapping observation of five older residents and writing a daily reflective journal. Findings.  From the reflection, a dominant major theme emerged named as the Learning Experience from Mapping Residents with two sub-themes entitled Mapper's Identification of Resident's Unique Needs and Mapper's Empowerment of Clinicians. Dementia Care Mapping recommendations from the mapper's experience highlighted effective approaches to conducting Dementia Care Mapping in residential care facilities. Conclusions.  The valuable process of reflection to Dementia Care Mapping provided the mapper with clinical insights. Further from the mapper's final reflection, a poem entitled Come Back Mind, Come Back to Me was conceived and penned. Relevance to clinical practice.  The mapper's engagement in ongoing reflection incorporated with Dementia Care Mapping has the potential to promote best practice for the care of older people living in aged care facilities.

  19. Effects of integrated dental care on oral treatment needs in residents of nursing homes older than 70 years.

    PubMed

    Gerritsen, Paul; Cune, Marco; van der Bilt, Andries; Abbink, Jan; de Putter, Cornelis

    2015-01-01

    To determine effects of integrated dental care in older nursing home residents. In three nursing homes offering integrated dental care, we studied the oral treatment need of 355 residents older than 70 years. To determine effects of integrated care, we discriminated between short-stay residents (≤6 months) and long-term residents (>6 months). Treatment need, determined intraorally by two dentists, remains high among short-stay residents (78%) and long-term residents (67%). The association between treatment need and length of stay was not significantly affected by indication for stay (somatic vs. psychogeriatric). All dentate residents needed oral treatment, except one long-term resident. However, among edentulous residents, particularly with a psychogeriatric indication for stay, treatment need appeared to reduce significantly in time, from 74% to 57%. Despite integrated dental care, oral treatment need remains in virtually all dentate residents and more than half of edentulous residents. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  20. Managing gait disorders in older persons residing in nursing homes: a review of literature.

    PubMed

    Canavan, Paul K; Cahalin, Lawrence P; Lowe, Susan; Fitzpatrick, Diane; Harris, Meredith; Plummer-D'Amato, Prudence

    2009-05-01

    Managing gait disorders in the nursing home setting is a challenge. Nursing home residents can present with a variety of factors that may contribute to the presentation of gait abnormalities. The development of an individualized intervention program can be effective in improving a resident's ability to ambulate. This article reviews the research pertaining to the management of gait disorders including deconditioning, therapeutic exercise intervention, dementia, and cardiovascular and cardiopulmonary systems. The review provides the reader with strategies to help improve and understand gait performance in older persons residing in nursing homes.

  1. Meeting American Geriatrics Society Competencies: Are Residents Meeting Expectations for Quality Care of Older Adults?

    PubMed

    Bynum, Debra L; Wilson, Lindsay A; Ong, Thuan; Callahan, Kathryn E; Dalton, Thomas; Ohuabunwa, Ugochi

    2015-09-01

    In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%. Residents reported that they often do not demonstrate all of the AGS recommended core competencies when caring for older adults in the hospital setting. Residents report more frequently performing activities that are routinely integrated into hospital systems such as reviewing medication lists, working with an interdisciplinary team, evaluating for inappropriate bladder catheters, and evaluating for pressure ulcers. There were no consistent differences between institutions and only minor differences noted between Family Medicine and Internal Medicine residents. Operationalizing core competencies by integrating them into hospital systems' quality process indicators may prompt more consistent high-quality care and ensure systems support residents' competence.

  2. A psychoeducational codependency support group for older adults who reside in the community: friends supporting friends.

    PubMed

    McIinnis-Perry, Gloria J; Good, Jim M

    2006-08-01

    Older adults with loved ones who are dependent on alcohol or drugs often experience the adverse effects of a codependent relationship. Many experience anxiety, low self-esteem, depression, and suicidal thoughts. A pilot psychoeducational codependency support group was developed to promote well-being and reduce the adverse effects of codependency among older persons. The study participants were a voluntary convenience sample of 22 older adults (ages 65 and older) residing in the community. A pretest and posttest were administered. Six 90-minute group sessions based on a curriculum developed by the authors were held during a 2-month period. Yalom's Therapeutic Factors were used to evaluate the group process. Results indicated that older adults benefit from a psychoeducational support group format and that codependency issues can be reduced.

  3. Stress and Depression among Older Residents in Religious Monasteries: Do Friends and God Matter?

    ERIC Educational Resources Information Center

    Bishop, Bishop J.

    2008-01-01

    The purpose of this investigation was to explore how friendship and attachment to God provide protective benefits against stress and depression. Participants included 235 men and women, age 64 and older, residing in religious monasteries affiliated with the Order of St. Benedict. Hierarchical multiple regression analyses were completed to assess…

  4. Birth Outcomes among Older Mothers in Rural versus Urban Areas: A Residence-Based Approach

    ERIC Educational Resources Information Center

    Lisonkova, Sarka; Sheps, Samuel B.; Janssen, Patricia A.; Lee, Shoo K.; Dahlgren, Leanne; MacNab, Ying C.

    2011-01-01

    Purpose: We examined the association between rural residence and birth outcomes in older mothers, the effect of parity on this association, and the trend in adverse birth outcomes in relation to the distance to the nearest hospital with cesarean-section capacity. Methods: A population-based retrospective cohort study, including all singleton…

  5. Birth Outcomes among Older Mothers in Rural versus Urban Areas: A Residence-Based Approach

    ERIC Educational Resources Information Center

    Lisonkova, Sarka; Sheps, Samuel B.; Janssen, Patricia A.; Lee, Shoo K.; Dahlgren, Leanne; MacNab, Ying C.

    2011-01-01

    Purpose: We examined the association between rural residence and birth outcomes in older mothers, the effect of parity on this association, and the trend in adverse birth outcomes in relation to the distance to the nearest hospital with cesarean-section capacity. Methods: A population-based retrospective cohort study, including all singleton…

  6. Stress and Depression among Older Residents in Religious Monasteries: Do Friends and God Matter?

    ERIC Educational Resources Information Center

    Bishop, Bishop J.

    2008-01-01

    The purpose of this investigation was to explore how friendship and attachment to God provide protective benefits against stress and depression. Participants included 235 men and women, age 64 and older, residing in religious monasteries affiliated with the Order of St. Benedict. Hierarchical multiple regression analyses were completed to assess…

  7. More than A to B: the role of free bus travel for the mobility and wellbeing of older citizens in London.

    PubMed

    Green, Judith; Jones, Alasdair; Roberts, Helen

    2014-03-01

    This study contributes to the literature on mobility and wellbeing at older ages through an empirical exploration of the meanings of free bus travel for older citizens, addressing the meanings this holds for older people in urban settings, which have been under-researched. Taking London as a case study, where older citizens have free access to a relatively extensive public transport network through a Freedom Pass, we explore from a public health perspective the mechanisms that link this travel benefit to determinants of wellbeing. In addition to the ways in which the Freedom Pass enabled access to health-related goods and services, it provided less tangible benefits. Travelling by bus provided opportunities for meaningful social interaction; travelling as part of the 'general public' provided a sense of belonging and visibility in the public arena - a socially acceptable way of tackling chronic loneliness. The Freedom Pass was described not only as providing access to essential goods and services but also as a widely prized mechanism for participation in life in the city. We argue that the mechanisms linking mobility and wellbeing are culturally, materially and politically specific. Our data suggest that in contexts where good public transport is available as a right, and bus travel not stigmatised, it is experienced as a major contributor to wellbeing, rather than a transport choice of last resort. This has implications for other jurisdictions working on accessible transport for older citizens and, more broadly, improving the sustainability of cities.

  8. Sexual Abuse of Older Residents in Nursing Homes: A Focus Group Interview of Nursing Home Staff

    PubMed Central

    Iversen, Maria Helen; Kilvik, Astrid; Malmedal, Wenche

    2015-01-01

    The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees' thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents' vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area. PMID:26078879

  9. Current Practices and Opportunities in a Resident Clinic Regarding the Care of Older Adults with Multimorbidity.

    PubMed

    Schoenborn, Nancy L; Boyd, Cynthia M; McNabney, Matthew; Ray, Anushree; Cayea, Danelle

    2015-08-01

    Multimorbidity (≥2 chronic conditions) affects more than half of all older adults. The American Geriatrics Society developed and published guiding principles for the care of older adults with multimorbidity in 2012. Improved clinician training in caring for older adults with multimorbidity is needed, but it is not clear what opportunities arise within clinical encounters to apply the guiding principles or how clinicians at all stages of training currently practice in this area. This project aimed to characterize current practice and opportunities for improvement in an internal medicine residency clinic regarding the care of older adults with multimorbidity. Qualitative content analysis of audio-recorded clinic visits. Thirty clinic visits between 21 internal medicine residents and 30 of their primary care patients aged 65 and older with two or more chronic conditions were audio-recorded. Patients' mean age was 73.6, and they had on average 3.7 chronic conditions and took 12.6 medications. Transcripts of the audio-recorded visit discussions were analyzed using standard techniques of qualitative content analysis to describe the content and frequency of discussions in the clinic visits related to the five guiding principles: patient preferences, interpreting the evidence, prognosis, clinical feasibility, and optimizing therapies. All visits except one included discussions that were thematically related to at least one guiding principle, suggesting regular opportunities to apply the guiding principles in primary care encounters with internal medicine residents. Discussions related to some guiding principles occurred much more frequently than others. Patients presented a number of opportunities to incorporate the guiding principles that the residents missed, suggesting target areas for future educational interventions. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  10. Current Practices and Opportunities in a Resident Clinic Regarding the Care of Older Adults with Multimorbidity

    PubMed Central

    Schoenborn, Nancy L.; Boyd, Cynthia M.; McNabney, Matthew; Ray, Anushree; Cayea, Danelle

    2015-01-01

    OBJECTIVES Multimorbidity (≥2 chronic conditions) affects more than half of all older adults. The American Geriatrics Society developed and published guiding principles for the care of older adults with multimorbidity in 2012. Improved clinician training in caring for older adults with multimorbidity is needed, but it is not clear what opportunities arise within clinical encounters to apply the guiding principles or how clinicians at all stages of training currently practice in this area. This project aimed to characterize current practice and opportunities for improvement in an internal medicine residency clinic regarding the care of older adults with multimorbidity. DESIGN Qualitative content analysis of audio-recorded clinic visits. SETTING AND PARTICIPANTS Thirty clinic visits between 21 internal medicine residents and 30 of their primary care patients aged 65 and older with two or more chronic conditions were audio-recorded. Patients’ mean age was 73.6, and they had on average 3.7 chronic conditions and took 12.6 medications. MEASUREMENTS Transcripts of the audio-recorded visit discussions were analyzed using standard techniques of qualitative content analysis to describe the content and frequency of discussions in the clinic visits related to the five guiding principles: patient preferences, interpreting the evidence, prognosis, clinical feasibility, and optimizing therapies. RESULTS AND CONCLUSIONS All visits except one included discussions that were thematically related to at least one guiding principle, suggesting regular opportunities to apply the guiding principles in primary care encounters with internal medicine residents. Discussions related to some guiding principles occurred much more frequently than others. Patients presented a number of opportunities to incorporate the guiding principles that the residents missed, suggesting target areas for future educational interventions. PMID:26200347

  11. Prevalence and risk factors of sarcopenia among nursing home older residents.

    PubMed

    Landi, Francesco; Liperoti, Rosa; Fusco, Domenico; Mastropaolo, Simona; Quattrociocchi, Davide; Proia, Anna; Russo, Andrea; Bernabei, Roberto; Onder, Graziano

    2012-01-01

    Sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals. At present, there are no data on sarcopenia in nursing home population. We evaluated the prevalence of sarcopenia and its association with functional and clinical status in a population of elderly persons aged 70 years and older living in nursing homes. This study was conducted selecting all the participants (n = 122) living in the teaching nursing homes of Catholic University of Rome who were aged 70 years and older from August 1, 2010, to September 30, 2010. The European Working Group on Sarcopenia in Older People (EWGSOP) criteria were adopted. Accordingly, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. Forty residents (32.8%) were identified as affected by sarcopenia. The multivariate logistic regression analysis showed a high increase in risk of sarcopenia for male residents (odds ratio [OR] 13.39; 95% confidence interval [CI] 3.51-50.63) and for residents affected by cerebrovascular disease (OR 5.16; 95% CI 1.03-25.87) or osteoarthritis (OR 7.24; 95% CI 2.02-25.95). Residents who had a body mass index higher than 21 kg/m(2) had a lower risk to be sarcopenic (OR 0.76; 95% CI 0.64-0.90) relative to those with body mass index less than 21 kg/m(2). Similarly, sarcopenia was less likely to be present among participants involved in leisure physical activity for 1 hour or more per day (OR 0.40; 95% CI 0.12-0.98). The present study suggests that among participants living in nursing homes, sarcopenia is highly prevalent and it is more represented among male residents (68%) than among female residents (21%). Our findings support the hypothesis that muscle mass is strongly associated with nutritional status and physical activity in nursing homes, too.

  12. Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador.

    PubMed

    Orces, Carlos H

    2015-01-01

    To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and its determinants among older adults in Ecuador. 25(OH)D deficiency and insufficiency prevalence rates were examined among participants in the National Survey of Health, Wellbeing, and Aging. Logistic regression models were used to evaluate demographic characteristics associated with 25(OH)D deficiency. Of 2,374 participants with a mean age of 71.0 (8.3) years, 25(OH)D insufficiency and deficiency were present in 67.8% (95% CI, 65.3-70.2) and 21.6% (95% CI, 19.5-23.7) of older adults in Ecuador, respectively. Women (OR, 3.19; 95% CI, 3.15-3.22), self-reported race as Indigenous (OR, 2.75; 95% CI, 2.70-2.80), and residents in rural (OR, 4.49; 95% CI, 4.40-4.58) and urban (OR, 2.74; 95% CI, 2.69-2.80) areas of the Andes Mountains region were variables significantly associated with 25(OH)D deficiency among older adults. Despite abundant sunlight throughout the year in Ecuador, 25(OH)D deficiency was significantly prevalent among older women, Indigenous subjects, and subjects residing in the Andes Mountains region of the country. The present findings may assist public health authorities to implement policies of vitamin D supplementation among older adults at risk for this condition.

  13. Toward the equivalence of the HIT and HIT 25 in community-residing older adults.

    PubMed

    Hayslip, B; Francis, J R

    1991-06-01

    In a study by the first author wherein 102 community-residing older adults were administered the Holtzman Inkblot Technique (HIT), data collected were analyzed regarding the equivalence of the HIT and the HIT 25. Although alpha coefficients and split-half correlations were low when single-response-per-card data were analyzed, corrected Spearman-Brown coefficients were more supportive of the use of the HIT 25 with older adults. These data suggest that although a shortened form of the HIT may be useful with aged persons, research exploring the substantive bases for creating a shortened version of the HIT is nevertheless necessary.

  14. The social environment of nursing homes and the health of older residents.

    PubMed

    Zurakowski, T L

    2000-07-01

    This study investigated the effects of two social environment variables, social support and anomia, on the self-reported health of older nursing home residents. Three specific hypotheses were tested as well as the fit of the data to the proposed theory. A nonrandom, convenience sample of 91 nursing home residents was drawn from four nursing homes. Only whites who could speak and understand English and who were judged to be cognitively intact or only mildly cognitively impaired were included. The data were analyzed using path analysis. Only one hypothesis asserting that anomia will have direct negative effects on self-reported health was fully supported.

  15. Older residents' perspectives on aged sexuality in institutionalized elderly care: a systematic literature review.

    PubMed

    Mahieu, Lieslot; Gastmans, Chris

    2015-12-01

    The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential

  16. Protocol for a process-oriented qualitative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme using the Researcher-in-Residence model

    PubMed Central

    Eyre, Laura; George, Bethan; Marshall, Martin

    2015-01-01

    Introduction The integration of health and social care in England is widely accepted as the answer to fragmentation, financial concerns and system inefficiencies, in the context of growing and ageing populations with increasingly complex needs. Despite an expanding body of literature, there is little evidence yet to suggest that integrated care can achieve the benefits that its advocates claim for it. Researchers have often adopted rationalist and technocratic approaches to evaluation, treating integration as an intervention rather than a process. Results have usually been of limited use to practitioners responsible for health and social care integration. There is, therefore, a need to broaden the evidence base, exploring not only what works but also how integrated care can most successfully be implemented and delivered. For this reason, we are carrying out a formative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme. Our expectation is that this will add value to the literature by focusing on the processes by which the vision and objectives of integrated care are translated through phases of development, implementation and delivery from a central to a local perspective, and from a strategic to an operational perspective. Methods and analysis The qualitative and process-oriented evaluation uses an innovative participative approach—the Researcher-in-Residence model. The evaluation is underpinned by a critical ontology, an interpretive epistemology and a critical discourse analysis methodology. Data will be generated using interviews, observations and documentary gathering. Ethics and dissemination Emerging findings will be interpreted and disseminated collaboratively with stakeholders, to enable the research to influence and optimise the effective implementation of integrated care across WELC. Presentations and publications will ensure that learning is shared as widely as possible. The study has received

  17. Protocol for a process-oriented qualitative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme using the Researcher-in-Residence model.

    PubMed

    Eyre, Laura; George, Bethan; Marshall, Martin

    2015-11-06

    The integration of health and social care in England is widely accepted as the answer to fragmentation, financial concerns and system inefficiencies, in the context of growing and ageing populations with increasingly complex needs. Despite an expanding body of literature, there is little evidence yet to suggest that integrated care can achieve the benefits that its advocates claim for it. Researchers have often adopted rationalist and technocratic approaches to evaluation, treating integration as an intervention rather than a process. Results have usually been of limited use to practitioners responsible for health and social care integration. There is, therefore, a need to broaden the evidence base, exploring not only what works but also how integrated care can most successfully be implemented and delivered. For this reason, we are carrying out a formative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme. Our expectation is that this will add value to the literature by focusing on the processes by which the vision and objectives of integrated care are translated through phases of development, implementation and delivery from a central to a local perspective, and from a strategic to an operational perspective. The qualitative and process-oriented evaluation uses an innovative participative approach-the Researcher-in-Residence model. The evaluation is underpinned by a critical ontology, an interpretive epistemology and a critical discourse analysis methodology. Data will be generated using interviews, observations and documentary gathering. Emerging findings will be interpreted and disseminated collaboratively with stakeholders, to enable the research to influence and optimise the effective implementation of integrated care across WELC. Presentations and publications will ensure that learning is shared as widely as possible. The study has received ethical approval from University College London's Research Ethics

  18. Assessing spiritual well-being in residents of nursing homes for older people using the FACIT-Sp-12: a cognitive interviewing study.

    PubMed

    Hall, Sue; Beatty, Sharon

    2014-08-01

    To detect any problems with completion of the Functional Assessment of Chronic Illness Therapy Spiritual Well-being Scale (FACIT-Sp-12), to analyse the causes of such problems and to propose solutions to overcome them. We audio-recorded face-to-face interviews with 17 older people living in one of three nursing homes in London, UK, while they completed FACIT-Sp-12. We used cognitive interviewing methods to explore residents' responses. Our analysis was based on the Framework approach to qualitative analysis. We developed the framework of themes a priori. These comprised: comprehension of the question; retrieval from memory of relevant information; decision processes; and response processes. Ten residents completed the FACIT-Sp-12 with no missing data. Most problems involved comprehension and/or selecting response options. Twelve residents had problems with comprehension of at least one question, particularly with abstract concepts (e.g. harmony, productivity), or where there were assumptions inherent in the questions (e.g. they had an illness). When residents had problems comprehending the question, they also found it difficult to select a response. Thirteen residents had difficulties selecting responses (e.g. categories did not reflect their views or were not meaningful in the context of the statement). Some chose not to respond, others responded to the question as they understood it. The FACIT-Sp-12 could provide valuable insights into the spiritual concerns of nursing home residents; however, data may be neither valid nor reliable if they do not comprehend the questions as intended and respond appropriately. Providing clear and detailed instructions, including definitions of abstract concepts, may improve the validity of this measure for this population.

  19. Environmental correlates of overweight and obesity in community residing older adults.

    PubMed

    Eisenstein, Amy R; Prohaska, Thomas R; Kruger, Judy; Satariano, William A; Hooker, Steven; Buchner, David; Kealey, Melissa; Hunter, Rebecca H

    2011-09-01

    This study examines the role of environmental correlates of overweight and obesity among older adults independent of walking activity and lower body function. In-person interviews were conducted with 789 adults aged 65 and older, residing in four areas in the U.S. Demographic information, general health, lower body function, walking behavior, and awareness of environmental infrastructure features using the modified Neighborhood Environment Walking Survey (NEWS) were obtained. Regression analyses examined the association between Body Mass Index (BMI) and environmental infrastructure features, adjusting for demographics and lower body function. Older adults who perceived their neighborhood as less safe from crime and had reduced access to services were more likely to have higher BMI. Controlling for demographic and functional characteristics, access to services remained significant. This association remained significant for those with lower functional status. This research suggests that neighborhood environment may have an influence on BMI above and beyond walking activity.

  20. Relationships of assertiveness, depression, and social support among older nursing home residents.

    PubMed

    Segal, Daniel L

    2005-07-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age = 75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r = -.33), but the correlations between social support and depression (r = -.15) and between social support and assertiveness (r = -.03) were small and nonsignificant. The correlation between overall physical health (a subjective self-rating) and depression was strong and negative (r = -.50), with lower levels of health associated with higher depression. An implication of this study is that an intervention for depression among nursing home residents that is targeted at increasing assertiveness and bolstering health status may be more effective than the one that solely targets social support.

  1. Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

    PubMed

    Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

    2015-01-01

    The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador

    PubMed Central

    Orces, Carlos H.

    2015-01-01

    Objectives. To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and its determinants among older adults in Ecuador. Methods. 25(OH)D deficiency and insufficiency prevalence rates were examined among participants in the National Survey of Health, Wellbeing, and Aging. Logistic regression models were used to evaluate demographic characteristics associated with 25(OH)D deficiency. Results. Of 2,374 participants with a mean age of 71.0 (8.3) years, 25(OH)D insufficiency and deficiency were present in 67.8% (95% CI, 65.3–70.2) and 21.6% (95% CI, 19.5–23.7) of older adults in Ecuador, respectively. Women (OR, 3.19; 95% CI, 3.15–3.22), self-reported race as Indigenous (OR, 2.75; 95% CI, 2.70–2.80), and residents in rural (OR, 4.49; 95% CI, 4.40–4.58) and urban (OR, 2.74; 95% CI, 2.69–2.80) areas of the Andes Mountains region were variables significantly associated with 25(OH)D deficiency among older adults. Conclusions. Despite abundant sunlight throughout the year in Ecuador, 25(OH)D deficiency was significantly prevalent among older women, Indigenous subjects, and subjects residing in the Andes Mountains region of the country. The present findings may assist public health authorities to implement policies of vitamin D supplementation among older adults at risk for this condition. PMID:26301259

  3. Health-Related Quality of Life in Older Coastal Residents After Multiple Disasters.

    PubMed

    Cherry, Katie E; Sampson, Laura; Galea, Sandro; Marks, Loren D; Baudoin, Kayla H; Nezat, Pamela F; Stanko, Katie E

    2017-02-01

    Exposure to multiple disasters, both natural and technological, is associated with extreme stress and long-term consequences for older adults that are not well understood. In this article, we address age differences in health-related quality of life in older disaster survivors exposed to the 2005 Hurricanes Katrina and Rita and the 2010 BP Deepwater Horizon oil spill and the role played by social engagement in influencing these differences. Participants were noncoastal residents, current coastal residents, and current coastal fishers who were economically affected by the BP oil spill. Social engagement was estimated on the basis of disruptions in charitable work and social support after the 2005 hurricanes relative to a typical year before the storms. Criterion measures were participants' responses to the SF-36 Health Survey which includes composite indexes of physical (PCS) and mental (MCS) health. The results of logistic regressions indicated that age was inversely associated with SF-36 PCS scores. A reduction in perceived social support after Hurricane Katrina was also inversely associated with SF-36 MCS scores. These results illuminate risk factors that impact well-being among older adults after multiple disasters. Implications of these data for psychological adjustment after multiple disasters are considered. (Disaster Med Public Health Preparedness. 2017;11:90-96).

  4. Cultural perspectives of older nursing home residents regarding signing their own DNR directives in Eastern Taiwan: a qualitative pilot study.

    PubMed

    Lee, Hsin-Tzu Sophie; Cheng, Shu-Chen; Dai, Yu-Tzu; Chang, Mei; Hu, Wen-Yu

    2016-05-06

    Chinese tradition and culture developed from Taoism, Confucianism, and Buddhism and have influenced ethnic Chinese for thousands of years, particularly thoughts on death. Many ethnic Chinese, particularly older people, refrain from discussing death-related concerns, making it difficult to obtain advance directives, including do-not-resuscitate (DNR) directives, signed independently by older people. This study explored the attitudes of older nursing home residents in Taiwan toward signing their own DNR directives. This study adopted purposive sampling and collected data through in-depth interviews. The data were analysed using qualitative inductive content analysis, and the study location was a nursing home in Eastern Taiwan. A total of 11participants were recruited from a sample of 12 eligible participants. Most of the older residents in this study refused to make decisions independently regarding DNR directives. Content analysis of the interviews revealed four themes concerning refusing to sign DNR directives independently: not going against nature, accepting the results of cause and effect, viewing the family as a decision-making system, and practising self-effacement. Chinese cultural aspects, including Taoist, Buddhist, and Confucian philosophy, affected the autonomy of the older residents, and they relied on others to make decisions for them. Professionals must respect this family-oriented decision-making thinking of older residents because it reflects personal choice. Otherwise, healthcare providers may play a mediating role in coordinating and communicating between older residents and their families regarding EOL-care-related concerns, replacing the traditional practice of holding a family meeting.

  5. Different Ways of Experiencing Music-Making in Later Life: Creative Music Sessions for Older Learners in East London

    ERIC Educational Resources Information Center

    Varvarigou, Maria; Hallam, Susan; Creech, Andrea; McQueen, Hilary

    2013-01-01

    There has been a gradual increase in the body of literature regarding seniors' musical preferences, learning approaches, development, and creativity. This literature dispels existing myths that perceive older people as a homogeneous group, characterized by decrepitude and diminishing capacity, and with a passive contribution to society. A…

  6. Different Ways of Experiencing Music-Making in Later Life: Creative Music Sessions for Older Learners in East London

    ERIC Educational Resources Information Center

    Varvarigou, Maria; Hallam, Susan; Creech, Andrea; McQueen, Hilary

    2013-01-01

    There has been a gradual increase in the body of literature regarding seniors' musical preferences, learning approaches, development, and creativity. This literature dispels existing myths that perceive older people as a homogeneous group, characterized by decrepitude and diminishing capacity, and with a passive contribution to society. A…

  7. Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities.

    PubMed

    Celso, B G; Ebener, D J; Burkhead, E J

    2003-11-01

    The present study examined the relationships between humor coping, health status, and life satisfaction among older residents of assisted living facilities. A structural equation model with latent variables was specified for the three variables. Health status was expected to directly affect humor coping and life satisfaction. Humor coping was hypothesized to have a direct association with life satisfaction and indirectly affect the relationship between health status and life satisfaction. Participants completed the Multidimensional Functional Assessment Questionnaire, Coping Humor Scale, and Life Satisfaction Index A. The relationships between health status and humor coping and health status and life satisfaction were statistically significant. Both the direct association of humor coping on life satisfaction and the intervening role between health status and life satisfaction were not supported. Humor as a coping strategy seems to be available to older adults who are in better health.

  8. Exploring the dynamics of middle-aged and older adult residents' perceptions of neighborhood safety.

    PubMed

    Pitner, Ronald O; Yu, Mansoo; Brown, Edna

    2011-07-01

    This study examined what variables best predict concerns about neighborhood safety among middle-aged and older adults. Eighty-five participants were selected from a Midwestern urban area. Participants completed a 22-item questionnaire that assessed their perceptions of neighborhood safety and vigilance. These items were clustered as: (a) community care and vigilance, (b) safety concerns, (c) physical incivilities, and (d) social incivilities. Police crime data were also used in the analyses. Our findings suggest that aspects of the broken window theory, collective efficacy, and place attachments play a role in affecting residents' perceptions of neighborhood safety.

  9. Use of Antipsychotics among Older Residents in Veterans Administration Nursing Homes

    PubMed Central

    Gellad, WF; Aspinall, SL; Handler, SM; Stone, RA; Castle, N; Semla, TP; Good, CB; Fine, MJ; Dysken, M; Hanlon, JT

    2013-01-01

    Background Antipsychotic medications are commonly prescribed to nursing home residents despite their well-established adverse event profiles. Because little is known about their use in Veterans Administration(VA) nursing homes (i.e., Community Living Centers(CLCs)), we assessed the prevalence and risk factors for their use in older residents of VA CLCs. Methods This cross-sectional study included 3,692 Veterans ≥age 65 who were admitted between January 2004-June 2005 to one of 133 VA CLCs and had a stay of ≥90 days. We used VA Pharmacy Benefits Management data to examine antipsychotic use and VA Medical SAS datasets and the Minimum Data Set to identify evidence-based indications for antipsychotic use (e.g., schizophrenia, dementia with psychosis). We used multivariable logistic regression with generalized estimating equations to identify factors independently associated with antipsychotic use. Results Overall, 948/3,692(25.7%) residents used an antipsychotic, of which 59.3% had an evidence-based indication for use. Residents with aggressive behavior (odds ratio[OR]=2.74, 95% confidence interval[CI]=2.04-3.67) and polypharmacy (9+ drugs; OR=1.84, 95%CI=1.41-2.40) were more likely to receive antipsychotics, as were users of antidepressants (OR=1.37, 95%CI=1.14-1.66), anxiolytic/hypnotics (OR=2.30, 95%CI=1.64-3.23) or drugs for dementia (OR=1.52, 95%CI=1.21-1.92). Those residing in Alzheimer's/dementia special care units were also more likely to use an antipsychotic (OR=1.66, 95%CI=1.26-2.21). Veterans with dementia but no documented psychosis were as likely as those with an evidence-based indication to receive an antipsychotic (OR=1.10, 95%CI=0.82-1.47). Conclusions Antipsychotic use is common in older VA CLC residents, including those without a documented evidence-based indication for use. Further quality improvement efforts are needed to reduce potentially inappropriate antipsychotic prescribing. PMID:23047785

  10. Health services access and use among older adults in North Carolina: urban vs rural residents.

    PubMed Central

    Blazer, D G; Landerman, L R; Fillenbaum, G; Horner, R

    1995-01-01

    OBJECTIVES. This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina. METHODS. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care. RESULTS. Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people. CONCLUSIONS. In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage. PMID:7573622

  11. Stress and depression among older residents in religious monasteries: do friends and God matter?

    PubMed

    Bishop, Alex J

    2008-01-01

    The purpose of this investigation was to explore how friendship and attach-0 ment to God provide protective benefits against stress and depression. Participants included 235 men and women, age 64 and older, residing in religious monasteries affiliated with the Order of St. Benedict. Hierarchical multiple regression analyses were completed to assess main and moderating effects of friendship and attachment to God relative to the influence of stress on depressive symptomology. Lower degree of friendship closeness (beta = -.12, p < .10) and greater insecurity with God (beta = -.15, p < .01) were directly associated with greater depressive symptoms. A significant three-way interaction (Stress x Friendship x Attachment to God) also existed relative to depressive symptoms (beta = .14, p < .05). Three "stress-buffering" mechanisms emerged relative to the influence of stress on depressive symptomology. First, a greater degree of friendship closeness in combination with less secure attachment to God represented a greater risk for depressive symptoms. Second, greater friendship closeness in combination with greater secure attachment to God reduced the risk for depressive symptoms. Third, lower degree of friendship closeness combined with less secure attachment to God diminished the noxious effects of stress on depressive symptoms. This has implications relative to how social and spiritual resources can be used to reduce stress and improve quality of life for older adults residing in religious communities.

  12. Resident-Managed Elder Intentional Neighborhoods: Do They Promote Social Resources for Older Adults?

    PubMed

    Glass, Anne P

    Social isolation has serious negative public health impacts for older adults. Survey data were collected at three resident-managed elder intentional neighborhoods in the United States (n = 59), to determine if these neighborhoods, each based on the cohousing model, promote development of social resources for their residents. Social resources were measured on three dimensions: social networks, neighborly support, and satisfaction with the neighborhood community. Respondents were White, mean age of 73.3 (range = 63-91), primarily female (76.3%), and generally had high levels of education and self-reported health. Almost half (47%) were never married/divorced and 37% were childless. Inclusion of neighborhood ties ameliorated risk of social isolation. Satisfaction with support and a variety of neighboring behaviors were reported. These neighborhoods are meeting the needs of a potentially at-risk population as an avenue to promote social resources and reduce social isolation. The implications for gerontological social workers include a role in helping to mobilize and support these types of neighborhoods as a way to encourage mutual support among older adults. With the increase in the aging population, such models of proactive interdependence and communal coping have the potential to lessen or delay the demands that socially isolated elders place on social workers.

  13. Effects of Horticultural Therapy on Psychosocial Health in Older Nursing Home Residents: A Preliminary Study.

    PubMed

    Chen, Yuh-Min; Ji, Jeng-Yi

    2015-09-01

    This preliminary study examined the effect of horticultural therapy on psychosocial health in older nursing home residents. A combined quantitative and qualitative design was adopted. Convenience sampling was used to recruit 10 older residents from a nursing home in Taichung, Taiwan. Participants joined a 10-week indoor horticultural program once a week, with each session lasting for about 1.5 hours. A single-group design with multiple measurements was adopted for the quantitative component of this study. Interviews held 1-2 days before the intervention (T0) were used to collect baseline data. The two outcome variables of this study, depression and loneliness, were reassessed during the 5th (T1) and 10th (T2) weeks of the intervention. Generalized estimating equations were used to test the mean differences among T0, T1, and T2 measures. After the 10-week program, qualitative data were collected by asking participants to share their program participation experiences. The results of generalized estimating equation showed significant improvements in depression and loneliness. Four categories emerged from the qualitative data content analysis: social connection, anticipation and hope, sense of achievement, and companionship. Given the beneficial effects of the horticulture therapy, the inclusion of horticultural activities in nursing home activity programs is recommended.

  14. Whose responsibility is it anyway? Hospital admission and discharge of older people in an inner-London District Health Authority.

    PubMed

    Victor, C R; Young, E; Hudson, M; Wallace, P

    1993-08-01

    The division of responsibilities that exists between primary and secondary health care services and health and social care services may create problems in the provision of care to patients whose needs mean that a number of different agencies are involved in their care. The objective of all the agencies involved is the smooth transfer of clients between different sectors of care provision. One client group thought to be particularly vulnerable to dislocations in the continuous pattern of care provision is older people. Problems over the division of responsibility between professional groups are particularly evident on admission to and discharge from hospital. It is the latter rather than the former aspect that has been the focus of research. An extensive multi-methods study of the admission and discharge of older people from hospital in an inter-city District Health Authority was undertaken. This paper examines the transfer of older people between different elements of the health and social care systems. Our study illustrates that on neither admission nor on discharge was there a clearly defined mechanism for affecting liaison between hospital and community. Clearly, the responsibility for this task must be delegated to a specific group. However, such responsibility must be given within a properly resourced and managed system, otherwise the current position of blurred responsibilities will remain. It is unclear as to how the reform of the National Health Service and the introduction of the internal market and the purchaser/provider division will aid the improved co-ordination which this study has identified as being required.

  15. Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

    PubMed Central

    Aspinall, Sherrie L.; Zhao, Xinhua; Semla, Todd P.; Cunningham, Francesca E.; Paquin, Allison M.; Pugh, Mary Jo; Schmader, Kenneth E.; Stone, Roslyn A.; Hanlon, Joseph T.

    2014-01-01

    Objectives Few studies have examined drug-disease interactions (DDIs) in older nursing home residents. Therefore, the objective is to describe the prevalence of, and factors associated with, DDIs according to The American Geriatrics Society 2012 Beers Criteria. Design Cross-sectional study. Setting Fifteen Veterans Affairs Community Living Centers. Participants Patients≥65 years old with a diagnosis of dementia/cognitive impairment, history of falls/hip fractures, heart failure (HF), history of peptic ulcer disease (PUD) and/or stage IV or V chronic kidney disease (CKD). Measurements Prevalence of medications that could exacerbate the above conditions (i.e., DDIs). Results Overall, 361 of 696 (51.9%) eligible residents had ≥1 DDI. None involved those with a history of PUD; one involved a resident with CKD, and four occurred in those with HF. In residents with dementia/cognitive impairment (N=540), 50.7% took a drug that could exacerbate these conditions; the most commonly involved medications were antipsychotics (35.4%) and benzodiazepines (14.4%). In those with a history of falls/hip fractures (N=267), 67.8% received an interacting medication, with SSRIs (33.1%), antipsychotics (30.7%) and anticonvulsants (25.1%) being most commonly involved. Using separate multivariable logistic regression models, factors associated with DDIs in both dementia/cognitive impairment and falls/fractures included: age 85+ (Adjusted Odds Ratio [aOR] and 95% confidence interval [CI] of 0.38; 0.24–0.60 and aOR 0.48; 95%CI 0.24–0.96, respectively); taking 5–8 medications (aOR 2.06; 95%CI 1.02–4.16 and aOR 4.76; 95%CI 1.68–13.5, respectively) and ≥9 medications (aOR 1.99; 95%CI 1.03–3.85 and aOR 3.68; 95%CI 1.41–9.61, respectively), and being a long stay patient (aOR 1.80; 95%CI 1.04–3.12 and aOR 2.35; 95%CI 1.12–4.91, respectively). Conclusion Drug-disease interactions were common in older nursing home residents with dementia/cognitive impairment and/or a history

  16. Access to primary care in Hong Kong, Greater London and New York City.

    PubMed

    Chau, Pui Hing; Woo, Jean; Gusmano, Michael K; Weisz, Daniel; Rodwin, Victor G; Chan, Kam Che

    2013-01-01

    We investigate avoidable hospital conditions (AHC) in three world cities as a way to assess access to primary care. Residents of Hong Kong are healthier than their counterparts in Greater London or New York City. In contrast to their counterparts in New York City, residents of both Greater London and Hong Kong face no financial barriers to an extensive public hospital system. We compare residence-based hospital discharge rates for AHC, by age cohorts, in these cities and find that New York City has higher rates than Hong Kong and Greater London. Hong Kong has the lowest hospital discharge rates for AHC among the population 15-64, but its rates are nearly as high as those in New York City among the population 65 and over. Our findings suggest that in contrast to Greater London, older residents in Hong Kong and New York face significant barriers in accessing primary care. In all three cities, people living in lower socioeconomic status neighborhoods are more likely to be hospitalized for an AHC, but neighborhood inequalities are greater in Hong Kong and New York than in Greater London.

  17. Fritz London

    NASA Astrophysics Data System (ADS)

    Gavroglu, Kostas

    2005-11-01

    Preface; Acknowledgements; Part I. From Philosophy to Physics: The years that left nothing unaffected; 1. The appeal of ideas; 2. Goëthe as a scientist; 3. How absolute is our knowledge?; 4. How do we come to know things?; 5. London's teachers in philosophy; 6. Husserl's teachings; 7. Expectations of things to come; 8. The thesis in philosophy; 9. Tolman's principle of similitude; 10. The necessary clarifications; 11. Work on quantum theory; 12. Transformation theory; 13. Unsuccessful attempts at unification; Part II. The Years in Berlin and the Beginnings of Quantum Chemistry: The mysterious bond; 14. London in Zürich; 15. Binding forces; 16. The Pauli principle; 17. Reactions to the Heitler-London paper; 18. Polyelectronic molecules and the application of group theory to problems of chemical valence; 19. Chemists as physicists?; 20. London's first contacts in Berlin; 21. Marriage; 22. Job offers; 23. Intermolecular forces; 24. The book which could not be written; 25. Leningrad and Rome; 26. Difficulties with group theory; 27. Linus Pauling's resonance structures; 28. Robert Mulliken's molecular orbitals; Part III. Oxford and Superconductivity: The rise of the Nazis; 29. Going to Oxford; 30. Lindemann, Simon and Heinz London; 31. Electricity in the very cold; 32. The end of old certainties; 33. The thermodynamic treatment; 34. The theory of Fritz and Heinz London; 35. Initial reactions by von Laue; 36. The discussion at the Royal Society; 37. Termination of the ICI fellowship; Part IV. Paris and Superfluidity: The Front Populaire; 38. The article in Nature 1937 and 'Nouvelle Conception'; 39. Laue again; 40. The structure of solid helium; 41. The peculiar properties of helium; 42. Bose-Einstein condensation; 43. The note in Nature; 44. The two-fluid model; 45. The trip to Jerusalem; 46. Leaving again; 47. The observer in quantum mechanics; Part V. United States and the Typing up of Loose Ends: Duke University, North Carolina; 48. The Soviet Union, Kapitza and

  18. Non-verbal communication of the residents living in homes for the older people in Slovenia.

    PubMed

    Zaletel, Marija; Kovacev, Asja Nina; Sustersic, Olga; Kragelj, Lijana Zaletel

    2010-09-01

    Aging of the population is a growing problem in all developed societies. The older people need more health and social services, and their life quality in there is getting more and more important. The study aimed at determining the characteristics of non-verbal communication of the older people living in old people's homes (OPH). The sample consisted of 267 residents of the OPH, aged 65-96 years, and 267 caregivers from randomly selected twenty-seven OPH. Three types of non-verbal communication were observed and analysed using univariate and multivariate statistical methods. In face expressions and head movements about 75% older people looked at the eyes of their caregivers, and about 60% were looking around, while laughing or pressing the lips together was rarely noticed. The differences between genders were not statistically significant while statistically significant differences among different age groups was observed in dropping the eyes (p = 0.004) and smiling (0.008). In hand gestures and trunk movements, majority of older people most often moved forwards and clenched fingers, while most rarely they stroked and caressed their caregivers. The differences between genders were statistically significant in leaning on the table (p = 0.001), and changing the position on the chair (0.013). Statistically significant differences among age groups were registered in leaning forwards (p = 0.006) and pointing to the others (p = 0.036). In different modes of speaking and paralinguistic signs almost 75% older people spoke normally, about 70% kept silent, while they rarely quarrelled. The differences between genders were not statistically significant while statistically significant differences among age groups was observed in persuasive speaking (p = 0.007). The present study showed that older people in OPH in Slovenia communicated significantly less frequently with hand gestures and trunk movements than with face expressions and head movements or different modes of speaking

  19. Biomedicine and 'Risky' Retirement Destinations: Older Western Residents in Ubud, Bali.

    PubMed

    Green, Paul

    2016-01-01

    International retirement migration is often conflated with the generic emergence of a new stage in the life course, the third age. I describe how well-travelled, globally orientated retirees are drawn to and experience biomedical provision in 'risky' retirement destinations. Drawing on ethnographic research in Ubud, Bali, Indonesia, I consider how older Western residents shape, share, and manage their health concerns in light of an Indonesian biomedical system that is transforming in the context of modern medical provision and an emerging retirement industry. Building on Rose and Novas's notion of biological citizenship, I illustrate the ways in which Western retirees engage with multiple biomedical realities built around localized, symbolic distinctions between 'hospital' and 'doctor,' immigration frameworks, the transregional context of medical tourism, and broader concerns relating to change and overdevelopment in Ubud and Bali.

  20. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    PubMed Central

    Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

    2017-01-01

    Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

  1. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services.

    PubMed

    Ewen, Heidi H; Washington, Tiffany R; Emerson, Kerstin G; Carswell, Andrew T; Smith, Matthew Lee

    2017-03-22

    Background: The majority of older adults prefer to remain in their homes, or to "age-in-place." To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults' residential environment is associated with their health status and HCBS utilization. Building upon the Person-Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well

  2. Undiagnosed Illness and Neuropsychiatric Behaviors In Community-residing Older Adults with Dementia1

    PubMed Central

    Hodgson, Nancy; Gitlin, Laura N.; Winter, Laraine; Czekanski, Kathleen

    2010-01-01

    The aim of this retrospective analysis was to examine prevalence of undiagnosed acute illness and characteristics including neuropsychiatric symptoms associated with illness in community-residing older adults with Alzheimer’s disease or related disorders. Subjects included 265 community-residing older adults with dementia who participated in one of two interventions being tested in randomized clinical trials. Measures included a brief nursing assessment and lab evaluations including complete blood count (CBC), blood chemistry (Chem 7), and thyroid function tests of serum samples and culture and sensitivity tests of urine samples. Undiagnosed illness was identified according to currently published criteria. Neuropsychiatric behaviors were assessed using 21 behaviors derived from standard measures. Thirty-six percent (N= 96) of patients had clinical findings indicative of undetected illness. Conditions most prevalent were bacteriuria (15%), followed by hyperglycemia (6%) and anemia (5%). The behavior most often demonstrated among those with detected illness was resisting or refusing care (66% versus 47% for those without detected illness). Individuals with detected illness had significantly lower functional status scores (3.8 vs. 4.4, t(275) = 7.01, p = .01), lower cognitive status scores (10.5 vs. 14.4, t(275) =12.1, p<.01) and were more likely to be prescribed psychotropic medications for behavior (41% vs. 26%, Chi2= 3.67, p<.05) than those without illness. Findings suggest that challenges of diagnosing acute illness with atypical presentation must be addressed to promote quality of care and the specialized needs for this vulnerable population. PMID:20921879

  3. Undiagnosed illness and neuropsychiatric behaviors in community residing older adults with dementia.

    PubMed

    Hodgson, Nancy A; Gitlin, Laura N; Winter, Laraine; Czekanski, Kathleen

    2011-01-01

    The aim of this retrospective analysis was to examine prevalence of undiagnosed acute illness and characteristics including neuropsychiatric symptoms associated with illness in community residing older adults with Alzheimer disease or related disorders. Subjects included 265 community residing older adults with dementia who participated in 1 of 2 interventions being tested in randomized clinical trials. Measures included a brief nursing assessment and laboratory evaluations including complete blood count, blood chemistry (Chem 7), and thyroid function tests of serum samples and culture and sensitivity tests of urine samples. Undiagnosed illness was identified according to currently published criteria. Neuropsychiatric behaviors were assessed using 21 behaviors derived from standard measures. Thirty-six percent (N=96) of patients had clinical findings indicative of undetected illness. Conditions most prevalent were bacteriuria (15%), followed by hyperglycemia (6%) and anemia (5%). The behavior most often demonstrated among those with detected illness was resisting or refusing care (66% vs. 47% for those without detected illness). Individuals with detected illness had significantly lower functional status scores [3.8 vs. 4.4, t(275)=7.01, P=0.01], lower cognitive status scores [10.5 vs. 14.4, t(275)=12.1, P<0.01], and were more likely to be prescribed psychotropic medications for behavior (41% vs. 26%, χ=3.67, P<0.05) than those without illness. Findings suggest that challenges of diagnosing acute illness with atypical presentation must be addressed to promote quality of care and the specialized needs for this vulnerable population.

  4. Factors Associated with the Risk of Falls of Nursing Home Residents Aged 80 or Older.

    PubMed

    Álvarez Barbosa, Francisco; Del Pozo-Cruz, Borja; Del Pozo-Cruz, Jesús; Alfonso-Rosa, Rosa M; Sañudo Corrales, Borja; Rogers, Michael E

    2016-01-01

    Falls are the leading cause of mortality and morbidity in older and represents one of the major and most costly public health problems worldwide. Evaluate the influences of lower limb muscle performance, static balance, functional independence and quality of life on fall risk as assessed with the timed up and go (TUG) test. Cross-sectional study. Fifty-two residents aged 80 or older were assessed and distributed in one of the two study groups (no risk of falls; risk of falls) according to the time to complete the TUG test. A Kistler force platform and linear transducer was used to determinate lower limb muscle performance. Postural Stability (static balance) was measured by recording the center of pressure. The EuroQol-5 dimension was used to assess Health-related quality of life and the Barthel index was used to examine functional status. Student's t-test was performed to evaluate the differences between groups. Correlations between variables were analyzed using Spearman or Pearson coefficient. ROC (receiver operating charasteristic) analysis was used to determine the cut-off points related to a decrease in the risk of a fall. Participants of no-fall risk group showed better lower limb performance, quality of life, and functional status. Cut-off points were determined for each outcome. Risk of falls in nursing home residents over the age of 80 is associated with lower limb muscle performance, functional status, and quality of Life. Cut-off points can be used by clinicians when working toward fall prevention and could help in determining the optimal lower limb muscle performance level for preventing falls. © 2015 Association of Rehabilitation Nurses.

  5. Metformin Safety Warnings and Diabetes Drug Prescribing Patterns for Older Nursing Home Residents.

    PubMed

    Zullo, Andrew R; Dore, David D; Gutman, Roee; Mor, Vincent; Alvarez, Carlos A; Smith, Robert J

    2017-10-01

    Diabetes mellitus is common in US nursing homes (NHs), and the mainstay treatment, metformin, has US Food and Drug Administration (FDA) boxed warnings indicating safety concerns in those with advanced age, heart failure, or renal disease. Little is known about treatment selection in this setting, especially for metformin. We quantified the determinants of initiating sulfonylureas over metformin with the aim of understanding the impact of FDA-labeled boxed warnings in older NH residents. National retrospective cohort in US NHs. Long-stay NH residents age ≥65 years who initiated metformin or sulfonylurea monotherapy following a period of ≥6 months with no glucose-lowering treatment use between 2008 and 2010 (n = 7295). Measures of patient characteristics were obtained from linked national Minimum Data Set assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare claims. Odds ratios (ORs) comparing patient characteristics and treatment initiation were estimated using univariable and multivariable multilevel logistic regression models with NH random intercepts. Of the 7295 residents in the study population, 3066 (42%) initiated metformin and 4229 (58%) initiated a sulfonylurea. In multivariable analysis, several factors were associated with sulfonylurea initiation over metformin initiation, including heart failure (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.1-1.4) and renal disease (OR 2.1, 95% CI 1.7-2.5). Compared with those aged 65 to <75 years, residents 75 to <85 (OR 1.3, 95% CI 1.2-1.5), 85 to <95 (OR 2.0, 95% CI 1.7-2.3), and ≥95 (OR 4.3, 95% CI 3.2-5.8) years were more likely to initiate sulfonylureas over metformin. In response to FDA warnings, providers initiated NH residents on a drug class with a known, common adverse event (hypoglycemia with sulfonylureas) over one with tenuous evidence of a rare adverse event (lactic acidosis with metformin). Copyright © 2017 AMDA – The Society for Post-Acute and Long

  6. A relational perspective on autonomy for older adults residing in nursing homes.

    PubMed

    Sherwin, Susan; Winsby, Meghan

    2011-06-01

    To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.

  7. The frequency of and reasons for acute hospital transfers of older nursing home residents.

    PubMed

    Kirsebom, Marie; Hedström, Mariann; Wadensten, Barbro; Pöder, Ulrika

    2014-01-01

    The purpose of the study was to examine the frequency of and reason for transfer from nursing homes to the emergency department (ED), whether these transfers led to admission to a hospital ward, and whether the transfer rate differs as a function of type of nursing home provider and to identify the frequency of avoidable hospitalizations as defined by the Swedish Association of Local Authorities and Regions (SALAR). The design was retrospective, descriptive. Data were collected in a Swedish municipality where 30,000 inhabitants are 65 years or older. Structured reviews of the electronic healthcare records were performed. Included were residents living in a nursing home age 65+, with healthcare records including documented transfers to the ED during a 9-month period in 2010. The transfer rate to the ED was 594 among a total of 431 residents (M=1.37 each). 63% resulted in hospitalization (M=7.12 days). Nursing home's transfer rate differed between 0.00 and 1.03 transfers/bed and was higher for the private for-profit providers than for public/private non-profit providers. One-fourth of the transfers were caused by falls and/or injuries, including fractures. The frequency of avoidable hospitalizations was 16% among the 375 hospitalizations. The proportion of transfers to the ED ranged widely between nursing homes. The reasons for this finding ought to be explored. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Memory performance, health literacy, and instrumental activities of daily living of community residing older adults.

    PubMed

    McDougall, Graham J; Mackert, Michael; Becker, Heather

    2012-01-01

    Health literacy is associated with cognitive function across multiple domains in older adults, and these older adults may face special memory and cognitive challenges that can limit their health literacy and, in turn, their ability to live independently. The aim of this study was to evaluate if an association existed among health literacy, memory performance, and performance-based functional ability in community-residing older adults. Forty-five adults participated in this study. Designed to reflect everyday memory, the Rivermead Behavioral Memory Test (RBMT) bridges laboratory-based measures of memory and assessments obtained by self-report and observation. The RBMT classifies individuals into four categories of memory performance: normal, poor, mildly impaired, and severely impaired. The participants were recruited in the two categories of normal (≥22) or impaired (≤16) category on the RBMT. The sample consisted of 14 who were in the impaired category and 31 in the normal group. Their average age was 77.11 years, and their average number of years of education was 15.33 years. Health literacy scores measured with the Rapid Estimate of Adult Literacy in Medicine. Health literacy scores were high (M = 65.09, SD = 2.80). Thirty-four participants or 76% of the sample scored a 66 out of a possible score of 80. Pearson correlations were calculated for the study variables. Health literacy scores with education and cognition (.30), memory performance groups (normal vs. poor; .25), and performance-based instrumental activities (.50) were associated significantly. The development of a broader assortment of health literacy instruments would improve the ability of researchers to both compare studies and build on the knowledge and results of others.

  9. London, England

    NASA Image and Video Library

    2003-01-18

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth. This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. http://photojournal.jpl.nasa.gov/catalog/PIA04301

  10. The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study.

    PubMed

    Potter, Rachel; Sheehan, Bart; Cain, Rebecca; Griffin, James; Jennings, Paul A

    2017-05-23

    Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. This study explores the relationship between the physical environment and depressive symptoms of older people living in care homes. In a prospective cohort study the physical environment of 50 care homes were measured using the Sheffield Care Environment Assessment Matrix (SCEAM) and depressive symptoms of 510 residents measured using the Geriatric Depression Scale (GDS-15). The study was supplemented with semi-structured interviews with residents living in the care homes. Quantitative data were analyzed using multi-level modeling, and qualitative data analyzed using a thematic framework approach. The overall physical environment of care homes (overall SCEAM score) did not predict depressive symptoms. Controlling for dependency, social engagement, and home type, having access to outdoor space was the only environmental variable to significantly predict depressive symptoms. Residents interviewed reported that access to outdoor space was restricted in many ways: locked doors, uneven foot paths, steep steps, and needing permission or assistance to go outside. We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.

  11. Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living.

    PubMed

    Hogan, David B; Freiheit, Elizabeth A; Strain, Laurel A; Patten, Scott B; Schmaltz, Heidi N; Rolfson, Darryl; Maxwell, Colleen J

    2012-09-14

    Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items), the Cardiovascular Health Study (CHS) frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL) residents followed over one year. The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+) participating in the Alberta Continuing Care Epidemiological Studies (ACCES). Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS). The area under the ROC curve (AUC) was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items) showing no significant association. For death and long-term care placement, the addition of frailty (however derived) or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items) showed significantly better performance over the other measures in predicting long-term care placement. Using different

  12. Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living

    PubMed Central

    2012-01-01

    Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items), the Cardiovascular Health Study (CHS) frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL) residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+) participating in the Alberta Continuing Care Epidemiological Studies (ACCES). Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS). The area under the ROC curve (AUC) was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items) showing no significant association. For death and long-term care placement, the addition of frailty (however derived) or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items) showed significantly better performance over the other measures in predicting long-term care

  13. Preventive care in general practice among healthy older New South Wales residents.

    PubMed

    Harris, Mark F; Islam, Fakhrul Md; Jalaludin, Bin; Chen, Jack; Bauman, Adrian E; Comino, Elizabeth J

    2013-06-16

    Despite being at high risk, disadvantaged patients may be less likely to receive preventive care in general practice. This study aimed to explore self-reported preventive care received from general practitioners and the factors associated with this by healthy New South Wales (NSW) residents aged 45-74 years. A self-completed questionnaire was sent to 100,000 NSW residents in the 45 and Up cohort study. There was a 60% response rate. After exclusions there were 39,964 participants aged 45-74 years who did not report cardiovascular disease or diabetes. Dichotomised outcome variables were participant report of having had a clinical assessment of their blood pressure (BP), blood cholesterol (BC) or blood glucose (BG), or received advice to eat less high fat food, eat more fruit and vegetables or be more physically active from their GP in the last 12 months. Independent variables included socio-demographic, lifestyle risk factors, health status, access to health care and confidence in self-management. Most respondents reported having had their BP (90.6%), BC (73.9%) or BG (69.4%) assessed. Fewer reported being given health advice to (a)eat less high fat food (26.6%), (b) eat more fruit and vegetables (15.5%) or (c) do more physical activity (19.9%). The patterns of association were consistent with recognised need: participants who were older, less well educated or overweight were more likely to report clinical assessments; participants who were overseas born, of lower educational attainment, less confident in their own self-management, reported insufficient physical activity or were overweight were more likely to report receiving advice. However current smokers were less likely to report clinical assessments; and rural and older participants were less likely to receive diet or physical activity advice. This study demonstrated a gap between reported clinical assessments and preventive advice. There was evidence for inverse care for rural participants and smokers, who

  14. Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents.

    PubMed

    Gupta, Gayatri; Aronow, Wilbert S

    2003-01-01

    To investigate the prevalence of osteoporosis, the prevalence of utilization of bone mineral density (BMD) measurements for diagnosis of osteoporosis, and prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis in postmenopausal women in an academic nursing home. The charts of all women aged 56 years and older residing in an academic nursing home were analyzed by one of the authors for the prevalence of osteoporosis, the prevalence of use of BMD measurements to diagnose osteoporosis, and the prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis. Of 136 postmenopausal women, mean age 79 +/- 10 years, 66 (49%) had measurements of BMD. Of these 66 women, 31 (47%) had osteoporosis, 21 (32%) had osteopenia, and 14 (21%) had normal BMD. Elemental calcium carbonate 1500 mg daily was prescribed to 17 of 31 women (55%) with osteoporosis, to 12 of 21 women (57%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 27 of 70 women (39%) with no BMD obtained. Any dose of calcium was prescribed to 78 of 136 elderly women (58%). Vitamin D supplements were prescribed to 13 of 31 women (42%) with osteoporosis, to 9 of 21 women (43%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 20 of 70 women (29%) with no BMD obtained. Vitamin D supplements were prescribed to 44 of 136 elderly women (32%). Biphosphonates were prescribed to 19 of 31 women (61%) with osteoporosis. Of 20 women on medications that increased the risk of osteoporosis, 6 (30%) had BMD measured. Nine of these 20 women (45%) were on calcium supplements. Older postmenopausal women in an academic nursing home have a high prevalence of osteoporosis and osteopenia, a low prevalence of measurement of BMD, and underuse of calcium, vitamin D supplements, and other antiresorptive therapies for treatment of osteoporosis.

  15. Does residing in urban or rural areas affect the incidence of polypharmacy among older adults in western China?

    PubMed

    Yang, Ming; Lu, Jing; Hao, Qiukui; Luo, Li; Dong, Birong

    2015-01-01

    The aim of this study is to explore the differences among older adults who are rural or urban residents with respects to their socioeconomic position, chronic health conditions and medication use. This cross-sectional study included 887 community-dwelling older adults (≥60 years) from western China. Trained interviewers collected data from all of the study subjects through face-to-face interviews. Polypharmacy was defined as the concomitant use of five or more medications. A total of 717 participants were included in the study analyses. Compared with their urban counterparts, the older adults in rural China were more likely to have more chronic health conditions, and a lower education level, annual income and insurance coverage rate. In addition, the rural inhabitants were less likely to use medications (58.7% vs. 75.7%, p<0.001). The intensity of medication use (the mean number of drugs) was 1.7 for rural residents and 2.3 for urban residents (p<0.001). The prevalence of polypharmacy was significantly lower in rural residents than urban residents (11.5% vs. 17.5%, p=0.021). Urban residence (odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.03-3.48), number of chronic conditions (OR 1.95, 95% CI 1.16-3.30), diabetes (OR 4.14, 95% CI 2.33-7.37), and cardiovascular disease (CVD) (OR 2.09, 95% CI 1.25-3.51) were positively associated with polypharmacy, whereas good self-rated health (OR 0.32, 95% CI 0.16-0.65) was negatively associated with polypharmacy. In conclusion, urban residence is independently associated with polypharmacy in Chinese elders regardless of chronic health conditions and socioeconomic status. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Memory performance and affect: are there gender differences in community-residing older adults?

    PubMed

    McDougall, Graham Joseph; Pituch, Keenan A; Stanton, Marietta P; Chang, Wanchen

    2014-08-01

    After age 65, the incidence of episodic memory decline in males is greater than in females. We explored the influence of anxiety and depression on objective and subjective memory performance in a diverse sample of community-residing older adults. The study was a secondary analysis of data on three samples of adults from two states, Ohio and Texas: a community sample (n = 177); a retirement community sample (n = 97); and the SeniorWISE Study (n = 265). The sample of 529 adults was 74% female, the average age was 76.58 years (range = 59-100 years), and educational attainment was 13.12 years (±3.68); 68% were Caucasian, and 17% had depressive symptoms. We found no memory performance differences by gender. Males and females were similarly classified into the four memory performance groups, with almost half of each gender in the poor memory category. Even though males had greater years of education, they used fewer compensatory memory strategies. The observed gender differences in memory were subjective evaluations, specifically metamemory. Age was not a significant predictor of cognition or memory performance, nor did males have greater memory impairment than females.

  17. High rates of hospital admission among older residents in assisted living facilities: opportunities for intervention and impact on acute care.

    PubMed

    Hogan, David B; Amuah, Joseph E; Strain, Laurel A; Wodchis, Walter P; Soo, Andrea; Eliasziw, Misha; Gruneir, Andrea; Hagen, Brad; Teare, Gary; Maxwell, Colleen J

    2014-01-01

    Little is known about health or service use outcomes for residents of Canadian assisted living facilities. Our objectives were to estimate the incidence of admission to hospital over 1 year for residents of designated (i.e., publicly funded) assisted living (DAL) facilities in Alberta, to compare this rate with the rate among residents of long-term care facilities, and to identify individual and facility predictors of hospital admission for DAL residents. Participants were 1066 DAL residents (mean age ± standard deviation 84.9 ± 7.3 years) and 976 longterm care residents (85.4 ± 7.6 years) from the Alberta Continuing Care Epidemiological Studies (ACCES). Research nurses completed a standardized comprehensive assessment for each resident and interviewed family caregivers at baseline (2006 to 2008) and 1 year later. We used standardized interviews with administrators to generate facility- level data. We determined hospital admissions through linkage with the Alberta Inpatient Discharge Abstract Database. We used multivariable Cox proportional hazards models to identify predictors of hospital admission. The cumulative annual incidence of hospital admission was 38.9% (95% confidence interval [CI] 35.9%- 41.9%) for DAL residents and 13.7% (95% CI 11.5%-15.8%) for long-term care residents. The risk of hospital admission was significantly greater for DAL residents with greater health instability, fatigue, medication use (11 or more medications), and 2 or more hospital admissions in the preceding year. The risk of hospital admission was also significantly higher for residents from DAL facilities with a smaller number of spaces, no licensed practical and/ or registered nurses on site (or on site less than 24 hours a day, 7 days a week), no chain affiliation, and from select health regions. The incidence of hospital admission was about 3 times higher among DAL residents than among long-term care residents, and the risk of hospital admission was associated with a number of

  18. Oscillating in and out of place: Experiences of older adults residing in homeless shelters in Montreal, Quebec.

    PubMed

    Burns, Victoria F

    2016-12-01

    Aging in place is desirable from the perspective of older adults and policy makers alike. However, the meaning of 'place' for adults experiencing homelessness has been largely overlooked. Addressing this gap, this constructivist grounded theory study discusses the meaning of place for 15 older adults residing in emergency homeless shelters in Montreal, Quebec. Findings revealed that four interrelated dimensions of place-that is, control, comfort, privacy, and security were instrumental in supporting participants' ability to feel in place across housed-homeless trajectories. Many felt out of place well before they lost their housing and some felt more in place during homelessness when shelter conditions and interpersonal relations supported these four dimensions. The empirically-driven model oscillating in and out of place extends and nuances existing understandings of aging in place and provides insights into policy and practice solutions for older adults who may not have a stable place to call home.

  19. Reducing inappropriate, anticholinergic and psychotropic drugs among older residents in assisted living facilities: study protocol for a randomized controlled trial.

    PubMed

    Pitkala, Kaisu H; Juola, Anna-Liisa; Soini, Helena; Laakkonen, Marja-Liisa; Kautiainen, Hannu; Teramura-Gronblad, Mariko; Finne-Soveri, Harriet; Bjorkman, Mikko

    2012-06-18

    Use of inappropriate drugs is common among institutionalized older people. Rigorous trials investigating the effect of the education of staff in institutionalized settings on the harm related to older people's drug treatment are still scarce. The aim of this trial is to investigate whether training professionals in assisted living facilities reduces the use of inappropriate drugs among residents and has an effect on residents' quality of life and use of health services. During years 2011 and 2012, a sample of residents in assisted living facilities in Helsinki (approximately 212) will be recruited, having offered to participate in a trial aiming to reduce their harmful drugs. Their wards will be randomized into two arms: one, those in which staff will be trained in two half-day sessions, including case studies to identify inappropriate, anticholinergic and psychotropic drugs among their residents, and two, a control group with usual care procedures and delayed training. The intervention wards will have an appointed nurse who will be responsible for taking care of the medication of the residents on her ward, and taking any problems to the consulting doctor, who will be responsible for the overall care of the patient. The trial will last for twelve months, the assessment time points will be zero, six and twelve months. The primary outcomes will be the proportion of persons using inappropriate, anticholinergic, or more than two psychotropic drugs, and the change in the mean number of inappropriate, anticholinergic and psychotropic drugs among residents. Secondary endpoints will be, for example, the change in the mean number of drugs, the proportion of residents having significant drug-drug interactions, residents' health-related quality of life (HRQOL) according to the 15D instrument, cognition according to verbal fluency and clock-drawing tests and the use and cost of health services, especially hospitalizations. To our knowledge, this is the first large

  20. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey

    PubMed Central

    2017-01-01

    Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants' smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (<12 g/dL in women and <13 g/dL in men). Gender-specific logistic regression models were used to examine the association between demographic and health characteristics and anemia. Results. A total of 2,372 subjects with a mean age of 71.8 (SD 8.2) years had their hemoglobin measured, representing an estimated 1.1 million older adults. The crude prevalence of anemia was 20.0% in women and 25.2% in men. However, higher anemia prevalence rates were seen with advancing age among black women and subjects residing in the urban coast. Likewise, certain health conditions such as hypoalbuminemia, cancer in men, chronic kidney disease, iron deficiency, and low grade inflammation were associated with increased odds of having anemia. Conclusions. Anemia is a prevalent condition among older adults in Ecuador. Moreover, further research is needed to examine the association between anemia and adverse health-related outcomes among older Ecuadorians. PMID:28321252

  1. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey.

    PubMed

    Orces, Carlos H

    2017-01-01

    Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants' smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (<12 g/dL in women and <13 g/dL in men). Gender-specific logistic regression models were used to examine the association between demographic and health characteristics and anemia. Results. A total of 2,372 subjects with a mean age of 71.8 (SD 8.2) years had their hemoglobin measured, representing an estimated 1.1 million older adults. The crude prevalence of anemia was 20.0% in women and 25.2% in men. However, higher anemia prevalence rates were seen with advancing age among black women and subjects residing in the urban coast. Likewise, certain health conditions such as hypoalbuminemia, cancer in men, chronic kidney disease, iron deficiency, and low grade inflammation were associated with increased odds of having anemia. Conclusions. Anemia is a prevalent condition among older adults in Ecuador. Moreover, further research is needed to examine the association between anemia and adverse health-related outcomes among older Ecuadorians.

  2. London, England

    NASA Technical Reports Server (NTRS)

    2003-01-01

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth.

    This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats

  3. London, England

    NASA Technical Reports Server (NTRS)

    2003-01-01

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth.

    This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats

  4. Communication between pharmacists and patients: the role of place of residence in determining the expectations of older adults.

    PubMed

    Ranelli, P L; Coward, R T

    1997-01-01

    The relationship between the place of residence of elderly patients and their expectations about the content and style of their communication with pharmacists was studied. Using stratified random sampling of households, telephone interviews were completed in Spring 1994 with 200 rural and 200 urban persons age 65 or older currently taking a prescribed drug that they picked up at a pharmacy. Respondents were asked about their sociodemographic characteristics, health, and experiences with prescription drugs. Factor analysis of items measuring the elders' expectations yielded one factor with nine items. Multivariate analysis was used to examine the effect of residence while controlling for other variables. Subjects currently took 3.2 +/- 2.2 drugs (mean +/- SD). Fifty-two percent of rural elders used independent pharmacies, and 83% of urban elders used chain pharmacies. On six of the nine items in the expectation scale, rural elders held significantly different (higher) expectations for their pharmacists compared with urban elders. The most fully specified model contained five variables significantly associated with higher expectations: elders who took fewer drugs and who had a stroke, angina, osteoporosis, and no coronary heart disease. Although place of residence was a significant predictor of elders' expectations in the first three models, it was not when drug experiences were added in. Overall, older people in different places of residence have dissimilar personal and drug characteristics, and pharmacists practicing in different community contexts can anticipate encountering different patient expectations.

  5. Nursing staff's actions during older residents' transition into long-term care facility in a nursing home in rural Norway.

    PubMed

    Eika, Marianne; Espnes, Geir Arild; Hvalvik, Sigrun

    2014-01-01

    Working in long-term care units poses particular staff challenges as these facilities are expected to provide services for seriously ill residents and give help in a homelike atmosphere. Licensed and unlicensed personnel work together in these surroundings, and their contributions may ease or inhibit a smooth transition for recently admitted residents. The aim of the study was to describe and explore different nursing staff's actions during the initial transition period for older people into a long-term care facility. Participant observation periods were undertaken following staff during 10 new residents' admissions and their first week in the facility. In addition 16 interviews of different staff categories and reading of written documents were carried out. The findings show great variations of the staff's actions during the older residents' initial transition period. Characteristics of their actions were (1) in the preparation period: "actions of sharing, sorting out, and ignoring information"; (2) on admission day: "actions of involvement and ignorance"; and (3) in the initial period: "targeted and random actions," "actions influenced by embedded knowledge," and "actions influenced by local transparency."

  6. Reducing inappropriate, anticholinergic and psychotropic drugs among older residents in assisted living facilities: study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Use of inappropriate drugs is common among institutionalized older people. Rigorous trials investigating the effect of the education of staff in institutionalized settings on the harm related to older people’s drug treatment are still scarce. The aim of this trial is to investigate whether training professionals in assisted living facilities reduces the use of inappropriate drugs among residents and has an effect on residents’ quality of life and use of health services. Methods and design During years 2011 and 2012, a sample of residents in assisted living facilities in Helsinki (approximately 212) will be recruited, having offered to participate in a trial aiming to reduce their harmful drugs. Their wards will be randomized into two arms: one, those in which staff will be trained in two half-day sessions, including case studies to identify inappropriate, anticholinergic and psychotropic drugs among their residents, and two, a control group with usual care procedures and delayed training. The intervention wards will have an appointed nurse who will be responsible for taking care of the medication of the residents on her ward, and taking any problems to the consulting doctor, who will be responsible for the overall care of the patient. The trial will last for twelve months, the assessment time points will be zero, six and twelve months. The primary outcomes will be the proportion of persons using inappropriate, anticholinergic, or more than two psychotropic drugs, and the change in the mean number of inappropriate, anticholinergic and psychotropic drugs among residents. Secondary endpoints will be, for example, the change in the mean number of drugs, the proportion of residents having significant drug-drug interactions, residents' health-related quality of life (HRQOL) according to the 15D instrument, cognition according to verbal fluency and clock-drawing tests and the use and cost of health services, especially hospitalizations. Discussion To our

  7. Sense of Coherence among Older Adult Residents of Long-Term Care Facilities in Taiwan: A Cross-Sectional Analysis

    PubMed Central

    Jueng, Ruo-Nan; Tsai, Der-Chong; Chen, I-Ju

    2016-01-01

    Background Growing evidence shows that sense of coherence (SOC) is related to health promotion. Knowledge of SOC among older adults in Taiwan is limited. The present study aimed to investigate SOC status and its relationship to personal and environmental factors among older adult residents of long-term care facilities (LTCFs) in northeastern Taiwan. Methods This cross-sectional study was performed in Yilan, Taiwan. With face-to-face interviews, we obtained data from 104 LTCF residents (aged 65 years and older) using the Chinese version of Antonovsky's short 13-item SOC scale. We also collected the information on personal characteristics, physical and social environmental resources. Multiple linear regression was used to analyze factors potentially influencing SOC. Results Of the participants, the mean score (±standard deviation) of SOC was 58.3 (±8.8), while scores on SOC subscales (comprehensibility, manageability, and meaningfulness) were 23.4 ±4.5, 17.9 ±3.8, and 17.0 ±3.2, respectively. Education level, activities of daily living and number of LTCF staff were found to be independently associated with SOC status after adjusting for demographic characteristics, health status, and environmental resources. In addition, interactions between personal and environmental factors had a crucial influence on SOC status. Conclusions Participants in this study had relatively low SOC scores compared to their counterparts in Western countries. In addition to personal factors, environmental factors can play a significant role in SOC status among older adult LTCF residents. Comprehensive evaluation of SOC status should consider person-environment interaction effects. PMID:26751949

  8. Curriculum on Resident Education in Care of Older Adults in Acute, Transitional and Extended Care Settings

    ERIC Educational Resources Information Center

    Kumar, Chandrika; Bensadon, Benjamin A.; Van Ness, Peter H.; Cooney, Leo M.

    2016-01-01

    Most geriatric care is provided in non-hospital settings. Internal Medicine and Family Medicine residents should therefore learn about these different clinical sites and acuity levels of care. To help facilitate this learning, a geriatrics training curriculum for internal medicine residents was developed that focused on cognition, function, goals…

  9. Longevity Trends in the Older Population of Louisiana with Residence Comparisons.

    ERIC Educational Resources Information Center

    Kwan, Yui-Huen; Bertrand, Alvin L.

    Utilizing Louisiana State Bureau of Vital Statistics and U.S. Census data, longevity trends with residence comparisons were examined for all persons 65 or over who died between 1962 and 1974, who were Louisiana residents at the time of death, and whose death was not due to external violence. Every third year in the 12 year period was arbitrarily…

  10. The Health Trade-Off of Rural Residence for Impaired Older Adults: Longer Life, More Impairment

    ERIC Educational Resources Information Center

    Laditka, James N.; Laditka, Sarah B.; Olatosi, Bankole; Elder, Keith T.

    2007-01-01

    Context: Years lived with and without physical impairment are central measures of public health. Purpose: We sought to determine whether these measures differed between rural and urban residents who were impaired at the time of a baseline measurement. We examined 16 subgroups defined by rural/urban residence, gender, race, and education. Methods:…

  11. The Health Trade-Off of Rural Residence for Impaired Older Adults: Longer Life, More Impairment

    ERIC Educational Resources Information Center

    Laditka, James N.; Laditka, Sarah B.; Olatosi, Bankole; Elder, Keith T.

    2007-01-01

    Context: Years lived with and without physical impairment are central measures of public health. Purpose: We sought to determine whether these measures differed between rural and urban residents who were impaired at the time of a baseline measurement. We examined 16 subgroups defined by rural/urban residence, gender, race, and education. Methods:…

  12. Investigating the psychometric properties of the Geriatric Suicide Ideation Scale (GSIS) among community-residing older adults.

    PubMed

    Heisel, Marnin J; Flett, Gordon L

    2016-01-01

    To investigate the psychometric properties of the Geriatric Suicide Ideation Scale (GSIS) among community-residing older adults. We recruited 173 voluntary participants, 65 years and older, into a 2+ year longitudinal study of the onset or exacerbation of depressive symptoms and suicide ideation. We assessed the internal consistency of the GSIS and its four component subscales, and its shorter and longer duration test-retest reliability, convergent (depression, social hopelessness, and loneliness), divergent (psychological well-being, life satisfaction, perceived social support, and self-rated health), discriminant (basic and instrumental activities of daily living and social desirability), criterion (history of suicide behavior), and predictive validity (future suicide ideation). The GSIS demonstrated strong test-retest reliability and internal consistency. Baseline GSIS scores were significantly positively associated with suicide risk factors, negatively associated with potential resiliency factors, and not associated with functional impairment or social desirability. GSIS scores significantly differentiated between participants with as compared to those without a history of suicide behavior. Baseline GSIS scores significantly predicted suicide ideation at a 2+ year follow-up assessment. Findings suggest strong measurement characteristics for the GSIS with community-residing older adults, including impressive consistency over time. These results are consistent with research attesting to the empirical and pragmatic strengths of this measure. These findings have implications for the monitoring of suicide risk when aiming to enhance mental health and well-being and prevent suicide in later life.

  13. Betel nut use among first and second generation Bangladeshi women in London, UK.

    PubMed

    Núñez-de la Mora, Alejandra; Jesmin, Fahmida; Bentley, Gillian R

    2007-10-01

    This study evaluated the effects of socio-economic variables and migration history on the prevalence of betel nut and smokeless tobacco use in both UK- and Bangladeshi born migrant women resident in London. No significant difference in betel nut use prevalence was found among women of different generations. However, in all groups betel nut users were significantly older and less educated than non-users. Among first generation women there was no effect of either length of time living in the UK or age at migration on use of betel nut, even after controlling for current age. No significant differences in prevalence use due to language spoken, occupation, marital status or borough of residence in London were found. We conclude that, although there are some indications of a change in behavior among younger individuals, betel nut chewing is a practice very much present among Bangladeshi women born and brought up in a bicultural context.

  14. Circadian rest-activity rhythms in demented and nondemented older community residents and their caregivers.

    PubMed

    Pollak, C P; Stokes, P E

    1997-04-01

    Disruptive nocturnal behaviors (DNBs) of older people often threaten the caregiving arrangements on which their community tenure depends. Dementing disorders are especially prone to result in disrupted sleep and agitated behaviors ("sundowning"). The objective here was to develop an objective correlate of DNBs, by which their severity and effects on caregivers can be measured. Quantitative comparison of subjective sleep and motor activity patterns in older people and their caregivers. It was hypothesized that older people with reported DNBs would be more motorically active at night than their caregivers. Subjects' homes. Twenty-five demented and 18 nondemented older day-care participants and their paired caregivers. Older subjects and caregivers simultaneously kept daily sleep logs and recorded wrist motor activity every .5 minute for 9 days. A novel method was devised to identify and exclude from analysis periods when the activity monitor was not being worn. Such periods were common. Activity data were analyzed by computing hourly means and by fitting cosine models by least squares. Demented older people were not significantly more active at night than their caregivers, though group differences varied by time of night. They were significantly less active in the daytime than were their caregivers. Nondemented older people were significantly more active at night than their caregivers and were as active by day as their caregivers. The caregivers of demented and nondemented older people had similar rest-activity patterns. The mean amplitudes of cosine models were smaller in the older adults. Acrophases (peaks) fell between 2 and 3 pm and did not differ significantly among the groups. As a result of increased nighttime motor activity and decreased daytime activity, rest-activity rhythms were flatter in older adults than in caregivers. This was not explained fully by age and does not necessarily imply that the output of a circadian pacemaker was low. Decreased daytime

  15. Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia.

    PubMed

    Mohd Mokhtar, Mohd Amin; Pin, Tan Maw; Zakaria, Mohd Idzwan; Hairi, Noran Naqiah; Kamaruzzaman, Shahrul Bahiyah; Vyrn, Chin Ai; Hua, Philip Poi Jun

    2015-08-01

    To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting. The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week. A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P < 0.001), and more likely to require investigations such as electrocardiogram (68.1% vs 16.6%, P < 0.001) or chest X-rays (67.6% vs 24.0%, P < 0.001) than their younger counterparts. Logistic regression methods showed that older adults remained an independent predictor of hospital admission (OR 2.75, 95% CI 2.11-3.57). The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met. © 2014 Japan Geriatrics Society.

  16. Picture Your Nursing Home: Exploring the Sense of Home of Older Residents through Photography

    PubMed Central

    van Hoof, J.; Verhagen, M. M.; Wouters, E. J. M.; Marston, H. R.; Rijnaard, M. D.; Janssen, B. M.

    2015-01-01

    The quality of the built environment can impact the quality of life and the sense of home of nursing home residents. This study investigated (1) which factors in the physical and social environment correlate with the sense of home of the residents and (2) which environmental factors are most meaningful. Twelve participants engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews. The data were analysed based on the six phases by Braun and Clarke. The four themes identified are (1) the physical view; (2) mobility and accessibility; (3) space, place, and personal belongings; and (4) the social environment and activities. A holistic understanding of which features of the built environment are appreciated by the residents can lead to the design and retrofitting of nursing homes that are more in line with personal wishes. PMID:26346975

  17. Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

    PubMed Central

    Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa

    2015-01-01

    Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22–0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01–0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in

  18. Physiotherapists' perceived motivators and barriers for organizing physical activity for older long-term care facility residents.

    PubMed

    Baert, Veerle; Gorus, Ellen; Guldemont, Nele; De Coster, Sofie; Bautmans, Ivan

    2015-05-01

    Information regarding factors that hinder or stimulate older adults in long-term care facilities (LTCF) for being physically active is available in the literature, but much less is known regarding perceived motivators and barriers among physiotherapists (PTs) to organize physical activity (PA) in LTCF. The main purpose of this study was to examine factors influencing PTs to organize PA in LTCF for older adults. A secondary goal was to examine the PTs' knowledge about and their barriers at the PA guidelines for older adults of the World Health Organization (WHO). A mixed qualitative and quantitative study was carried out using semistructured interviews (n = 24) followed by an online survey (n = 254). As a frame the social-ecological model (McLeroy) was used, distinguishing factors at the intrapersonal, interpersonal, and community level. In the qualitative component the PTs reported 41 motivators and 35 barriers for organizing PA in LTCF. The survey revealed that although the majority of the respondents (71%) are convinced of the usefulness of PA in LTCF, 84% are not familiar with the WHO-guidelines. Seventy-five percent of the respondents believe that the WHO-guidelines are not feasible for LTCF-residents. The strongest motivators on the intrapersonal level were maintaining the independence of the residents (98%), reducing the risk of falling (98%), and improving the physical (93%) and psychological (90%) wellbeing of LTCF-residents. The social interaction among LTCF-residents (91%) during PA was the strongest motivator on the interpersonal level. Motivators on the community level are the belief that PA is the basis of their physiotherapeutic work (89%) and that offering varied activities avoids PA becoming monotonous (71%). Barriers on the intra- and interpersonal level were of less influence. On the community level, they felt hindered to organize PA because of lack of time (38%) and the overload of paperwork (33%). This study described different motivators

  19. The Use of Local Parks by Older Residents of Urban Areas.

    ERIC Educational Resources Information Center

    Godbey, Geoffrey; Blazey, Michael

    Local parks in five large cities (San Francisco, Houston, Atlanta, Chicago, Boston) were selected for a study of the use of urban parks by older adults (55 to 65 and over). Interviews were conducted with park users to determine: (1) meaning, motivation, and satisfactions associated with local park usage; (2) factors of usage such as time of day,…

  20. Social Resources and Disordered Living Conditions: Evidence from a National Sample of Community-Residing Older Adults

    PubMed Central

    Cornwell, Erin York

    2015-01-01

    For older adults aging in the community, living conditions can promote health, enhance coping, and reduce disablement – but they can also create stress and increase risks of illness, accidents, and decline. While socioeconomic disparities in housing likely contribute to inequalities in interior conditions, I argue that living conditions are also shaped by social resources such as co-residential relationships, social network ties, and social support. In this paper, I examine the distribution of a set of risky or stressful physical and ambient living conditions including structural disrepair, clutter, lack of cleanliness, noise, and odor. Using data from the National Social Life, Health, and Aging Project (NSHAP), I find that low income and African American older adults have more disordered living conditions, as do those with poorer physical and mental health. In addition, older adults who have a co-resident partner, more non-residential network ties, and more sources of instrumental support are exposed to fewer risky or harmful living conditions. This suggests that living conditions are an important, though overlooked, mechanism through which household composition, social networks, and social support affect health and well being in later life. PMID:25651314

  1. Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program.

    PubMed

    Mountford, Christopher G; Okonkwo, Arthur C O; Hart, Kathryn; Thompson, Nick P

    2016-01-01

    This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and ≥2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p < 0.001); dietetic advice resulting in the greatest improvement. There were no significant changes in BMI (p = 0.445), MAMC (p = 0.256), or GDS (p = 0.385) following the interventions. Dietitian advice may slow the progression of nutritional decline. In this study oral nutritional supplements over a 3-month period did not significantly improve nutritional status in malnourished care home residents.

  2. Individual and contextual determinants of resident-on-resident abuse in nursing homes: a random sample telephone survey of adults with an older family member in a nursing home.

    PubMed

    Schiamberg, Lawrence B; von Heydrich, Levente; Chee, Grace; Post, Lori A

    2015-01-01

    Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Soybeans or Soybean Products Consumption and Depressive Symptoms in Older Residents in Rural Northeast China: A Cross-Sectional Study.

    PubMed

    Yu, S; Guo, X; Yang, H; Zheng, L; Sun, Y

    2015-11-01

    Depression is one of the most common mental disorders among elderly subjects. The purpose of this study is to estimate the prevalence of depressive symptoms and the association between soybeans consumption and depressive symptoms among older residents in rural Northeast China. Cross-sectional study. A representative sample of the rural Northeast residents. This survey was conducted from July 2012 to August 2013 which randomly selected and examined a total of 1717 residents aged ≥ 65 years from the rural Northeast China. All participants completed the Patient Health Questionnaire-9 (PHQ-9). Information on demographic and lifestyle characteristics and blood biochemical indexes were collected by well-trained personnel. The prevalence of depressive symptoms in the elderly was 8.9%. Women had significantly higher prevalence of depressive symptoms than men (13.3% vs.4.6%, P<0.001). Individuals consuming soybeans ≥4times/week had statically lower possibility to have depressive symptoms than those rarely consuming (3.6%vs. 12.5%, P<0.05). In addition to some conventional risk factors like sex, annual income, educational status, current smoking and chronic diseases status were associated with depressive symptoms, proper sleep duration (7-8h/d) [OR(95%CI):0.28(0.15,0.53)] and frequently consumption of soybeans or soybean products [OR (95%CI): 0.36 (0.15,0.87) for 2-3times/week and OR (95%CI):0.50 (0.34,0.74) for ≥4times/week] significantly decreased the risk of depressive symptoms among elderly in rural Northeast China. Women had significantly higher prevalence of depressive symptoms than men in rural China. Individuals who rarely consume soybeans or soybean products are more likely to suffer depressive symptoms. Rural elderly residents should be cautiously screened to prevent or treat depression.

  4. Special Considerations for Older Adults With Diabetes Residing in Skilled Nursing Facilities

    PubMed Central

    Haas, Linda B.

    2014-01-01

    In Brief About 25% of all residents of skilled nursing facilities (SNFs) have diabetes, and that proportion is expected to increase. SNF residents with diabetes have special needs related to nutrition, hydration, physical activity, and medical therapy. Vigilant assessment and maintenance of safety is also crucial for such patients, including but not limited to issues such as hyper- and hypoglycemia, polypharmacy, falls, lower-extremity problems, and transitions of care. Interventions to provide stable glycemic control; ensure adequate nutrition, hydration, and physical activity; decrease polypharmacy; prevent falls; facilitate transitions of care; and improve the diabetes-related knowledge of SNF staff can help to meet these needs. Although this article focuses on SNFs, many of the topics covered also apply to elderly people with diabetes in other long-term care settings. PMID:26246754

  5. Dentition, nutritional status and adequacy of dietary intake among older residents in assisted living facilities.

    PubMed

    Saarela, Riitta K T; Lindroos, Eeva; Soini, Helena; Hiltunen, Kaija; Muurinen, Seija; Suominen, Merja H; Pitkälä, Kaisu H

    2016-06-01

    We examined the relationships between dentition, nutritional status and dietary intakes of energy, protein and micronutrients among older people in assisted living facilities in Helsinki. Poor dentition is associated with malnutrition. Less is known about how dentition is associated with detailed nutrient intakes in institutionalised older people. This cross-sectional study assessed 343 participants (mean age 83 years). Dentition was assessed by trained ward nurses and divided into edentulous participants without dentures (group 1), edentulous participants with removable dentures (group 2) and those with any natural teeth (group 3). Nutritional status was assessed by Mini Nutritional Assessment (MNA). The energy, protein and nutrient intakes were calculated from detailed 1-day food diaries and compared with the recommendations of the Finnish National Nutrition Council as a measure of dietary adequacy. Assessment included also participants' cognitive and functional status. Of the participants, 8.2, 39.1 and 52.8% were in groups 1, 2 and 3, respectively. Altogether 22% were malnourished according to MNA. Group 1 had the poorest nutritional status. A large proportion of participants consumed less than the recommended amounts of energy, protein or micronutrients. Half of the participants consumed <60 g/day of protein. The intake of protein was significantly lower in group 1 than in other two groups. Malnutrition and inadequate protein intake were very common and associated with dentition among older people with multiple disabilities in assisted living facilities. Assessment of dental status should be part of good nutritional care in long-term care. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  6. Active Residents in Care Homes (ARCH): study protocol to investigate the implementation and outcomes of a whole-systems activity programme in residential care homes for older people.

    PubMed

    Koskela, Sian A; Jones, Fiona; Clarke, Natasha; Anderson, Liezl; Kennedy, Bernadette; Grant, Robert; Gage, Heather; Hurley, Michael V

    2017-03-01

    To evaluate the effectiveness, acceptability and costs of Active Residents in Care Homes, ARCH - a programme aiming to increase opportunities for activity in older care home residents. Feasibility study. Residential care homes for older people. 10-15 residents, staff and family members will be recruited in each of the three participating care homes. ARCH is a 12-month 'whole-systems' programme implemented by occupational therapists and physiotherapists. They will conduct a comprehensive assessment of each care home, considering the physical environment, working practices and organisation structure as well as residents' individual needs, and recommend ways to address barriers and increase residents' activity levels. The therapists will then work with staff to improve understanding of the issues, instigate training, environmental, organisational and working practice changes as necessary. Residents' activity levels, health and quality of life will be tested using several measures to see which are practicable and appropriate for this population in this context. This includes: Assessment of Physical Activity in Frail Older People; Pool Activity Level Checklist; Dementia Care Mapping observations; and EQ-5D-5L. Residents will be assessed prior to programme implementation then 4- and 12-months post-implementation. Semi-structured interviews will explore the experiences of residents, staff, family members and therapists. Providing evidence of effectiveness and acceptability of ARCH, and documenting factors that impede/facilitate implementation will help us identify ways to enhance the care and quality of life of older people in residential care, and our understanding of how to implement them. ISRCTN24000891. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  7. Functional fitness and physical activity of Portuguese community-residing older adults.

    PubMed

    Gouveia, Élvio R; Maia, José A; Beunen, Gaston P; Blimkie, Cameron J; Fena, Ercília M; Freitas, Duarte L

    2013-01-01

    The purposes of this study were to generate functional-fitness norms for Portuguese older adults, to determine age and sex differences, and to analyze the physical activity-associated variation in functional fitness. The sample was composed of 802 older adults, 401 men and 401 women, age 60-79 yr. Functional fitness was assessed using the Senior Fitness Test. Physical activity level was estimated via the Baecke questionnaire. The P50 values decreased from 60 to 64 to 75 to 79 yr of age. A significant main effect for age group was found in all functional-fitness tests. Men scored significantly better than women in the chair stand, 8-ft up-and-go, and 6-min walk. Women scored significantly better than men in chair sit-and-reach and back scratch. Active participants scored better in functional-fitness tests than their average and nonactive peers. This study showed a decline in functional fitness with age, better performance of men, and increased proficiency in active participants.

  8. Prevalence and potentially reversible factors associated with anorexia among older nursing home residents: results from the ULISSE project.

    PubMed

    Landi, Francesco; Lattanzio, Fabrizia; Dell'Aquila, Giuseppina; Eusebi, Paolo; Gasperini, Beatrice; Liperoti, Rosa; Belluigi, Andrea; Bernabei, Roberto; Cherubini, Antonio

    2013-02-01

    The principal aims of the present study were to explore the prevalence of anorexia and the factors correlated to anorexia in a large population of older people living in nursing home. Secondary, we evaluated the impact of anorexia on 1-year survival. Data are from baseline evaluation of 1904 participants enrolled in the Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziano study, a project evaluating the quality of care for older persons living in an Italian nursing home. All participants underwent a standardized comprehensive evaluation using the Italian version of the inter Resident Assessment Instrument Minimum Data Set (version 2.0) for Nursing Home. We defined anorexia as the presence of lower food intake. The relationship between covariates and anorexia was estimated by deriving ORs and relative 95% CIs from multiple logistic regression models including anorexia as the dependent variable of interest. Hazard ratios and 95% CIs for mortality by anorexia were calculated. More than 12% (240 participants) of the study sample suffered from anorexia, as defined by the presence of decreased food intake or the presence of poor appetite. Participants with functional impairment, dementia, behavior problems, chewing problems, renal failure, constipation, and depression, those treated with proton pump inhibitors and opioids had a nearly 2-fold increased risk of anorexia compared with participants not affected by these syndromes. Furthermore, participants with anorexia had a higher risk of death for all causes compared with nonanorexic participants (hazard ratio 2.26, 95% CI: 2.14-2.38). The major finding is that potentially reversible causes, such as depression, pharmacologic therapies, and chewing problems, were strongly and independently associated with anorexia among frail older people living in nursing home. Furthermore, anorexia was associated with higher rate of mortality, independently of age and other clinical and functional variables. Copyright © 2013

  9. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities.

    PubMed

    Genao, Liza; Buhr, Gwendolen T

    2012-04-01

    Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more harm than good, leading to increased rates of adverse drug effects and more recurrent infections with drug-resistant bacteria. It also does not improve genitourinary symptoms (eg, polyuria or malodorous urine) or lead to improved mortality rates; thus, distinguishing UTIs from asymptomatic bacteriuria is imperative in the LTC setting. This article provides a comprehensive overview of UTI in the LTC setting, outlining the epidemiology, risk factors and pathophysiology, microbiology, diagnosis, laboratory assessment, and management of symptomatic UTI.

  10. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities

    PubMed Central

    Genao, Liza; Buhr, Gwendolen T.

    2013-01-01

    Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more harm than good, leading to increased rates of adverse drug effects and more recurrent infections with drug-resistant bacteria. It also does not improve genitourinary symptoms (eg, polyuria or malodorous urine) or lead to improved mortality rates; thus, distinguishing UTIs from asymptomatic bacteriuria is imperative in the LTC setting. This article provides a comprehensive overview of UTI in the LTC setting, outlining the epidemiology, risk factors and pathophysiology, microbiology, diagnosis, laboratory assessment, and management of symptomatic UTI. PMID:23418402

  11. The effect of a music programme during lunchtime on the problem behaviour of the older residents with dementia at an institution in Taiwan.

    PubMed

    Chang, Fang-Yu; Huang, Hui-Chi; Lin, Kuan-Chia; Lin, Li-Chan

    2010-04-01

    To study the effect of a music programme during lunchtime on problem behaviour among institutionalised older residents with dementia. Symptoms of dementia among older people include depression, problems with memory, insomnia and problem behaviours. Problem behaviour has been identified by families and nurses as the greatest challenge that needs to be addressed. Several studies have found that music therapy can reduce problem behaviours among dementia sufferers and, based on this finding, music has been recommended for incorporation as part of dementia management. This study used a quasi-experimental design with an eight-week time series follow-up. The intervention was background music when residents had their lunch meal. A purposive sampling technique was used. Forty-one participants were selected from an institution housing residents with dementia located in a city in Taiwan. The mean age of participants was 81.68 (SD 6.39) years old. The mean score for Mini-Mental State Examination (MMSE) was 10.66 (SD 6.85). The mean of Barthel Activity of Daily Living score was 56.83 (SD 38.12). The results showed that the music programme reduced, significantly, physical and verbal aggressive behaviour among the older residents with dementia. The study identified that there was a one-week time lag between the implementation of the music programme and a significant effect on the residents. The results from this study suggested that music is able to reduce the degree of problem behaviours among the older residents with dementia and this helps to ease work-load of nurse aides and nurses during meal times. The results may serve as a reference for the future treatment of problem behaviour among the older with dementia.

  12. Re-Imagining the Care Home: A Spatially Responsive Approach to Arts Practice with Older People in Residential Care

    ERIC Educational Resources Information Center

    Hatton, Nicola

    2014-01-01

    This paper considers some of the spatial challenges of doing arts projects with older people in care homes, including those living with dementia. It reflects on the author's own experience of running a performance project with residents with at a care home in North London. Drawing on Lefebvre's concept of socially produced space, it argues that…

  13. Re-Imagining the Care Home: A Spatially Responsive Approach to Arts Practice with Older People in Residential Care

    ERIC Educational Resources Information Center

    Hatton, Nicola

    2014-01-01

    This paper considers some of the spatial challenges of doing arts projects with older people in care homes, including those living with dementia. It reflects on the author's own experience of running a performance project with residents with at a care home in North London. Drawing on Lefebvre's concept of socially produced space, it argues that…

  14. SOS--Satisfied or Stuck, Why Older Rural Residents Stay Put: Aging in Place or Stuck in Place in Rural Utah

    ERIC Educational Resources Information Center

    Erickson, Lance D.; Call, Vaughn R. A.; Brown, Ralph B.

    2012-01-01

    As rural communities undergo substantial demographic and economic changes, understanding the migration intentions and their antecedents of rural elderly persons becomes increasingly important. Using data drawn from a survey of adults from 24 rural Utah communities conducted in 2008, we examine whether rural residents 60 years of age or older plan…

  15. Environmental exposures to polychlorinated biphenyls (PCBs) among older residents of upper Hudson River communities.

    PubMed

    Fitzgerald, Edward F; Belanger, Erin E; Gomez, Marta I; Hwang, Syni-an; Jansing, Robert L; Hicks, Heraline E

    2007-07-01

    The upper Hudson River has been heavily contaminated with polychlorinated biphenyls (PCBs) due to discharges from former electrical capacitor plants in Hudson Falls and Fort Edward, NY. An epidemiologic study was conducted to assess the impact of dietary and residential exposure on PCB body burden among older, long-term, non-occupationally exposed adults living in the vicinity of these former capacitor plants. The study population consisted of 133 persons 55-74 years of age who had lived in Hudson Falls or Fort Edward for 25 years or more. The comparison group consisted of 120 persons from Glens Falls, which is upriver. Both groups were interviewed, and blood samples were obtained for congener-specific PCB analysis. Persons from the study area reported greater past consumption of Hudson River fish than did the comparison area, but current rates were very low in both areas. The geometric mean serum PCB concentrations for the study and comparison populations did not differ significantly (3.07 ppb wet weight and 3.23 ppb, respectively, for total PCB). Serum PCB concentrations increased with cumulative lifetime exposure to PCBs from Hudson River fish consumption (p<0.10). Persons who lived within 800 m of the river did not have significantly greater serum PCB concentrations than the control population, nor did persons who lived downwind and within 800 m of a PCB-contaminated site. The results indicate no detectable differences in serum PCB levels according to proximity or wind direction relative to local point sources, but lifetime consumption of Hudson River fish was positively associated with serum PCB concentrations.

  16. Use of Supplements in Puerto Rican Older Adults Residing in an Elderly Project

    PubMed Central

    Olivera, Enid J.; Palacios, Cristina

    2014-01-01

    Objective There has been a notable increase in the use of nutritional supplements in elders. Studies indicate that there may be a health risk in this population associated with the possible interactions of supplements with medications. Objective: Explore the profile of use of nutritional supplements in the elderly and the possible health risks from the concurrent use of certain supplements and medications. Methods This was an exploratory cross-sectional study in a convenient sample of 130 subjects aged 60 years and older. The data was collected using a previously validated questionnaire. Chi2 was used to associate the use of supplements by demographics and health information and Spearman correlation to establish the relationship between the number of nutritional supplements, medications used and health conditions reported. Results About 63% of the subjects were women. Women used more supplements compared to men (p<0.05). Most common supplements used were multivitamins and calcium. Non vitamin non mineral (NVNM) supplements use was low and the most used were garlic, chondroitin, glucosamine, and ginger. The conditions most related to the use of supplements were hypertension and arthritis. There was a significant correlation between the number of nutritional supplements with number of medications (R=0.27; p<0.01) and number of health conditions (R=0.31; p<0.01). There were 8 possible health risks associated with the use of NVNM together with anticoagulants and antidiabetics. Conclusion Supplement use was higher in women and in participants with hypertension and arthritis, with some potential risks to health between the use of certain NVNM and medications. PMID:23844469

  17. High-Intensity Telemedicine Decreases Emergency Department Use for Ambulatory Care Sensitive Conditions by Older Adult Senior Living Community Residents.

    PubMed

    Shah, Manish N; Wasserman, Erin B; Gillespie, Suzanne M; Wood, Nancy E; Wang, Hongyue; Noyes, Katia; Nelson, Dallas; Dozier, Ann; McConnochie, Kenneth M

    2015-12-01

    Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) are common among older adults. The high-intensity telemedicine model of care has been proposed as an innovative approach to expand access to acute illness care, thereby preventing ED visits. The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of ED use for ACSCs. We performed a prospective cohort study at a primary care geriatrics practice that provides care to 22 SLCs. Six SLCs selected as intervention facilities, with the remaining SLCs serving as controls. Consenting practice patients at intervention facilities could have patient-to-provider, real-time, or store-and-forward high-intensity telemedicine services to diagnose and treat illnesses. The primary outcome was the rate of ED visits for which the primary diagnosis was an "ambulatory-care-sensitive" condition by the Institute of Medicine, which we compared between control and intervention participants. During the study period, control participants had 310 ED visits for ACSCs, for a rate of 0.195 visits/person-year. Intervention participants visited the ED for ACSCs 85 times, for a rate of 0.138 visits/person-year [unadjusted rate ratio (RR): 0.71, 95% confidence interval (CI): 0.53-0.94]. Among intervention participants, ED use for ACSCs decreased at an annual rate of 34% (RR: 0.661, 95% CI: 0.444-0.982), whereas, in the control group there was no statistically significant change in ED use over time (RR: 1.01, 95% CI: 0.90-1.14). Providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year, compared with no change in the rate of ED use for ACSCs among the control group. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  18. The Hispanic Paradox: Race/Ethnicity and Nativity, Immigrant Enclave Residence and Cognitive Impairment Among Older US Adults.

    PubMed

    Weden, Margaret M; Miles, Jeremy N V; Friedman, Esther; Escarce, José J; Peterson, Christine; Langa, Kenneth M; Shih, Regina A

    2017-05-01

    Hispanics, and particularly foreign-born Mexican Americans, have been shown to fare better across a range of health outcomes than might be expected given the generally higher levels of socioeconomic disadvantage in this population, a phenomena termed the "Hispanic Paradox". Previous research on social disparities in cognitive aging, however, has been unable to address both race/ethnicity and nativity (REN) in a nationally-representative sample of US adults leaving unanswered questions about potentially "paradoxical" advantages of Mexican ethnic-origins and the role of nativity, socioeconomic status (SES), and enclave residence. We employ biennial assessments of cognitive functioning to study prevalent and incident cognitive impairment (CI) within the three largest US REN groups: US-born non-Hispanic whites (US-NHW), US-born non-Hispanic blacks (US-NHB), US-born Mexican Americans (US-MA), and foreign-born Mexican Americans (FB-MA). Data come from a nationally-representative sample of community-dwelling older adults in the Health and Retirement Study linked with the 2000 Census and followed over 10 years (N = 8,433). Large disadvantages in prevalent and incident CI were observed for all REN minorities respective to US-born non-Hispanic whites. Individual and neighborhood SES accounted substantially for these disadvantages and revealed an immigrant advantage: FB-MA odds of prevalent CI were about half those of US-NHW and hazards of incident CI were about half those of US-MA. Residence in an immigrant enclave was protective of prevalent CI among FB-MA. The findings illuminate important directions for research into the sources of cognitive risk and resilience and provide guidance about CI screening within the increasingly diverse aging US population. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Influence of urban residence on use of psychotropic medications in Pennsylvania, USA: cross-sectional comparison of older adults attending senior centers.

    PubMed

    Edelstein, Offer; Pater, Karen; Sharma, Ravi; Albert, Steven M

    2014-02-01

    Differences in medication use by geographic region may indicate differences in access to specialist medical care, especially in the case of prescriptions for psychotropic medications. We assessed the effect of more or less urbanized residence on likelihood of psychotropic medication use in a large cohort of older adults in Pennsylvania, USA. Community-dwelling older adults were recruited from senior centers across Pennsylvania. Participant residences were geocoded and categorized according to US Department of Agriculture Rural-Urban Continuum Codes. We used the codes to identify respondents who live in relatively urban counties with 250,000 or more residents (n = 1,360) or less urban counties with fewer than 250,000 residents (n = 401). Participants reported prescription medications in a clinical interview. Psychotropic medications were categorized by class. Logistic regression models were estimated to assess the independent effect of residence on likelihood of psychotropic medication use. Geographic region was significantly associated with use of psychotropic medications. Psychotropic medication use was higher in less urban areas (19.7%) relative to more urban areas (14.2%), p = 0.007. In adjusted models, degree of urban residence was a significant correlate in models that adjusted for sociodemographic features and medical status (odds ratio 1.62; 95% confidence interval 1.13-2.31, p < 0.01). Use of psychotropic medications on the Beers list also increased with less urban residence (13.0 vs. 8.3%, p = 0.005). Older adults living in less urbanized areas are more likely to be prescribed psychotropic drugs. This difference may indicate a health disparity based on access to geriatric specialists or mental health care.

  20. Collecting saliva and measuring salivary cortisol and alpha-amylase in frail community residing older adults via family caregivers.

    PubMed

    Hodgson, Nancy A; Granger, Douglas A

    2013-12-18

    Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

  1. Slow Gait Speed and Risk of Long-Term Nursing Home Residence in Older Women, Adjusting for Competing Risk of Mortality: Results from the Study of Osteoporotic Fractures.

    PubMed

    Lyons, Jennifer G; Ensrud, Kristine E; Schousboe, John T; McCulloch, Charles E; Taylor, Brent C; Heeren, Timothy C; Stuver, Sherri O; Fredman, Lisa

    2016-12-01

    To determine whether slow gait speed increases the risk of costly long-term nursing home residence when accounting for death as a competing risk remains unknown. Longitudinal cohort study using proportional hazards models to predict long-term nursing home residence and subdistribution models with death as a competing risk. Community-based prospective cohort study. Older women (mean age 76.3) participating in the Study of Osteoporotic Fractures who were also enrolled in Medicare fee-for-service plans (N = 3,755). Gait speed was measured on a straight 6-m course and averaged over two trials. Long-term nursing home residence was defined using a validated algorithm based on Medicare Part B claims for nursing home-related care. Participants were followed until long-term nursing home residence, disenrollment from Medicare plan, death, or December 31, 2010. Over the follow-up period (median 11 years), 881 participants (23%) experienced long-term nursing home residence, and 1,013 (27%) died before experiencing this outcome. Slow walkers (55% of participants with gait speed <1 m/s) were significantly more likely than fast walkers to reside in a nursing home long-term (adjusted hazards ratio (aHR) = 1.79, 95% confidence interval (CI) = 1.54-2.09). Associations were attenuated in subdistribution models (aHR = 1.52, 95% CI = 1.30-1.77) but remained statistically significant. Older community-dwelling women with slow gait speed are more likely to experience long-term nursing home residence, as well as mortality without long-term residence. Ignoring the competing mortality risk may overestimate long-term care needs and costs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  2. Differences in fall injury hospitalization and related survival rates among older adults across age, sex, and areas of residence in Canada.

    PubMed

    Johnson, Shanthi; Kelly, Sheila; Rasali, Drona

    2015-12-01

    Falls are the leading cause of injury-related hospital admissions in Canadian older adults, accounting for 85 % of injury hospitalizations among older adults aged over 65 years. While many of these injuries can lead to death, the survival rates of fall-related injuries are rarely examined. This surveillance study examined the fall injury hospitalization and survival rates among older adults in the context of place. Saskatchewan's health administrative data on injury hospitalizations among individuals aged 65 years and over (n = 39,867) was utilized for this study. Variables of interest included age group, sex, and the geographical area of residence at the time of hospitalization (rural, urban, north). Logistic regression analysis was applied to determine the association of variables of interest (age group, sex, and area of residence at the time of hospitalization as the covariate) with frequency of fall injury hospitalizations. Probable time to death due to fall-related injury hospitalization was determined by survival analysis. Three key findings that emerged from the present study are the following: (1) fall injury hospitalizations accounted for 77 % of all injury hospitalizations; (2) fall injury hospitalization rates varied by age group, sex, and area of residence, with advancing age, women, and certain geographical areas showing higher rates; and (3) survival rates also varied by sex and area of residence. Women had longer survival estimates after a fall injury hospitalization compared to men, and those living in the north have the shortest survival estimates. The findings from the study highlighted the high rate of fall-related injury hospitalization among older adults varying with their age group, sex, and area of residence. These factors need to be considered in injury surveillance and fall prevention research as well as programs and policies that support the reduction of falls.

  3. Relationships among self-efficacy, depression, life satisfaction, and adaptation among older korean adults residing in for-profit professional nursing facilities.

    PubMed

    Chang, Ae-Kyung; Park, James; Sok, Sohyune R

    2013-09-01

    Adapting to a new environment is especially difficult for older adults relocating into professional nursing facilities or other specialized care centers. This relocation is a prominent life stressor in older adults. This study examined the self-efficacy, depression, life satisfaction, and adaptation and the relationships among these four variables of older Korean adults residing in for-profit professional nursing facilities to provide preliminary information necessary to improve nursing interventions. This was a cross-sectional and descriptive correlation study. The 322 participants were all over the age of 65 years and resided in one of three different for-profit professional nursing facilities in Seoul and Gyeonggi-do, South Korea. Measures used included a demographic characteristics form, Self-Efficacy Instrument, Korean Simple Depression Scale, Standard Life Satisfaction Instrument, and Facility Adaption Scale. Results found positive self-efficacy, depression, life satisfaction, and adaptation among participants. We found significant positive correlations among self-efficacy, life satisfaction, and adaptation and significant negative correlations among depression, life satisfaction, and adaptation. Moreover, we found noticeable differences in the degree of adaptation to professional nursing facility placement in several variables, including gender, age, level of education, religious background, perceived health status, presence of a spouse, presence of a nonprofessional caregiver(s), and decision maker. This cross-sectional study provides preliminary evidence that older Korean adults in for-profit professional nursing facilities generally maintain a healthy level of well-being. However, nursing interventions to improve self-efficacy and life satisfaction and decrease depression in older adult residents are needed to help these older adults adapt to life in such facilities.

  4. Ethnic differences in the +405 and -460 vascular endothelial growth factor polymorphisms and peripheral neuropathy in patients with diabetes residing in a North London, community in the United Kingdom.

    PubMed

    Zitouni, Karima; Tinworth, Lorna; Earle, Kenneth Anthony

    2017-06-29

    There are marked ethnic differences in the susceptibility to the long-term diabetic vascular complications including sensory neuropathy. The vascular endothelial growth factor (VEGF) +405 (C/G) and -460 (T/C) polymorphisms are associated with retinopathy and possibly with nephropathy, however no information is available on their relationship with peripheral neuropathy. Therefore, we examined the prevalence of these VEGF genotypes in a multi-ethnic cohort of patients with diabetes and their relationship with evident peripheral diabetic neuropathy. In the current investigation, we studied 313 patients with diabetes mellitus of African-Caribbean, Indo-Asian and Caucasian ethnic origin residing in an inner-city community in London, United Kingdom attending a single secondary care centre. Genotyping was performed for the VEGF +405 and VEGF -460 polymorphisms using a pyrosequencing technique. Forty-nine patients (15.6%) had clinical evidence of peripheral neuropathy. Compared to Caucasian patients, African-Caribbean and Indo-Asian patients had lower incidence of neuropathy (24.6%, 14.28%, 6.7%, respectively; P = 0.04). The frequency of the VEGF +405 GG genotype was more common in Indo-Asian patients compared to African-Caribbean and Caucasian patients (67.5%, 45.3%, 38.4%, respectively; p ≤ 0.02). The G allele was more common in patients with type 2 diabetes of Indo-Asian origin compared to African-Caribbean and Caucasian origin (p ≤ 0.02). There was no difference between the ethnic groups in VEGF -460 genotypes. The distributions of the VEGF +405 and VEGF -460 genotypes were similar between the diabetic patients with and without neuropathy. In this cohort of patients, VEGF +405 and VEGF -460 polymorphisms were not associated with evident diabetic peripheral neuropathy, however an association was found between VEGF +405 genotypes and Indo-Asian which might have relevance to their lower rates of ulceration and amputation. This finding highlights the need for

  5. Jack London's "White Fang."

    ERIC Educational Resources Information Center

    Westall, Robert

    1993-01-01

    Relates the kinds of reading done in childhood by a now distinguished writer, Robert Westall. Describes specifically how Jack London's novel, "White Fang," influenced the development of this writer. Narrates and comments on the action of the novel. (HB)

  6. The London Schools Planetarium

    ERIC Educational Resources Information Center

    Richards-Jones, P.

    1973-01-01

    Summarizes the scientific activities conducted at the London Schools Planetarium by students of primary and secondary schools and of teacher colleges. Included is a table illustrating the astronomical background of student teachers. (CC)

  7. Materials modelling in London

    NASA Astrophysics Data System (ADS)

    Ciudad, David

    2016-04-01

    Angelos Michaelides, Professor in Theoretical Chemistry at University College London (UCL) and co-director of the Thomas Young Centre (TYC), explains to Nature Materials the challenges in materials modelling and the objectives of the TYC.

  8. Chronic diseases among older people and co-resident psychological morbidity: a 10/66 Dementia Research Group population-based survey.

    PubMed

    Honyashiki, Mina; Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Llibre-Rodrigues, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Prince, Martin J

    2011-11-01

    This is the first study to investigate the associations between chronic health conditions of older people and their impact on co-resident psychological morbidity using population-based samples in low and middle income countries (LAMICs). Single-phase cross-sectional catchment area surveys were undertaken in urban sites in Cuba, Dominican Republic and Venezuela, and in rural and urban catchment areas in Mexico, Peru, India and China. All residents aged 65 years and over were interviewed with a co-resident key informant. Exposures were structured clinical diagnoses (10/66 and DSM-IV dementia and ICD-10 depression), self-reported diagnosis (stroke) and physical impairments. Mediating variables were dependence and disability (WHODAS 2.0), and the outcome was co-resident psychological morbidity assessed using SRQ-20. Poisson regression analysis was used to estimate the prevalence ratios (PRs) for the associations between health conditions and psychological morbidity in each site, and meta-analysis was used to pool the estimates. 11,988 pairs comprising a participant and a co-resident informant were included in the analysis. After meta-analysis, independent effects were noted for depression (PR2.11; 95% CI 1.82-2.45), dementia (PR 1.98; 95% CI 1.72-2.28), stroke (PR 1.42; 95% CI 1.17-1.71) and physical impairments (PR 1.17; 95% CI 1.13-1.21). The effects were partly mediated through disability and dependence. The mean population attributable fraction of total chronic conditions was 30.1%. The prevalence of co-resident psychological morbidity is higher among co-residents of older people with chronic conditions. This effect was prominent for, but not confined to, depression and dementia. Attention needs to be directed to chronic conditions.

  9. Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting

    PubMed Central

    Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

    2013-01-01

    Purpose To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self

  10. A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities.

    PubMed

    Davison, Tanya E; Eppingstall, Barbara; Runci, Susannah; O'Connor, Daniel W

    2017-07-01

    The aim of this study was to evaluate the efficacy and acceptability of a psychological intervention based on acceptance and commitment therapy (ACT) to improve symptoms of depression and anxiety among older adults living in long-term care. Forty one residents aged between 63 and 97 years (M = 85.3 years) participated in this study. Residents were allocated to receive either a 12 session ACT intervention implemented by trainee psychology therapists or a wait-list control group. Measures of depression and anxiety were collected at baseline and 8 week post-intervention, and residents who received the intervention were tracked for three months. A treatment satisfaction questionnaire was administered to residents who received the intervention and a sample of 10 facility staff members. Using an intention to treat approach and controlling for baseline scores, scores on depression measures were significantly lower after the ACT intervention than after the wait-list control. These outcomes were maintained at three-month follow-up. Treatment satisfaction was rated highly by both residents and their care staff. This preliminary trial suggests that ACT shows promise as a therapeutic approach to address symptoms of depression in long-term care.

  11. Reasons for living, meaning in life, and suicide ideation: investigating the roles of key positive psychological factors in reducing suicide risk in community-residing older adults.

    PubMed

    Heisel, Marnin J; Neufeld, Eva; Flett, Gordon L

    2016-01-01

    To investigate the roles of reasons for living (RFL) and meaning in life (MIL) in potentially promoting mental health and well-being and protecting against suicide ideation among community-residing older adults and to investigate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA). Of 173 older adults initially recruited into a longitudinal study on late-life suicide ideation, 109 completed the RFL-OA and measures of cognitive and physical functioning and positive and negative psychological factors at a two-year follow-up assessment. We tested a model in which RFL and MIL protect against suicide ideation, controlling for demographic and clinical factors. We also assessed the psychometric properties of the RFL-OA in community-residing older adults, investigating its internal consistency and its convergent (MIL, perceived social support, and life satisfaction), divergent (loneliness, depressive symptom severity, and suicide ideation), and discriminant validity (cognitive and physical functioning). RFL-OA scores explained significant variance in suicide ideation, controlling for age, sex, depressive symptom severity, and loneliness. MIL explained significant unique variance in suicide ideation, controlling for these factors and RFL, and MIL significantly mediated the association between RFL and suicide ideation. Psychometric analyses indicated strong internal consistency (α = .94), convergent, divergent, and discriminant validity for the RFL-OA relative to positive and negative psychological factors and cognitive and physical functioning. These findings add to a growing body of literature suggesting merit in investigating positive psychological factors together with negative factors when assessing suicide risk and planning psychological services for older adults.

  12. Good oral health, adequate nutrient consumption and family support are associated with a reduced risk of being underweight amongst older Malaysian residents of publicly funded shelter homes.

    PubMed

    Visvanathan, Renuka; Ahmad, Zaiton

    2006-01-01

    A low body mass index in older people has been associated with increased mortality. The main objective of this study was to identify factors associated with low body mass indices [ BMIs] (< 18.5 kg/m2) in older residents of shelter care facilities in Peninsular Malaysia. 1081 elderly people (59% M) over the age of 60 years were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well being. Body mass index was also determined. Subjects were recruited from publicly funded shelter homes in Peninsular Malaysia. 14.3% of residents had BMIs < 18.5 kg/m2. Multivariate analyses (adjusted for age and sex) revealed that having no family (RR 1.98[95%CI 1.40-2.82], p<0.001) and negative responses to statement 3 [I eat few fruits or vegetables or milk products] (RR 0.62 [95% CI 0.42-0.90]; P= 0.013) and statement 5 [I have tooth or mouth problems that make it hard for me to eat] (RR 0.69 [95%CI 0.50-0.96]; P= 0.023) of the ' Determine Your Nutritional Health Checklist' were independently associated with low BMIs (<18.5 kg/m2). Older people with no family support were at risk of becoming underweight. Older people who consumed fruits, vegetables or milk or had good oral health were less likely to be underweight. Nutrient intake, oral health and social support were important in ensuring healthy body weight in older Malaysians.

  13. 110. Shaws Cove Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    110. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  14. 111. Shaws Cove Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    111. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  15. 117. Thames River Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    117. Thames River Bridge. New London, New London Co., CT. Sec. 4215, MP 124.09. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  16. Rural Residence and Prescription Medication Use by Community-Dwelling Older Adults: A Review of the Literature

    ERIC Educational Resources Information Center

    Grymonpre, Ruby E.; Hawranik, Pamela G.

    2008-01-01

    Context: Due to various barriers to health care access in the rural setting, there is concern that rural older adults might have lower access to prescribed medications than their urban counterparts. Purpose: To review published research reports to determine prevalence and mean medication use in rural, noninstitutionalized older adults and assess…

  17. Rural Residence and Prescription Medication Use by Community-Dwelling Older Adults: A Review of the Literature

    ERIC Educational Resources Information Center

    Grymonpre, Ruby E.; Hawranik, Pamela G.

    2008-01-01

    Context: Due to various barriers to health care access in the rural setting, there is concern that rural older adults might have lower access to prescribed medications than their urban counterparts. Purpose: To review published research reports to determine prevalence and mean medication use in rural, noninstitutionalized older adults and assess…

  18. The wrong London

    NASA Astrophysics Data System (ADS)

    Griffiths, Hugh; Tong, Kenneth

    2010-01-01

    Your article "Optics pioneers scoop Nobel prize" (November 2009 pp6-7) incorrectly states that Charles Kao, who shared the 2009 Nobel Prize for Physics with Willard Boyle and George Smith, received his PhD from Imperial College London.

  19. The basic data for residents aged 16 years or older who received a comprehensive health check examinations in 2011-2012 as a part of the Fukushima Health Management Survey after the great East Japan earthquake.

    PubMed

    Kawasaki, Yukihiko; Hosoya, Mitsuaki; Yasumura, Seiji; Ohira, Tetsuya; Satoh, Hiroaki; Suzuki, Hitoshi; Sakai, Akira; Ohtsuru, Akira; Takahashi, Atsushi; Ozasa, Kotaro; Kobashi, Gen; Kamiya, Kenji; Yamashita, Shunichi; Abe, Masafumi

    2014-01-01

    To assist in the long-term health management of residents and evaluate health impacts after the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant accident in Fukushima Prefecture, the Fukushima prefectural government decided to conduct the Fukushima Health Management Survey. This report describes the results for residents aged 16 years or older who received the health check examinations and evaluates the data obtained from 2011 and 2012. The target group consisted of residents aged 16 years or older who had lived in the evacuation zone. The health check examinations were performed on receipt of an application for a health check examination from any of the residents. The examinations, including measurements of height, weight, abdominal circumference/body mass index (BMI), blood pressure, biochemical laboratory findings, and peripheral blood findings, were performed as required. 1) A total of 56,399 (30.9%) and 47,009 (25.4%) residents aged 16 years or older received health checks in 2011 and 2012, respectively. 2) In both years, a number of male and female residents in the 16-39 year age group were found to suffer obesity, hyperlipidemia, hyperuricemia, or liver dysfunction, and the prevalence of obesity and hyperlipidemia among residents increased with age. Furthermore, the proportion of residents with hypertension, glucose metabolic abnormalities or renal dysfunction was higher in those aged 40 years or older. 3) The frequencies of obesity, hypertension and hyperlipidemia among residents in 2012 were lower than those in 2011. However, the prevalence of liver dysfunction, hyperuricemia, glucose metabolic abnormalities and renal dysfunction among residents was higher in 2012 than in 2011. These results suggested the number of residents who had lived in the evacuation zone with obesity, hyperlipidemia, hyperuricemia, liver dysfunction, hypertension, glucose metabolic abnormalities, or renal dysfunction increased with age in all age groups

  20. Staff perspectives on the provision of end-of-life care in a community residence for older adults with developmental disabilities.

    PubMed

    Kirkendall, Abbie M; Waldrop, Deborah

    2013-09-01

    The purpose of the study was to describe the perceptions of community residence (CR) staff who have cared for older adults with developmental disabilities (ADDs) that are at the end of life. This exploratory, descriptive study utilized qualitative methods that involved semistructured interviews with CR staff members. The setting was a CR that was also an intermediate care facility (ICF) that provided 24-hour residential treatment for medical and/or behavioral needs. At least one registered nurse was present at all times. A CR with at least one resident who was over the age of 40 and had a diagnosis of a life-limiting illness was chosen. Participants included three frontline workers, four managers, and one registered nurse. In-person interviews included open-ended questions about end-of-life care for older ADDs. Demographics such as age, length of time working with ADDs, and education were analyzed using descriptive statistics. Descriptive statistics were used to analyze demographics such as age, and length of time working with ADDs. Interviews were digitally recorded, transcribed, and analyzed using grounded theory techniques. Four themes illuminated unique elements of the provision of end-of-life care in a CR: (1) influence of relationships, (2) expression of individuality, (3) contribution of hospice, (4) grief and bereavement, and (5) challenges to end-of-life care. The results provided insight into the unique needs of older ADDs at the end of life and how this influences their care. Emphasis was also placed on the importance of specialized care that involved collaborations with hospice for older ADDs who remain in a CR at the end of life.

  1. The Dependence on Smokeless Tobacco in the South Asian Communities in East London

    PubMed Central

    Khaja, Amjad Hussain; Zwiad, Abdulsalam Ali; Tarakji, Bassel; Gazal, Giath; Albaba, Feras; KalajI, Nader; Petro, Waleed

    2016-01-01

    Background & Objective: The purpose of the study was to understand the dependency on smokeless tobacco. Methods: The major aspect of the interview was to study the type of chewing tobacco used, frequency of purchase of chewing tobacco, change in attitude and behavior after the use of chewing tobacco. This study was done in 2005 in London. Of the 110 respondents interviewed 88 were used for the data analysis. Study Design: An exploratory study was conducted in East London, United Kingdom. The selected sample was interviewed through a questionnaire, based on the Severson Smokeless Tobacco Dependence Scale. Results: Cross tabulations report that in a sample of 88 South Asian UK resident men 46.6% used leaf (paan), 43.2% used processed form of chewing tobacco and 10.2% used gutka. Older age (67%) respondents were more likely than the younger age (30%) respondents to chew tobacco. The frequency of purchase of chewing tobacco is reported high (67.2%) in the older age group than the younger age group (50%). Conclusion: This current study used an amended form of the Severson Smokeless Tobacco Scale questionnaire to study the dependency on smokeless tobacco. The study could be developed in the selection of the sample, which would include both males and females to study the dependency on smokeless tobacco. PMID:26234985

  2. Nutritional status among older residents with dementia in open versus special care units in municipal nursing homes: an observational study

    PubMed Central

    2013-01-01

    Background Undernutrition is widespread among institutionalised elderly, and people suffering from dementia are at particularly high risk. Many elderly with dementia live in open units or in special care units in nursing homes. It is not known whether special care units have an effect on the nutritional status of the residents. The aim of this study was therefore to examine the nutritional status of residents with dementia in both open units and in special care units. Methods Among Oslo’s 29 municipal nursing homes, 21 participated with 358 residents with dementia or cognitive impairment, of which 46% lived in special care units. Nutritional status was assessed using the Malnutrition Universal Screening Tool and anthropometry. Results We found no differences (p > 0.05) in risk of undernutrition, body mass index, mid-upper arm muscle circumference or triceps skinfold thickness between residents in open units and those in special care units. Residents in special care units were significantly younger and stronger when measured with a hand-grip test. Conclusions We found no difference in nutritional status between nursing home residents with dementia/cognitive impairment in open units versus in special care units. PMID:23496975

  3. The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

    PubMed Central

    Lorenc, Ava; Lorigan, James; Jowata, Mohamade; Brook, Gary; Banarsee, Ricky

    2014-01-01

    Background HIV has changed from a rapidly deteriorating illness to a complex chronic disease, with increasing incidences of comorbidity, including cancer, and liver, lung and cardiovascular diseases. North West London has 6719 individuals living with the human immunodeficiency virus (HIV), 873 of whom reside in the London Borough of Brent. Traditionally, commissioning services have focused on HIV therapy alone without considering how comorbidity affects treatment outcome and total service costs. Setting The setting for the study was NHS Brent Primary Care Trust, London UK. Question What associated comorbidities are present in people in Brent (London, UK) living with HIV, and how common are they? Methods A point-prevalence audit of retrospective data was conducted on all HIV-positive patients in Brent (financial year 2011/12). Data were collected from genito-urinary medicine (GUM) services, community services and general practitioners (GPs) on HIV diagnosis, patient demographics and past/current comorbidities: hepatitis B and C, cardiovascular disease, diabetes and mental health disorders. Results This study identified that 29% of people living with HIV/AIDS (PLWHA) in Brent have at least one comorbidity. The most common was hepatitis, followed by mental health disorders and cardiovascular disease (CVD). Comorbidity was more likely in older male patients (in particular CVD and diabetes) and White patients (except for diabetes which was more common in Asian groups). Discussion/Conclusion Many PLWHA in Brent suffer from a number of other conditions, which appear largely independent of HIV. Findings confirm the need to treat HIV as a long-term condition, including patient education, empowerment and encouraging self-management. The multi-morbidity of many PLWHA suggests a role for both primary care and collaborative, holistic, patient-centred and individualised healthcare. Service providers and commissioners need to consider comorbidities in their treatment of and

  4. Atmospheric merger in London

    NASA Astrophysics Data System (ADS)

    At the invitation of Imperial College, the Laboratory for Planetary Atmospheres, University College London, will be integrated in August with the Atmospheric Physics Group to form a single teaching and research unit. The new group, to be located at Imperial College, will be headed by Garry Hunt.The new group will possess a balanced research program in the observational and interpretative aspects of atmospheric physics. The existing Imperial College group actively researches cumulonimbus dynamics and climate modeling.

  5. "I Feel Trapped": The Tension Between Personal and Structural Factors of Social Isolation and the Desire for Social Integration Among Older Residents of a High-Crime Neighborhood.

    PubMed

    Portacolone, Elena; Perissinotto, Carla; Yeh, Jarmin Christine; Greysen, S Ryan

    2017-02-17

    The aim of this study was to examine the factors contributing to the social isolation of older residents of a high-crime neighborhood through the in-depth examination of their lived experiences. A deeper understanding of factors contributing to social isolation can allow policymakers and health care providers to create policies and programs to alleviate the social isolation of these vulnerable and understudied individuals. Participants were recruited through the support of the Housing Authority and Police and Fire Departments of Richmond, California, a town with a high-crime rate. Fifty-nine ethnographic interviews were conducted with 20 individuals of 58-95 years of age. Transcripts and fieldnotes were analyzed with a focus on the specific factors contributing the social isolation of participants. An overarching theme of tension between personal and structural factors of social isolation and desire for social integration emerged from qualitative content analysis. A tension emerged between a longing to participate in society and the immersion in a reality so dense with obstacles that made participation in society difficult to attain. Four specific themes also emerged. Three themes demonstrated underlying factors of social isolation stemming from the personal sphere and the physical and social environment. The fourth theme illustrated participants' desire for social integration. Findings demonstrate the salience of interventions and programs to make neighborhoods safe and accessible to older residents. Findings also suggest a need to reframe the conceptual framework for social isolation to better measure and alleviate this public health problem.

  6. Disturbed social recognition and impaired risk judgement in older residents with mild cognitive impairment after the Great East Japan Earthquake of 2011: the Tome Project.

    PubMed

    Akanuma, Kyoko; Nakamura, Kei; Meguro, Kenichi; Chiba, Masanori; Gutiérrez Ubeda, Sergio Ramón; Kumai, Keiichi; Kato, Yuka; Oonuma, Jiro; Kasai, Mari; Nakatsuka, Masahiro; Seki, Takashi; Tomita, Hiroaki

    2016-11-01

    After the Great East Japan Earthquake of 2011, we investigated the safety of residents in the affected communities. Most of the people requiring help were elderly and had previously been assessed as Clinical Dementia Rating (CDR) 0.5 (i.e. as having mild cognitive impairment (MCI)). We examined how well they understood the television news and whether they could make appropriate decisions. This community-based study of dementia and difficulties following a disaster started in Tome, northern Japan. The subjects were 188 randomly selected older residents who underwent CDR, blood tests, magnetic resonance imaging, and cognitive tests, including an original visual risk cognition task. They were shown NHK news broadcasts from the day of the earthquake to determine whether they could understand the content. Neither the CDR 0 (healthy) nor the CDR 0.5 (MCI) subjects fully understood the television news. Some subjects did not recognize the danger of aftershocks and engaged in risky behaviour. CDR 0.5 subjects who exhibited such behaviour scored lower on the visual risk cognition task. It is noteworthy that television news is difficult to understand, even for healthy older adults. We found that MCI subjects had particular difficulties due to the disaster and suggest that risk cognition could be evaluated using visually presented materials. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  7. Relationship between preventive health services and use of inpatient and outpatient care by residents aged 40 or older in 44 municipalities in Osaka Prefecture, Japan.

    PubMed

    Nakanishi, N; Tatara, K

    1998-12-01

    We examined the relationships between preventive health services provided under the Law for Health and Medical Services for the Elderly and the use of inpatient and outpatient care by insured residents aged 40 or older covered by the National Health Insurance in 44 municipalities in Osaka Prefecture. Factor analyses showed that hospital admission rate and inpatient days per 100 insured persons, bed days per insured person, inpatient days per case, mean bed days, the proportion of long-stay (180 days or more), and the rate of long-stay per 1,000 insured persons accounted for the first factors of inpatient care with factor loadings of more than 0.82. Outpatient utilization rate and outpatient days per 100 insured persons comprised the first factors of outpatient care with factor loadings of more than 0.80. Patient cost per case and the proportion of high patient cost (600,000 Yen or more for inpatient care and 60,000 Yen or more for outpatient care) made up the second factors of either type of patient care with factor loadings of more than 0.87. The frequency of use of health check-ups and the numbers of instruction classes and participants in health education and health counseling per 100 residents showed negative correlations with indices of inpatient and outpatient care, except for patient cost per day. The scores for the first and second factors of inpatient care and for the first factor of outpatient care correlated negatively with all indices of the use of preventive health services. More active provision of preventive health services may therefore contribute to reducing the subsequent use of inpatient and outpatient care among residents aged 40 or older.

  8. Health Status and Social Networks as Predictors of Resilience in Older Adults Residing in Rural and Remote Environments

    PubMed Central

    Lee, Aaron; Carrico, Catherine; Bourassa, Katelynn; Slosser, Andrea

    2016-01-01

    Purpose. Health status and social networks are associated with resilience among older adults. Each of these factors may be important to the ability of adults to remain in rural and remote communities as they age. We examined the association of health status and social networks and resilience among older adults dwelling in a rural and remote county in the Western United States. Methods. We selected a random sample of 198 registered voters aged 65 years or older from a frontier Wyoming county. Hierarchical linear regression was used to examine the association of health status as well as social networks and resilience. We also examined health status as a moderator of the relationship between social networks and resilience. Results. Family networks (p = 0.024) and mental health status (p < 0.001) significantly predicted resilience. Mental health status moderated the relationship of family (p = 0.004) and friend (p = 0.021) networks with resilience. Smaller family and friend networks were associated with greater resilience when mental health status was low, but not when it was high. Conclusion. Efforts to increase mental health status may improve resilience among older adults in rural environments, particularly for those with smaller family and friends networks. PMID:27478639

  9. Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults

    PubMed Central

    Caballer, Vicent-Benavent; Lisón, Juan Francisco; Rosado-Calatayud, Pedro; Amer-Cuenca, Juan José; Segura-Orti, Eva

    2015-01-01

    [Purpose] The main objective of this study was to determine the contributions and extent to which certain physical measurements explain performance in the 6-minute walk test in healthy older adults living in a geriatric nursing home and for older adults dwelling in the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive impairment who were independent in their daily activities. [Methods] The 6-minute walk test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery, and hand-grip strength were examined. [Results] Strong significant associations were found between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise multiple regression on the entire sample showed that lower-limb function was a significant and independent predictor for the 6-minute walk test. Additionally, lower-limb function was a strong predictor for the 6-minute walk test in our nursing home group, whereas mobility was found to be the best predictor in our community-dwelling group. [Conclusion] Better lower-limb function, balance, and mobility result in a higher distance covered by healthy older adults. Lower-limb function and mobility appeared to best determine walking performance in the nursing home and community-dwelling groups, respectively. PMID:26696740

  10. Health Status and Social Networks as Predictors of Resilience in Older Adults Residing in Rural and Remote Environments.

    PubMed

    McKibbin, Christine; Lee, Aaron; Steinman, Bernard A; Carrico, Catherine; Bourassa, Katelynn; Slosser, Andrea

    2016-01-01

    Purpose. Health status and social networks are associated with resilience among older adults. Each of these factors may be important to the ability of adults to remain in rural and remote communities as they age. We examined the association of health status and social networks and resilience among older adults dwelling in a rural and remote county in the Western United States. Methods. We selected a random sample of 198 registered voters aged 65 years or older from a frontier Wyoming county. Hierarchical linear regression was used to examine the association of health status as well as social networks and resilience. We also examined health status as a moderator of the relationship between social networks and resilience. Results. Family networks (p = 0.024) and mental health status (p < 0.001) significantly predicted resilience. Mental health status moderated the relationship of family (p = 0.004) and friend (p = 0.021) networks with resilience. Smaller family and friend networks were associated with greater resilience when mental health status was low, but not when it was high. Conclusion. Efforts to increase mental health status may improve resilience among older adults in rural environments, particularly for those with smaller family and friends networks.

  11. Patterns of antimicrobial use for respiratory tract infections in older residents of long-term care facilities

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVE: To describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly residents of long-term care facilities (LTCFs). DESIGN: Data from a prospective, randomized, controlled study conducted from April 1998 through August 2001 to investigate the effect of vitamin ...

  12. Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

    ERIC Educational Resources Information Center

    Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

    2008-01-01

    The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

  13. Depression in older nursing home residents: the influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy.

    PubMed

    Choi, Namkee G; Ransom, Sandy; Wyllie, Richard J

    2008-09-01

    Based on in-depth interviews with 65 older nursing home residents, this study examined the residents' own understanding and perceptions of depressive symptoms, causes of their depression, their self-reported coping strategies, and their preferences for acceptable depression interventions. About half (n = 32) of all interviewees stated that they were either feeling depressed or experiencing negative affects. The major themes related to the causes of their depression were loss of independence, freedom and continuity with their past life; feelings of social isolation and loneliness; lack of privacy and frustration at the inconvenience of having a roommate and sharing a bathroom; loss of autonomy due to the institutional regimen and regulations; ambivalence toward cognitively impaired residents; ever-present death and grief; staff turnover and shortage; and stale programming and lack of meaningful in-house activities. Self-reported coping mechanisms included religion and stoicism, a sense of reality, positive attitude and family support. In regard to depression treatment, the interviewees appeared to prefer nursing home programs that reduce their isolation over group or individual psychotherapy.

  14. Cosmopolitanism, geographical imaginaries and belonging in North London.

    PubMed

    Devadason, Ranji

    2010-01-01

    Cosmopolitanism has been described as the cultural habitus of globalisation. It is therefore, albeit defined somewhat loosely, often associated with ethnically diverse, global cities. This paper considers the extent to which London engenders cosmopolitan values amongst its residents. It draws on survey data from the LOCAL MULTIDEM study of minorities' political participation to address these themes. The analysis examines perceptions of respect, belonging and geographical imaginaries - amongst established minorities and the ethnic majority - in north London. It is argued that cosmopolitan ethics are transformative and dialectical and, critically, cannot remain the preserve of the privileged in multi-ethnic neighbourhoods. The analysis presented demonstrates that a sense of belonging and cosmopolitan imaginaries are not evenly accessed by different ethnic groups; notably, that Bangladeshi Londoners who are born and bred in the city are less likely to appropriate these discourses than Caribbean, Indian or White residents.

  15. Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S.

    PubMed

    Choi, Sunha; Kim, Giyeon; Lee, Sungkyu

    2016-12-01

    Using the 2004-2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals' mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults' immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities.

  16. Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S

    PubMed Central

    Choi, Sunha; Kim, Giyeon

    2016-01-01

    Using the 2004–2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals’ mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults’ immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities. PMID:26910461

  17. A Flex-Model for long-term assessment of community-residing older adults following disasters.

    PubMed

    Rosenkoetter, Marlene M; McDonough, JoEllen; McCall, Amber; Smith, Deborah; Looney, Stephen

    2015-01-01

    For the rapidly growing older adult population, disaster consequences are frequently life disruptive and even life threatening. By 2050, it is estimated that the global older adult population will reach 22 percent of the total. With declining health, this population poses a particular risk needing to be addressed in emergency preparedness and disaster recovery. The purpose of this article is to describe a Flex-Model (F-M) for the long-term assessment of older adults following a disaster. An F-M is a series of three-dimensional representations of an archetype with flexible components, both linear and parallel, that can be adapted to situations, time, place, and needs. The model incorporates the Life Patterns Model and provides a template that can be adjusted to meet the needs of a local community, healthcare providers, and emergency management officials, regardless of the country or region, during the months after a disaster. The focus is on changes resulting from the disaster including roles, relationships, support systems, use of time, self-esteem, and life structure. Following a baseline assessment, each of these life patterns is assessed through the model with options for interventions over time. A pilot study was conducted in Georgia to gain information that would be helpful in developing a more specific assessment tool following a severe winter storm. While this is a local study, the findings can nevertheless be used to refine and focus the F-M for future implementation. Results indicated that older adults used high-risk heating and lighting sources and many were totally responsible for their own welfare. Findings have implications for emergency preparedness and long-term recovery.

  18. Social resources and disordered living conditions: evidence from a national sample of community-residing older adults.

    PubMed

    York Cornwell, Erin

    2014-07-01

    For older adults aging in the community, living conditions can promote health, enhance coping, and reduce disablement--but they can also create stress and increase risks of illness, accidents, and decline. Although socioeconomic disparities in housing likely contribute to inequalities in interior conditions, I argue that living conditions are also shaped by social resources such as coresidential relationships, social network ties, and social support. In this article, I examine the distribution of a set of risky or stressful physical and ambient living conditions including structural disrepair, clutter, lack of cleanliness, noise, and odor. Using data from the National Social Life, Health, and Aging Project (NSHAP), I find that low-income and African American older adults have more disordered living conditions as do those with poorer physical and mental health. In addition, older adults who have a coresident partner, more nonresidential network ties, and more sources of instrumental support are exposed to fewer risky or harmful living conditions. This suggests that living conditions are an important, though overlooked, mechanism through which household composition, social networks, and social support affect health and well-being in later life.

  19. Challenges and barriers to health care and overall health in older residents of Alaska: evidence from a national survey

    PubMed Central

    Foutz, Julia D.; Cohen, Steven A.; Cook, Sarah K.

    2016-01-01

    Background From 1970 to 2010, the Alaskan population increased from 302,583 to 698,473. During that time, the growth rate of Alaskan seniors (65+) was 4 times higher than their national counterparts. Ageing in Alaska requires confronting unique environmental, sociodemographic and infrastructural challenges, including an extreme climate, geographical isolation and less developed health care infrastructure compared to the continental US. Objective The objective of this analysis is to compare the health needs of Alaskan seniors to those in the continental US. Design We abstracted 315,161 records of individuals age 65+ from the 2013 and 2014 Behavioral Risk Factor Surveillance System, of which 1,852 were residents of Alaska. To compare residents of Alaska to residents of the 48 contiguous states we used generalized linear models which allowed us to adjust for demographic differences and survey weighting procedures. We examined 3 primary outcomes – general health status, health care coverage status and length of time since last routine check-up. Results Alaskan seniors were 59% less likely to have had a routine check-up in the past year and 12% less likely to report excellent health status than comparable seniors in the contiguous US. Conclusions Given the growth rate of Alaskan seniors and inherent health care challenges this vulnerable population faces, future research should examine the specific pathways through which these disparities occur and inform policies to ensure that all US seniors, regardless of geographical location, have access to high-quality health services. PMID:27056177

  20. Challenges and barriers to health care and overall health in older residents of Alaska: evidence from a national survey.

    PubMed

    Foutz, Julia D; Cohen, Steven A; Cook, Sarah K

    2016-01-01

    From 1970 to 2010, the Alaskan population increased from 302,583 to 698,473. During that time, the growth rate of Alaskan seniors (65+) was 4 times higher than their national counterparts. Ageing in Alaska requires confronting unique environmental, sociodemographic and infrastructural challenges, including an extreme climate, geographical isolation and less developed health care infrastructure compared to the continental US. The objective of this analysis is to compare the health needs of Alaskan seniors to those in the continental US. We abstracted 315,161 records of individuals age 65+ from the 2013 and 2014 Behavioral Risk Factor Surveillance System, of which 1,852 were residents of Alaska. To compare residents of Alaska to residents of the 48 contiguous states we used generalized linear models which allowed us to adjust for demographic differences and survey weighting procedures. We examined 3 primary outcomes - general health status, health care coverage status and length of time since last routine check-up. Alaskan seniors were 59% less likely to have had a routine check-up in the past year and 12% less likely to report excellent health status than comparable seniors in the contiguous US. Given the growth rate of Alaskan seniors and inherent health care challenges this vulnerable population faces, future research should examine the specific pathways through which these disparities occur and inform policies to ensure that all US seniors, regardless of geographical location, have access to high-quality health services.

  1. Connecting Londoners with Their City through Digital Technologies

    ERIC Educational Resources Information Center

    Swift, Frazer

    2013-01-01

    London is one of the most complex, dynamic and diverse cities in the world, with 8 million residents, over 300 languages spoken in its schools, and some 30 million overseas visitors every year. Reaching out to and connecting all these people with the city's heritage while catering to their many interests, motivations and learning needs is a huge…

  2. Connecting Londoners with Their City through Digital Technologies

    ERIC Educational Resources Information Center

    Swift, Frazer

    2013-01-01

    London is one of the most complex, dynamic and diverse cities in the world, with 8 million residents, over 300 languages spoken in its schools, and some 30 million overseas visitors every year. Reaching out to and connecting all these people with the city's heritage while catering to their many interests, motivations and learning needs is a huge…

  3. Social Capital and Suicidal Ideation in Community-Dwelling Older Residents: A Multilevel Analysis of 10,094 Subjects in Japan.

    PubMed

    Noguchi, Masayuki; Kobayashi, Tomoko; Iwase, Toshihide; Suzuki, Etsuji; Kawachi, Ichiro; Takao, Soshi

    2017-01-01

    Social capital, the collective resources of groups including perceptions of trust and reciprocity, is recognized as an important contributor to suicide. We examined the association of individual- and community-level social capital with suicidal ideation after adjusting for social support among older adults living in the community. In August 2010 we sent questionnaires to all residents aged 65 years and older living in 3 rural municipalities (N = 21,232) in Okayama Prefecture, Japan; 13,919 questionnaires were returned (response rate: 65.6%). The final analysis included 10,094 participants. The outcome variable was suicidal ideation. Exposure variables were individual-level mistrust and lack of reciprocity (level 1), and the aggregated responses of these variables from 35 communities in the municipalities (level 2). Covariates included age, sex, educational attainment, marital status, the number of cohabitants, years of residence, self-rated socioeconomic status, disability, social support, and psychological distress. Multilevel logistic regression analysis was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). After adjusting for social support and psychological distress, we found that mistrust and lack of reciprocity were only associated with suicidal ideation at the individual level. Stratified analysis showed that among subjects with psychological distress, mistrust was associated with suicidal ideation at individual (OR: 1.88; 95% CI: 1.42-2.51) and community levels (OR: 1.98; 95% CI: 1.02-3.81). Our findings show that individual- and community-level social capital is a possible protective factor for suicidal ideation, particularly for people with psychological distress. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. A Case Study Investigation into the Use of Multi-compartment Compliance Aids in Older People Resident in Very Sheltered Housing.

    PubMed

    MacLure, Katie; MacLeod, Joan; Forbes-McKay, Katrina; Paudyal, Vibhu; Cunningham, Scott; Strath, Alison; Lynch, Rory; Stewart, Derek

    2016-12-01

    Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines, heralded by some as a solution to non-adherence but with little evidence of benefit. The aim was to use a theoretical approach to describe the behavioural determinants impacting the use of MCAs in older people from the perspectives of the individual and health and social care providers. A case study investigation was conducted. The study took place in three very sheltered housing sites in North East Scotland. Twenty residents (≥65 years) using an MCA for at least 6 months and 34 members of their care team [17 formal carers, eight general practitioners (GPs), eight pharmacists, one family member]. Semi-structured, face-to-face interviews with items based on the Theoretical Domains Framework were conducted. Interviews were audio-recorded, transcribed and analysed thematically. Several behavioural determinants impacted the use of MCAs from the perspectives of the stakeholders involved. Goals of use related to promoting adherence and safety, with less emphasis on independence. Beliefs of consequences related to these goals and were considered of value, with additional consequences of concern around reduced awareness of medicines and complexities of changing medicines. There was a lack of clearly defined roles of professionals for all processes of MCA use, with evidence of blurring and gaps in roles. There were additional issues relating to capabilities of older people in using MCAs and capacity issues for pharmacy-supplied MCAs. Several behavioural determinants impacted the use of MCAs, and while MCAs were valued, there is a need to more clearly define, develop, implement and evaluate a model of care encompassing resident and medicines assessment, supply and ongoing review of MCAs.

  5. Neighborhood Environment is Associated with Overweight and Obesity, Particularly in Older Residents: Results from Cross-Sectional Study in Dutch Municipality.

    PubMed

    Putrik, Polina; van Amelsvoort, Ludovic; De Vries, Nanne K; Mujakovic, Suhreta; Kunst, Anton E; van Oers, Hans; Jansen, Maria; Kant, Ijmert

    2015-12-01

    We explored whether overweight and obesity were associated with the physical and social environment at neighborhood level. Data from Maastricht municipality survey (The Netherlands) were used (n = 9771 adults). Multinomial regression models were computed (outcome being normal weight, overweight, or obese). We found inconsistent associations between neighborhood social and physical environment characteristics and overweight and obesity in the total sample. The effects were more consistent and stronger for older residents (>65) and obesity as an outcome. Better scores on traffic nuisance, green space, social cohesion, nuisance, and safety were associated with lower odds of obesity among elderly (OR ranged between 0.71 [95% CI 0.44 to 0.93] to 0.85 [95% CI 0.74 to 0.96] for each point of improvement in neighborhood social and physical environment (scale 0-10)). We showed that there are neighborhood-level factors that are associated with obesity, particularly in elderly residents. These could be targeted in preventive strategies outside health care settings.

  6. Levels and patterns of daily physical activity and sedentary behavior measured objectively in older care home residents in the United Kingdom.

    PubMed

    Barber, S E; Forster, A; Birch, K M

    2015-01-01

    Physical activity is important for maintaining independence and quality of life in older people living in care homes. Little is known about patterns of physical activity or sedentary behavior in this population. Thirty-three care home residents (82.6 ± 9.2 years) wore an ActiGraph GTX3 accelerometer for seven days, which provided minutes of sedentary behavior and low, light, and moderate-to-vigorous physical activity. Participants undertook the Mini-Mental State Examination and care staff reported activities of daily living (Barthel index) and functional ambulation classification (FAC) for each participant. Participants spent on average 79% of their day sedentary, 14% in low, 6% in light, and 1% in moderate-to-vigorous physical activity. Activity levels did not significantly differ between days or hours of the day (P > .05). Levels of physical activity were very low and time being sedentary was high. This study can inform physical activity and sedentary behavior interventions for care homes' residents.

  7. London: An Art Teacher's Inspiration

    ERIC Educational Resources Information Center

    Guhin, Paula

    2012-01-01

    Often overshadowed in people's minds by Paris, London is truly an artist's jewel. The art and architecture, history, gardens and museums are inspiring, yes, but there's so much more to this ancient city. The performances, attractions and markets are a boon to the creative soul. London can be surprisingly inexpensive to visit. Gazing at statues,…

  8. London: An Art Teacher's Inspiration

    ERIC Educational Resources Information Center

    Guhin, Paula

    2012-01-01

    Often overshadowed in people's minds by Paris, London is truly an artist's jewel. The art and architecture, history, gardens and museums are inspiring, yes, but there's so much more to this ancient city. The performances, attractions and markets are a boon to the creative soul. London can be surprisingly inexpensive to visit. Gazing at statues,…

  9. London International Youth Science Forum

    ERIC Educational Resources Information Center

    Auty, Geoff

    2010-01-01

    In this article, the author discusses the 2010 London International Youth Science Forum (LIYSF) and shares his experience in attending the forum. Unlike the Harry Messel event in Sydney, which takes place every two years, LIYSF is an annual event. Before moving to Imperial College London, LIYSF was held at the Institute of Electrical Engineers and…

  10. Looking into 'London'

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This mosaic image from the microscopic imager on the Mars Exploration Rover Opportunity shows the rock abrasion tool target, 'London.' The image was taken by the Mars Exploration Rover Opportunity on its 149th sol on Mars (June 24, 2004). Scientists 'read' the geology of the image from bottom to top, with the youngest material pictured at the bottom of the image and the oldest material in the layers pictured at the top. Millimeter-scale layers run horizontally across the exposed surface, with two sliced sphere-like objects, or 'blueberries' on the upper left and upper right sides of the impression. This material is similar to the evaporative material found in 'Eagle Crater.' However, the intense review of these layers in Endurance Crater is, in essence, deepening the water story authored by ancient Mars.

    In Eagle Crater, the effects of water were traced down a matter of centimeters. Endurance Crater's depth has allowed the tracing of water's telltale marks up to meters. Another process that significantly affects martian terrain is muddying the water story a bit. Although it is clear that the layers in Endurance were affected by water, it is also evident that Aeolian, or wind, processes have contributed to the makeup of the crater.

  11. Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities.

    PubMed

    Allen, Joanne; Inder, Kerry J; Harris, Melissa L; Lewin, Terry J; Attia, John R; Kelly, Brian J

    2013-08-14

    The demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness. Data from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness. Physical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing psychological impairment was more

  12. Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities

    PubMed Central

    2013-01-01

    Background The demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness. Methods Data from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness. Results Physical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing

  13. Effects on Weight, Blood Lipids, Serum Fatty Acid Profile and Coagulation by an Energy-Dense Formula to Older Care Residents: A Randomized Controlled Crossover Trial.

    PubMed

    Tylner, Sara; Cederholm, Tommy; Faxén-Irving, Gerd

    2016-03-01

    Dietary intake in frail old adults is often lower than estimated needs. The aim of this study was to evaluate the effects of an energy-dense oral supplement on nutritional status, food intake, and physical function in residents living in care residential homes. Randomized controlled intervention trial with a crossover design. Five care residential homes in the southern Stockholm area. Older people living at care residential homes: age 65 or older, malnourished or at risk of malnutrition according to Mini Nutritional Assessment-Short Form (MNA-SF). Energy-dense formula (oleic and linoleic acid emulsion enriched with protein and micronutrients) (Calogen Extra, Nutricia) 30 mL distributed 3 times daily for 6 weeks. Body weight, 3-day food and fluid record, appetite rating, and physical function (ie, Short Physical Performance Battery, grip strength, and peak expiratory flow). Biochemical indicators of nutritional status, blood lipids, and serum phospholipid fatty acid (FA) profile. Twenty-eight participants completed the 2 phases of the crossover study; group A (n = 14, 87 ± 6 years, 50% women) and group B (n = 14, 82 ± 8 years, 71% women). The intervention periods combined resulted in significantly (P < .05) increased energy intake (238 ± 544 kcal), weight gain (1.4 ± 3.7 kg), improved appetite, relative reduction of saturated FA and increase in polyunsaturated FA, increased apoliporotein A, and reduced serum fibrinogen (-0.9 ± 1.5 g/L). Distribution of an oleic and linoleic acid based fat emulsion enriched with protein and micronutrients (Calogen Extra) 3 times daily to old people in care residential homes improved nutritional status, had positive effects on fatty acid profile and blood lipids, and a potential antithrombotic effect. CLINICALTRIALS. NCT01259999. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS

    PubMed Central

    Mehl-Madrona, Lewis; Renfrew, Nita M; Mainguy, Barbara

    2011-01-01

    Introduction: Reiki is a Japanese form of energy healing that has become popular in the US. Reiki training involves three stages—levels I, II, and III—to a master practitioner level and requires both giving and receiving Reiki. We set out to implement a program to train clients of a supported residence in Brooklyn, NY. They were all older than age 50 years and had HIV/AIDS and substance-abuse and/or mental-health disorders. Methods: A qualitative, narrative-inquiry study was conducted. The Reiki master kept a journal of her 3 years of providing 90 minutes of Reiki treatment and/or training once weekly at the residence. Forty-five of 50 potential participants attended these sessions with various frequencies. Stories were collected from 35 participants regarding their experience of Reiki training. We posited success as continued involvement in the program. Results: All 35 participants reported receiving benefit from participation in Reiki. Participants first took part in training because of the offered subway tokens; however, 40 continued their involvement despite a lack of compensation. When asked why they continued, participants reported life-changing experiences, including a greater ability to cope with addictions, a greater ability to manage counseling, healing of wounds, improvement of T-cell counts, and improved skills of daily living. Conclusion: Reiki training can be successfully implemented in a supported housing facility with people with HIV/AIDS and comorbid disorders. Some people in our study population reported areas of improvement and life-changing experiences. Our study did not establish the efficacy of Reiki, but our findings support the effect of the entire gestalt of implementing a program related to spirituality and healing and supports the goal of implementing a larger randomized, controlled trial in this setting to establish the efficacy of Reiki. PMID:22058669

  15. Cost-effectiveness of a stepped care programme to prevent depression and anxiety in residents in homes for the older people: a randomised controlled trial.

    PubMed

    Bosmans, J E; Dozeman, E; van Marwijk, Harm W J; van Schaik, Digna J F; Stek, Max L; Beekman, Aartjan T F; van der Horst, Henriette E

    2014-02-01

    Depression and anxiety are common in residents of elderly homes. Both disorders have negative effects on functioning, well-being and health-care utilisation. Besides treatment, prevention can be an option to reduce the burden of mental disorders. The objective of this study was to evaluate the cost-effectiveness of a stepped care programme to prevent the onset of depression and anxiety disorders in residents of elderly homes compared with usual care from a societal perspective. Outcomes were incidence of depression and/or anxiety, severity of depressive and anxiety symptoms and quality-adjusted life years. Health-care utilisation was measured during interviews. Multiple imputation was used to impute missing cost and effect data. Uncertainty around cost differences and incremental cost-effectiveness ratios was estimated using bootstrapping. Cost-effectiveness planes and acceptability curves were created. The incidence of depression and anxiety combined in the intervention group was not reduced in comparison with the usual care group. There was also no effect on the other outcomes. Mean total costs in the intervention group were €838 higher than in the usual care group, but this difference was not statistically significant (95% confidence interval, -593 to 2420). Cost-effectiveness planes showed that there was considerable uncertainty. Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.46 for reducing the incidence of depression and anxiety combined. A stepped care programme to prevent depression and anxiety in older people living in elderly homes was not considered cost-effective in comparison with usual care. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects.

    PubMed

    Veronese, N; Cereda, E; Solmi, M; Fowler, S A; Manzato, E; Maggi, S; Manu, P; Abe, E; Hayashi, K; Allard, J P; Arendt, B M; Beck, A; Chan, M; Audrey, Y J P; Lin, W-Y; Hsu, H-S; Lin, C-C; Diekmann, R; Kimyagarov, S; Miller, M; Cameron, I D; Pitkälä, K H; Lee, J; Woo, J; Nakamura, K; Smiley, D; Umpierrez, G; Rondanelli, M; Sund-Levander, M; Valentini, L; Schindler, K; Törmä, J; Volpato, S; Zuliani, G; Wong, M; Lok, K; Kane, J M; Sergi, G; Correll, C U

    2015-11-01

    Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m(2)), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI = 1.26-1.58) for underweight, 0.85 (95% CI = 0.73-0.99) for overweight and 0.74 (95% CI = 0.57-0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR = 1.65 [95% CI = 1.13-2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting. © 2015 World Obesity.

  17. Multiple sclerosis among immigrants in Greater London.

    PubMed Central

    Dean, G; McLoughlin, H; Brady, R; Adelstein, A M; Tallett-Williams, J

    1976-01-01

    Among immigrants resident in greater London from Europe, Ireland, the USSR, the old Commonwealth countries of Australia, Canada, and New Zealand, North and South America, Egypt, Turkey, and Iran the incidence of admission to hospital for probable multiple sclerosis (MS) between 1960 and 1972 was high or moderately high. The incidence was the same order as that found in those born in the United Kingdom. Immigrants from India, Pakistan, and other Asian countries and from new Commonwealth Africa and America, which includes the West Indies, had a low incidence of hospital admission for MS. Immigrants from countries where the risk of MS is low whose parents were born in Europe had a reduced incidence of admission to hospital but not the very low incidence found in those parents were also born in these countries. Emigrating to England from low risk parts of the world did not seem to increase the risk of developing MS. PMID:1260384

  18. Community Engagement using World Café: The Well London Experience.

    PubMed

    Sheridan, Kevin; Adams-Eaton, Faye; Trimble, Allison; Renton, Adrian; Bertotti, Marcello

    2010-01-01

    The Well London programme was launched across twenty boroughs in London during late 2007 to improve the health and well-being of residents living in some of the most deprived communities in London. Well London employed a multi-stage community engagement process which informed the overall project strategy for each intervention area. In this article we establish and describe the key principles that guided the design of this innovative community engagement process. Principles included building collaborative partnerships, working with whole-systems, privileging community knowledge and working with the deficit of experience in each area. The article then describes in detail how these principles were operationalised throughout the preparation and delivery of forty World Cafes, which were the first open community activities of the Well London community engagement process. Finally, this article reflects on and summarises the lessons learned when employing innovative, inclusive and transparent community engagement for health promotion.

  19. Community Engagement using World Café: The Well London Experience

    PubMed Central

    Sheridan, Kevin; Adams-Eaton, Faye; Trimble, Allison; Renton, Adrian; Bertotti, Marcello

    2016-01-01

    The Well London programme was launched across twenty boroughs in London during late 2007 to improve the health and well-being of residents living in some of the most deprived communities in London. Well London employed a multi-stage community engagement process which informed the overall project strategy for each intervention area. In this article we establish and describe the key principles that guided the design of this innovative community engagement process. Principles included building collaborative partnerships, working with whole-systems, privileging community knowledge and working with the deficit of experience in each area. The article then describes in detail how these principles were operationalised throughout the preparation and delivery of forty World Cafes, which were the first open community activities of the Well London community engagement process. Finally, this article reflects on and summarises the lessons learned when employing innovative, inclusive and transparent community engagement for health promotion. PMID:27857453

  20. Does long term residency near industry have an impact on the body burden of polychlorinated dibenzo-p-dioxins, furans, and polychlorinated biphenyls in older women?

    PubMed

    Pless-Mulloli, T; Edwards, R; Howel, D; Wood, R; Paepke, O; Herrmann, T

    2005-12-01

    For the retrospective study of environment and health linkages biomarkers of exposure are required. Polychlorinated dibenzo-dioxins and furans (PCDD/F) and polychlorinated biphenyls (PCBs) have been useful markers in some settings. This is the first study of PCDD/F body burden in a population based sample from the UK. The authors aimed to investigate whether long term residents close to a heavy chemical industrial complex (Teesside, UK) had a higher body burden and distinct pattern of PCDD/F and PCBs. We measured current levels of PCDD/F and PCBs in a population based sample of older women (mean 64 years, range 42-79 years). Forty women were recruited, 20 living near (zone A: 0.1-2.7 km) and 20 distant (zone C: 5-40 km) from industry during 2000-03. The authors ascertained occupational exposure to lung carcinogens, residential history, consumption of local produce, breast feeding, diet, and height and weight. The mean body burden measured on lipid basis in ng/kg for the whole sample was: WHO-TEQ (PCDD/Fs): 29.9, 2378TCDD: 4.0, PCB 118:16200, PCB156: 13100. Body burdens were similar to others reported from industrialised countries, except that mean 2378TCDD was slightly higher. Mean ages, body mass index, and lifelong dietary patterns were similar in both zones. The authors found no significant difference in mean body burden levels between zones A and C before or after adjustment for covariates. All congener patterns were consistent with an urban background pattern, and there was no significant difference between congener compositions in the two zones. The TCDD body burden increased with age with accelerated increments above age 70. Long term residency near heavy and chemical industry did not have an effect on women's body burden of PCDD/Fs and PCBs on Teesside, UK. The body burden of PCDD/F and PCBs was not a suitable biomarker for chronic, non-occupational exposure to industrial air pollution.

  1. London through a Biologist's Eyes

    ERIC Educational Resources Information Center

    Flannery, Maura C.

    2004-01-01

    A professor of biology discovered that the people who are in literature rather than science, saw the same readings very differently and were looking for very different things like how nature writings expressed the author's views on nature, or what they communicated about the human experience of the living world. Further he visits London to see the…

  2. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  3. London's Tutorial Classes; An Assessment

    ERIC Educational Resources Information Center

    Brook, F. G.

    1970-01-01

    Growth during the 1960s in the number and scope of tutorial classes by the London University Department of Extra-Mural Studies is attributed to considerable help from voluntary personnel, emphasis on written work, and other factors potentially signficant to extension education elsewhere in Britain. (LY)

  4. Effects of an Exercise Program on Mentally Impaired Older Adults--Alzheimer's and Dementia Residents in a Long-Term Care Facility.

    ERIC Educational Resources Information Center

    Frizzell, Linda Bane

    This study attempted to define the current bases for physical exercise and activity for healthy older adults and to use those data as a basis for developing physical exercises and activities for older adults with mental impairments. An 8-week exercise program was developed and evaluated to determine its effect on satisfaction and quality of life…

  5. Economic Resources for Older Women.

    ERIC Educational Resources Information Center

    Miller, Sheila J.

    Although the older person's economic stiuation has improved, older women, minorities, and rural residents have incomes significantly lower than those for the older population in general. Older married women may appear to be financially secure, but many of their resources often disappear when their husbands die. Widowhood or divorce endangers the…

  6. Japan Biotech Forum: London 2010.

    PubMed

    Al-Shamahi, Asma

    2010-11-01

    The Japan Biotech Forum, held in London, included topics covering new licensing developments in the Japanese pharma and biotech industries. This conference report highlights selected presentations on licensing opportunities from several Japanese companies, including CanBas, LivTech, REGiMMUNE, D Western Therapeutics Institute and Chiome Bioscience. Investigational drugs discussed include CBP-501 (CanBas), LIV-2008 (LivTech), RGI-2001 (REGiMMUNE), IVX-214 (D Western Therapeutics Institute/ Nippon Shinyaku) and anti-Sema 3A (Chiome Bioscience).

  7. Challenges to conducting research with older people living in nursing homes

    PubMed Central

    Hall, Sue; Longhurst, Susan; Higginson, Irene J

    2009-01-01

    Background Although older people are increasingly cared for in nursing homes towards the end of life, there is a dearth of research exploring the views of residents. There are however, a number of challenges and methodological issues involved in doing this. The aim of this paper is to discuss some of these, along with residents' views on taking part in a study of the perceptions of dignity of older people in care homes and make recommendations for future research in these settings. Methods Qualitative interviews were used to obtain the views on maintaining dignity of 18 people aged 75 years and over, living in two private nursing homes in South East London. Detailed field notes on experiences of recruiting and interviewing participants were kept. Results Challenges included taking informed consent (completing reply slips and having a 'reasonable' understanding of their participation); finding opportunities to conduct interviews; involvement of care home staff and residents' families and trying to maintain privacy during the interviews. Most residents were positive about their participation in the study, however, five had concerns either before or during their interviews. Although 15 residents seemed to feel free to air their views, three seemed reluctant to express their opinions on their care in the home. Conclusion Although we experienced many challenges to conducting this study, they were not insurmountable, and once overcome, allowed this often unheard vulnerable group to express their views, with potential long-term benefits for future delivery of care. PMID:19703277

  8. Low on the London Scale

    NASA Astrophysics Data System (ADS)

    Webb, S.

    2013-09-01

    Until relatively recently, many authors have assumed that if extraterrestrial life is discovered it will be via the discovery of extraterrestrial intelligence: we can best try to detect life by adopting the SETI approach of trying to detect beacons or artefacts. The Rio Scale, proposed by Almár and Tarter in 2000, is a tool for quantifying the potential significance for society of any such reported detection. However, improvements in technology and advances in astrobiology raise the possibility that the discovery of extraterrestrial life will instead be via the detection of atmospheric biosignatures. The London Scale, proposed by Almár in 2010, attempts to quantify the potential significance of the discovery of extraterrestrial life rather than extraterrestrial intelligence. What might be the consequences of the announcement of a discovery that ranks low on the London Scale? In other words, what might be society's reaction if 'first contact' is via the remote sensing of the byproducts of unicellular organisms rather than with the products of high intelligence? Here, I examine some possible reactions to that question; in particular, I discuss how such an announcement might affect our views of life here on Earth and of humanity's place in the universe.

  9. Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

    PubMed

    Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

    2010-03-01

    Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

  10. London's Jewish Communities and State Education

    ERIC Educational Resources Information Center

    Martin, Jane

    2012-01-01

    The Inner London education authority was a notable example of a radical and powerful local government body from which the fight for the comprehensive principle in English secondary education emerged. Building on previous work of women's contribution to state education in London, this articles focuses on Anglo-Jewish educator activists who helped…

  11. School Improvement in London: A Global Perspective

    ERIC Educational Resources Information Center

    McAleavy, Tony; Elwick, Alex

    2016-01-01

    This report considers how successful London's schools have been over the past decade and identifies potentially transferable components of the success story. There is much to be learned from the transformation undergone in London that is relevant to policymakers and educationalists worldwide, working in both high-income and low-income countries.…

  12. Jack London: The Paradox of Individualism.

    ERIC Educational Resources Information Center

    Deane, Paul

    1968-01-01

    Because of their interest in naturalism and socialism, critics often overlook the major intellectual conflict in Jack London's work: the paradox of individualism. London regards society as affecting the individual in two ways: it either promotes individuality or it demands a conformity that undermines individualism. When society fails Buck in…

  13. See you at London Vet Show.

    PubMed

    2016-11-05

    London Vet Show is fast approaching: it takes place from November 17 to 18 and is being held at ExCeL London for the first time. Zoe Davies, marketing manager, highlights some of what BVA is offering at the event. British Veterinary Association.

  14. Health and Social Service Needs of the Elderly: A Comparison of Residents of Public Housing and Residents of the Neighboring Community. Institute on Aging Monograph Series.

    ERIC Educational Resources Information Center

    Evashwick, Connie; And Others

    The second part of a study compared health and social service needs of older persons residing in public housing and older persons residing in the neighboring community. A survey was conducted of 461 residents in four buildings supported by the Seattle Housing Authority (SHA) and 422 residents age 62 and older living within five blocks of one…

  15. Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: food and nutrition programs for community-residing older adults.

    PubMed

    Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

    2010-01-01

    Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services. Copyright 2010 The American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  16. Bangladeshi women's experiences of infant feeding in the London Borough of Tower Hamlets.

    PubMed

    Rayment, Juliet; McCourt, Christine; Vaughan, Lisa; Christie, Janice; Trenchard-Mabere, Esther

    2016-07-01

    This study examined the main factors that influence Bangladeshi women living in London's decisions to partially breastfeed their children, including the influence of older women within the community. Fifty-seven women of Bangladeshi origin living in the London Borough of Tower Hamlets took part in seven discussion groups between April and June 2013. Five groups were held with women of child-bearing age and two groups with older women in the community. A further eight younger women and three older women took part in one-on-one interviews. Interviews were also carried out with eight local health care workers, including public health specialists, peer support workers, breastfeeding coordinators and a health visitor. The influences on women's infant feeding choices can be understood through a 'socio-ecological model', including public health policy; diverse cultural influences from Bangladesh, London and the Bangladeshi community in London; and the impacts of migration and religious and family beliefs. The women's commitment to breastfeeding was mediated through the complexity of their everyday lives. The tension between what was 'best' and what was 'possible' leads them not only to partially breastfeed but also to sustain partial breastfeeding in a way not seen in other socio-cultural groups in the United Kingdom.

  17. Pulmonary function of London firemen.

    PubMed Central

    Douglas, D B; Douglas, R B; Oakes, D; Scott, G

    1985-01-01

    In a longitudinal study of a sample of firemen in London 1006 firemen were interviewed and examined in 1976 and 895 were seen a second time 12 months later. On each occasion a Medical Research Council respiratory questionnaire was administered and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured. The average levels of FEV1, FVC, and FEV1/FVC in both years compared favourably with conventional predicted values. Separate multiple regression analysis for the two years indicated that the FEV1 and FVC fell more rapidly in those aged over 40, and that cigarette smoking had a strong harmful effect on these measures of function. Only among men with over 20 years' service was there possibly any evidence (not statistically significant) of an effect from duration of employment. The comparatively large fall in FEV1 and FVC from 1976 to 1977 was due mainly to instrumental variation. The prevalence of respiratory symptoms was higher in smokers than non-smokers and increased with the number of cigarettes smoked. PMID:3965016

  18. "We expect seniors to be able to prepare and recover from a cyclone as well as younger members of this community": Emergency Management's Expectations of Older Adults Residing in Aging, Remote Hamlets on Australia's Cyclone-Prone Coastline.

    PubMed

    Astill, Sandra; Miller, Evonne

    2017-07-24

    To investigate the extent to which older residents feel they can remain "self-reliant" during future natural disasters and to compare the findings with the viewpoints of local policy-makers and with those charged with caring for the elderly both on a day-to-day basis and in times of crisis. This study used an array of non-probability snowballing techniques to seek the participation of senior citizens over the age of 65 years, emergency services officers, community health carers, and local government disaster managers located in aging, remote, coastal Australian communities vulnerable to cyclones and storm surges. All respondents participated in either a face-to-face personal interview or a focus group, with senior citizens also completing a self-administered questionnaire. This research found a discrepancy between policy expectations and the experiences of both the elderly and those who care for them, as well as a lack of understanding with regard to the term "self-reliant." These results highlight the inability of older adults in aging, remote, coastal Australian communities to remain "self-reliant" in the future, impacting both disaster management policies and the future capacity of these communities to remain resilient. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

  19. Outcome in ambulatory status immediately following hip fracture surgery in the acute setting: a comparison of nursing home residents and community older adults.

    PubMed

    Dharmarajan, T S; Tankala, H; Patel, B; Sipalay, M; Norkus, E P

    2001-01-01

    To compare the ambulatory status following hip fracture surgery in the acute setting between older adults from long-term care facilities (LTCF) and the community. A 650-bed, urban, inner city, university-affiliated teaching hospital. One hundred forty hip fracture patients (60-97 years) from long-term care facilities and the community were examined. Ambulatory status before and after surgery was categorized four ways based on the degree of independence in ambulation: A1 = independent ambulation (with or without an assisting device), A2 = assistance of another person required, A3 = predominant use of a wheelchair, and A4 = bed-bound. Change in ambulatory status was designated as "moderate" if the deterioration was one status level only (A1 to A2, A2 to A3, and A3 to A4) or "major" if the deterioration was more than one status level (A1 to A3/A4 or A2 to A4). Additional variables such as age, sex, risk factors, length of stay, history of drug use, and laboratory results also were examined. Hip fracture patients from LTCF were older (P = 0.0160) and had more overall risk factors for hip fracture (P = 0.0039) than community patients. They also had higher rates of dementia (P < 0.000), arrhythmia (P = 0.025), delirium (P = 0.0016) and anxiolytics use (P = 0.019) than patients from the community. On admission, LTCF patients had lower serum calcium (P = 0.0003), phosphorus (P = 0.0210), and albumin (P = 0.0004) than community patients. Before hospitalization they also were less ambulatory (P = 0.002) than community patients. Post surgery, ambulatory status declined in both groups. However, a "major" change (decline) in ambulatory status occurred more often in LTCF patients (P = 0.001). A greater decline in ambulatory status is seen in patients from LTCF than in community patients, immediately following hip fracture surgery. Compared with community patients, LTCF patients are also older, sicker (higher total risk score) and have an increased risk for a decline in

  20. Thyroid Hormone Therapy and Risk of Thyrotoxicosis in Community-Resident Older Adults: Findings from the Baltimore Longitudinal Study of Aging.

    PubMed

    Mammen, Jennifer S; McGready, John; Oxman, Rachael; Chia, Chee W; Ladenson, Paul W; Simonsick, Eleanor M

    2015-09-01

    Both endogenous and exogenous thyrotoxicosis has been associated with atrial fibrillation and low bone mineral density. Therefore, this study investigated the risk factors associated with prevalent and incident thyrotoxicosis and the initiation of thyroid hormone therapy in a healthy, aging cohort. A total of 1450 ambulatory community volunteer participants in the Baltimore Longitudinal Study of Aging examined at the NIA Clinical Research Unit in Baltimore, MD, have undergone longitudinal monitoring of serum thyrotropin (TSH) and thyroid hormone (free thyroxine and free triiodothryonine) levels as well as medication use every one to four years, depending on age, between 2003 and 2014. The prevalence of low TSH was 9.6% for participants on thyroid hormone and 0.8% for nontreated individuals (p < 0.001). New cases occurred at a rate of 17.7/1000 person-years of exposure to thyroid hormone therapy [CI 9-32/1000] and 1.5/1000 person-years in the unexposed population [CI 0.7-2.9/1000]. Women were more likely to be treated and more often overtreated than men were. The adjusted hazard ratio (HR) for thyrotoxicosis between treated and untreated women was 27.5 ([CI 7.2-105.4]; p < 0.001) and 3.8 for men ([CI 1.2-6.3]; p < 0.01). White race/ethnicity and older age were risk factors for thyroid hormone therapy but not overtreatment. Body mass index was not associated with starting therapy (HR = 1.0). Thyroid hormone initiation was highest among women older than 80 years of age (3/100 person-years). For one-third of treated participants with follow-up data, overtreatment persisted at least two years. Iatrogenic thyrotoxicosis accounts for approximately half of both prevalent and incident low TSH events in this community-based cohort, with the highest rates among older women, who are vulnerable to atrial fibrillation and osteoporosis. Physicians should be particularly cautious in treating subclinical hypothyroidism in elderly women in light of recent studies

  1. London Dispersion Forces and "The Wave"

    NASA Astrophysics Data System (ADS)

    Wilcox, C. Jayne

    1998-10-01

    An analogy is presented likening London dispersion forces to "The Wave", a popular ritual performed by fans attending sports events in large stadia. Similarities between people in the stands and electrons in atoms are emphasized.

  2. Career development at London Vet Show.

    PubMed

    2016-09-03

    Are you considering a career change? Perhaps you want help to develop within your current role? Either way, you will find a relevant session in the BVA Career Development stream at the London Vet Show in November. British Veterinary Association.

  3. The Tower of London bomb explosion.

    PubMed Central

    Tucker, K; Lettin, A

    1975-01-01

    After the detonation of a bomb in the Tower of London 37 people were brought to St. Bartholomew's Hospital. The explosion caused numerous severe injuries of a type rarely seen in peacetime. PMID:1148778

  4. Simple kcal/kg formula is comparable to prediction equations for estimating resting energy expenditure in older cognitively impaired long term care residents.

    PubMed

    Silver, H J; Wall, R; Hollingsworth, E; Pruitt, A; Shotwell, M; Simmons, S

    2013-01-01

    Assessment of energy needs is a critical step in developing the nutrition care plan, especially for individuals unable to modulate their own energy intakes. The purpose of this study was to assess precision and accuracy of commonly used prediction equations in comparison to measured resting energy expenditure in a sample of "oldest old" adults residing in long term care (LTC). Resting energy expenditure (mREE) was measured by indirect calorimetry in 45 residents aged 86.1 ± 7.3 years, and compared to frequently used prediction equations (pREE): Mifflin St.Jeor, Harris Benedict, World Health Organization and Owen. Precision and accuracy were determined by concordance correlation coefficients and number of individuals within ± 10% of mREE. Bland Altman plots with linear dependence trends were constructed to visualize agreement. To complete analyses, the common 25 kcal/kg formula was assessed and alternative formulas were determined for best fit by regressing adjusted mREE on body weight. mREE averaged 976.2 ± 190.3 kcal/day for females and 1260.0 ± 275.9 kcal/d for males. The strength of the relationships between pREE and mREE were only moderate (r = 0.41 - 0.72). In examining linear trends in the Bland Altman plots, significant systematic deviation from mREE was detected for all pREE. Two kcal/kg formulas were generated: 20.6 kcal/kg for females and 22.7 kcal/kg for males, which were not significantly different. None of the prediction equations adequately estimated energy needs in this sample of the "oldest old." A simple formula using 21-23 kcal/kg may be a more practical and reliable method to determine energy needs in the LTC setting.

  5. 12. Photo copy of drawing, May 21, 1963. NEW LONDON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. Photo copy of drawing, May 21, 1963. NEW LONDON LEDGE LIGHT STATION LIGHTING. Drawing no. 03-2730, U.S. Coast Guard Civil Engineering Unit, Warwick, Rhode Island. - New London Ledge Lighthouse, Long Island Sound, East of main harbor channel, New London, New London County, CT

  6. A tale of two cities: factors affecting place of cancer death in London and New York.

    PubMed

    Decker, Sandra L; Higginson, Irene J

    2007-06-01

    Most American and English cancer patients prefer to die at home. Factors associated with greater likelihood of dying at home have been contradictory in many studies and no studies have compared the effects of factors in different countries. The objective of this paper is to compare the factors affecting place of cancer death in two major cities, New York and London. We use data on all individuals aged >/=40 dying of cancer in London (59 604) and New York City (51 668) in the years 1995 through 1998. The probability of death at home is examined in each city as a function of gender, age group (40-55, 56-64, 65-74, 75+), year, type of cancer, and area socioeconomic status, using multiple logistic regression. Although the probability of death at home is the same in the two cities (approximately 1 in 5), being female lowers the odds of death at home by approximately 7% in London, and raises it by approximately 22% in New York. Older age is associated with increased odds of dying at home in New York but decreased odds of dying at home in London. Being in the lowest tercile of socioeconomic status (relative to the highest) lowers the odds of death at home by 22% in London and 39% in New York. Site of death varies significantly by patient and area characteristics in both cities, an understanding, which should be taken account of in future planning of end-of-life care.

  7. Implementation of observational pain management protocol to improve pain management for long-term institutionalized older care residents with dementia: study protocol for a cluster-randomized controlled trial.

    PubMed

    Liu, Justina Yat Wa; Lai, Claudia

    2014-03-13

    Systematic use of observational pain tools has been advocated as a means to improve pain management for care home residents with dementia. Pain experts suggest that any observational tool should be used as part of a comprehensive pain management protocol, which should include score interpretation and verification with appropriately suggested treatments. The Observational Pain Management Protocol (Protocol) was therefore developed. This study aims to investigate the extent to which the implementation of this Protocol can improve pain management in care home residents with dementia. In this two-group, single-blinded, cluster-randomized controlled trial, 122 care home residents with dementia and pain-related diagnoses will be recruited from eight care homes (that is 15 to 16 residents from each care home). Invitations will be sent to all local care homes who meet the home selection criteria. The eight care homes will be randomly selected from all care homes that agree to join this trial. They will then be randomized to either the control or experimental conditions. Participants from each care home will be placed into their home's corresponding group to avoid 'contamination' effects across participants. Each intervention cycle will take 16 weeks (that is, baseline assessment and care home staff training for 4 weeks and Protocol implementation for 12 weeks). The Protocol will guide the pain management of the participants in the experimental care homes. Meanwhile, the control care homes will continue their usual pain management strategies. Intervention effects will be measured weekly during the protocol implementation period and compared with the baseline measurements, as well as between the experimental and control conditions. Although similar pain protocols have been suggested previously, the recommendations were based on experts' opinions rather than evaluation of research studies. The feasibility and effectiveness of this kind of pain management protocol, tailored to

  8. Efficacy of an Exercise and Nutritional Supplement Program on Physical Performance and Nutritional Status in Older Adults With Mobility Limitations Residing at Senior Living Facilities.

    PubMed

    Corcoran, Michael P; Nelson, Miriam E; Sacheck, Jennifer M; Reid, Kieran F; Kirn, Dylan; Fielding, Roger A; Chui, Kenneth K H; Folta, Sara C

    2017-01-17

    This cluster-randomized trial was designed to determine the efficacy of a 6-month exercise-nutritional supplement program (ENP) on physical function and nutritional status for older adults and the feasibility of implementing this program in a senior living setting. Twenty senior living facilities were randomized to either a three day per week group-based ENP led by a trained facility staff member or a health education program (SAP). Participants (N=121) completed a short physical performance battery, 400 meter walk, handgrip strength test, and mini-nutrition assessment. 25-hydroxyvitamin D [25(OH)D], Insulin-like growth-factor 1 (IGF-1) and activity level were also measured. The ENP did not significantly improve physical function or nutritional status compared with the SAP. Compared with baseline, participants in the ENP engaged in 39 minutes less physical activity per week at 6-months. Several facility characteristics hindered implementation of the ENP. This study highlights the complexity of implementing an evidence-based program in a field setting.

  9. [Description of health status and functional capacity of the 65-year-old and older population residing in the University Region of Health of Puerto Rico].

    PubMed

    Oliver-Vázquez, M; Suárez-Pérez, E; De Andino, R M; Vega Torres, R; Conde, J G; Rosado, R R

    1999-12-01

    This study intended to describe the health and functional status of the population 65 years and over resident in the Puerto Rico University Health Region (municipalities of Canóvanas, Loiza, Carolina and Trujillo Alto, Puerto Rico). Four ninety one hundred elderly subjects selected from a random sample of households, were interviewed. A questionnaire was designed to gather data of the following variables: health conditions, functional capacity, health services utilization, social support and preventive measures. Descriptive measures and chi-square were utilized for the statistical analysis. Findings revealed a population composed mostly of women with a higher prevalence of health conditions than their male counterparts. More than half of the sample report visual problems, arthritis or hypertension. Almost a quarter had diabetes mellitus. The prevalence of these conditions was higher in the age group over 75, with the exception of diabetes. Thirty percent of the sample was classified as functionally dependent, condition that increased with the subject's age. Findings evidence the need of an early assessment in this population in order to intervene with potentially modifiable factors to prevent future disability and improve quality of life of the aged.

  10. Resident resistance.

    PubMed

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  11. Burden of post-herpetic neuralgia in a sample of UK residents aged 50 years or older: findings from the zoster quality of life (ZQOL) study

    PubMed Central

    2014-01-01

    Background Post-herpetic neuralgia (PHN) is the most common complication of herpes zoster (shingles). As a chronic condition, PHN can have a substantial adverse impact on patients’ lives. However, UK-specific data concerning the burden of PHN on individual patients, healthcare systems and wider society, are lacking. As the first UK-wide cross-sectional study of its kind, The Zoster Quality of Life (ZQOL) study was designed to address these concerns. Methods Patients (n = 152) with a confirmed diagnosis of PHN (defined as pain persisting ≥ 3 months following rash onset) and aged ≥50 years were recruited from primary and secondary/tertiary care centres throughout the UK. All patients completed validated questionnaires, including the Zoster Brief Pain Inventory (ZBPI), the Medical Outcomes Study Short-Form 36 (SF-36), the EuroQol-5 Dimensions (EQ-5D) and the Treatment Satisfaction with Medication (TSQM) questionnaire. Where available, mean patient population scores on these questionnaires were compared to scores derived from age-matched normative samples to quantify the burden associated with PHN. Results Despite numerous consultations with healthcare professionals and receiving multiple medications for the management of their PHN, the majority of patients reported being in pain ‘most of the time’ or ‘all of the time’. A total of 59.9% (n = 91) of all PHN patients reported pain in the preceding 24 hours to assessment at levels (ZBPI worst pain ≥ 5) typically considered to have a significant impact on Health Related Quality of Life (HRQoL). Accordingly, scores for SF-36 and EQ-5D indicated significant deficits in HRQoL among PHN patients compared to age-matched norms (p < 0.05) and patients reported being dissatisfied with the perceived efficacy of therapies received for the management of PHN. Increased pain severity was observed among older participants and higher levels of pain severity were associated with greater HRQo

  12. Fritz London's Legacy at Duke University

    NASA Astrophysics Data System (ADS)

    Meyer, Horst

    2006-03-01

    When 3He became available in small quantities after WWII Fritz London, Professor at Duke University since 1939, became very interested in its properties in the liquid and solid phases, as contrasted with those of 4He. His influence and that of his colleague Walter Gordy led to the appointment of William Fairbank in 1952, who was able to verify experimentally the prediction on the Fermi degeneracy of liquid 3He below 1K, a few weeks before London's death in 1954. With his students and associates, Fairbank carried out a number of important experiments which became classics, several of which will be described. At Duke he also started planning other experiments inspired by London's predictions. After W. Fairbank's departure for Stanford in 1959, further research on liquid and solid 3He and 3He-4He mixtures was carried out by his successors at Duke University and some of the results in the sixties will be briefly described.

  13. Patterns of dignity-related distress at the end of life: a cross-sectional study of patients with advanced cancer and care home residents.

    PubMed

    Hall, Sue; Davies, Joanna M; Gao, Wei; Higginson, Irene J

    2014-10-01

    To provide effective palliative care in different settings, it is important to understand and identify the sources of dignity-related distress experienced by people nearing the end of life. To describe and compare the sources of dignity-related distress reported by cancer patients and care home residents. Secondary analysis of merged data. Participants completed the Patient Dignity Inventory (assessing 25 sources of dignity-related distress) and measures of quality of life and depression. A total of 45 adult patients with advanced cancer referred to hospital-based palliative care teams in London, United Kingdom, and 60 residents living in one of 15 care homes in London. Care home residents were older and had poorer functioning. Both groups reported a wide range of dignity-related problems. Although the number or problems reported on the Patient Dignity Inventory was similar for the two groups (mean (standard deviation): 5.9 (5.5) for cancer patients and 4.1 (4.3) for care home residents, p = 0.07), there was a tendency for more cancer patients to report some existential problems. Experiencing physically distressing symptoms and functional limitations were prevalent problems for both groups. Patient Dignity Inventory problems were associated with poorer performance status and functioning for residents, with age and cognitive impairment for cancer patients and with poorer quality of life and depression for both groups. Although characteristics of the samples differed, similarities in the dignity-related problems reported by cancer patients and care home residents support research suggesting a common pathway towards death for malignant and non-malignant disease. A wider understanding of the sources of dignity-related distress would help clinicians provide more effective end-of-life care. © The Author(s) 2014.

  14. Suicide on the London Underground System.

    PubMed

    Farmer, R; O'Donnell, I; Tranah, T

    1991-09-01

    Over the past 50 years there has been an increase in the numbers of people jumping/falling in front of trains on the London Underground system. Case-fatality rates have fallen from 70% in the 1950s to 55% today. The proportion certified as suicide has fallen while the proportions certified as accidents or open verdicts have risen. There is unusual clustering of events at some stations which are adjacent to psychiatric units. The hypothesis that ease of access to London Underground stations may sometimes be a determinant of suicide is investigated.

  15. Partnership working by default: district nurses and care home staff providing care for older people.

    PubMed

    Goodman, Claire; Robb, Nadia; Drennan, Vari; Woolley, Rosemary

    2005-11-01

    Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to

  16. Jack London and the San Francisco earthquake

    USGS Publications Warehouse

    Sachs, J.S.

    1982-01-01

    After it was over, it seemed to many, and especially to eyewitnesses like Jack London, that the earthquake and fire had devastated San Francisco. However people were confident that, like the phoeniz, San Francisco would rise from the ashes and regain her palce as the "Imperial City of the West." 

  17. Stage Voice Training in the London Schools.

    ERIC Educational Resources Information Center

    Rubin, Lucille S.

    This report is the result of a six-week study in which the voice training offerings at four schools of drama in London were examined using interviews of teachers and directors, observation of voice classes, and attendance at studio presentations and public performances. The report covers such topics as: textbooks and references being used; courses…

  18. Knives and Other Weapons in London Schools

    ERIC Educational Resources Information Center

    Neill, S. R. St. J.

    2005-01-01

    London schools operate in an area where crime rates, including violent crime, is statistically more frequent than the average for the whole of England and Wales (Moore and Yeo 2004). Violent crime in the capital increased (though not to a statistically significant extent) between 2002/3 and 2003/4 (Moore and Yeo 2004b). This has led to a…

  19. Preventing suicide on the London Underground.

    PubMed

    Clarke, R V; Poyner, B

    1994-02-01

    A field study was carried out to investigate the possibility of preventing suicide on the London Underground. Four groups of potentially valuable measures were identified with the objectives of: (i) reducing public access to the tracks; (ii) improving surveillance by station staff; (iii) facilitating emergency stops; and (iv) reducing injury. These strategies are discussed.

  20. E. B. Nicholson and the London Institution

    ERIC Educational Resources Information Center

    Manley, K. A.

    1973-01-01

    This article provides a history of the London Institution from 1805 to 1912, with special emphasis on E. B. Nicholson's term of office. The last years of the Institution are considered, its financial difficulties being traced back to the terms of its original foundation, and to the changing situation of its members. (47 references) (Author/SJ)

  1. A resilient NHS for London 2012.

    PubMed

    Wapling, Andy; Mooney, Tom

    2011-02-01

    London will host the Olympic and Paralympic Games in 2012. Hosting the Games brings with it both opportunities and challenges for the capital and country. The National Health Service (NHS) in London has a crucial role to play in the delivery of a safe and secure Games. It must also protect its business as usual services and be prepared to respond to any enhanced or additional threats and hazards that may be created by the presence of the Games. NHS London leads a programme of work to ensure that the NHS fulfils its responsibilities during the Games. The programme's Health Resilience workstream has adopted a structured planning process to assess risks, identify gaps in the capability of the NHS, and ensure those gaps are addressed prior to the Games. It acknowledges that training, exercising and testing play vital roles in capability. This work aims to ensure that London's health services will respond in a timely, proportionate and appropriate manner to any incident during the Games. This paper gives an overview of the Olympic context within which this resilience work is taking place, and details the planning processes and relationships employed in planning for such a major event.

  2. Michael Fisher at King's College London

    NASA Astrophysics Data System (ADS)

    Domb, Cyril

    Michael Fisher spent the first 16 years of his academic life in the Physics Department of King's College, London, starting as an undergraduate and ending as a full professor. A survey is undertaken of his activities and achievements during the various periods of this phase of his career.

  3. Knives and Other Weapons in London Schools

    ERIC Educational Resources Information Center

    Neill, S. R. St. J.

    2005-01-01

    London schools operate in an area where crime rates, including violent crime, is statistically more frequent than the average for the whole of England and Wales (Moore and Yeo 2004). Violent crime in the capital increased (though not to a statistically significant extent) between 2002/3 and 2003/4 (Moore and Yeo 2004b). This has led to a…

  4. Movement and Character. Lecture, London, 1946

    ERIC Educational Resources Information Center

    Montesorri, Maria

    2013-01-01

    Dr. Montessori's words from the 1946 London Lectures describe principles of intelligence and character, the work of the hand, and movement with a purpose as being integral to self-construction. The perfection of movement is spiritual, says Dr. Montessori. Repetition of practical life exercises are exercises in movement with the dignity of human…

  5. Black Pupils' Achievement in Inner London.

    ERIC Educational Resources Information Center

    Mabey, Christine

    1986-01-01

    This paper looks at the relationship between reading attainment and examination achievement of Black Afro-Caribbean students who formed part of a cohort of inner London schoolchildren included in a longitudinal study. The findings of the research are discussed in terms of policy implications for education. (Author/CT)

  6. Ensuring equine biosecurity at London 2012.

    PubMed

    Slater, Josh

    2013-02-02

    The London 2012 Olympic and Paralympic Equestrian Games were the highest profile event in the 2012 equestrian calendar and were the culmination of four years of detailed and meticulous biosecurity planning to ensure that all horses arrived, competed and returned home safely and in good health. Josh Slater, Anthony Greenleaves and Andy Paterson describe how this was achieved.

  7. Social and economic hardship among people living with HIV in London.

    PubMed

    Ibrahim, F; Anderson, J; Bukutu, C; Elford, J

    2008-10-01

    To examine the social and economic circumstances of people living with HIV in London. Between June 2004 and June 2005, 1687 people living with HIV (73% response) receiving treatment and care in north-east London National Health Service out-patient clinics completed a confidential, self-administered questionnaire. The questionnaire sought information on employment, income, education, residency status in the UK and housing. In total, 1604 respondents were included in the analysis: Black African heterosexual women (n=480) and men (224); White (646) and ethnic minority (i.e. non-White) homosexual men (112); White heterosexual men (64) and women (39); and Black Caribbean heterosexual women (26) and men (13). Black African heterosexual men and women consistently reported more difficulties than any other group in relation to employment, income, housing and residency status. Half the Black African heterosexual men (46.8%) and women (51.2%) reported insecure residency status in the UK, significantly more than any other group (P<0.001). Just under half the respondents (46.6%) were employed at the time of the survey; Black African heterosexual women (35.3%) and men (45.4%) were less likely to be employed than White (57.6%) or ethnic minority (53.7%) homosexual men (P<0.001). Forty per cent of Black African heterosexual men and women, 22.9% of ethnic minority homosexual men and 9.6% of White homosexual men did not have enough money to cover their basic needs (P<0.001). In this study of people living with HIV in London, a substantial number faced social and economic hardship, particularly Black African and other ethnic minority respondents. Our findings provide further evidence that in London HIV is associated with poverty, particularly among migrant and ethnic minority populations.

  8. Health effects of the London bicycle sharing system: health impact modelling study.

    PubMed

    Woodcock, James; Tainio, Marko; Cheshire, James; O'Brien, Oliver; Goodman, Anna

    2014-02-13

    To model the impacts of the bicycle sharing system in London on the health of its users. Health impact modelling and evaluation, using a stochastic simulation model. Central and inner London, England. Total population operational registration and usage data for the London cycle hire scheme (collected April 2011-March 2012), surveys of cycle hire users (collected 2011), and London data on travel, physical activity, road traffic collisions, and particulate air pollution (PM2.5, (collected 2005-12). 578,607 users of the London cycle hire scheme, aged 14 years and over, with an estimated 78% of travel time accounted for by users younger than 45 years. Change in lifelong disability adjusted life years (DALYs) based on one year impacts on incidence of disease and injury, modelled through medium term changes in physical activity, road traffic injuries, and exposure to air pollution. Over the year examined the users made 7.4 million cycle hire trips (estimated 71% of cycling time by men). These trips would mostly otherwise have been made on foot (31%) or by public transport (47%). To date there has been a trend towards fewer fatalities and injuries than expected on cycle hire bicycles. Using these observed injury rates, the population benefits from the cycle hire scheme substantially outweighed harms (net change -72 DALYs (95% credible interval -110 to -43) among men using cycle hire per accounting year; -15 (-42 to -6) among women; note that negative DALYs represent a health benefit). When we modelled cycle hire injury rates as being equal to background rates for all cycling in central London, these benefits were smaller and there was no evidence of a benefit among women (change -49 DALYs (-88 to -17) among men; -1 DALY (-27 to 12) among women). This sex difference largely reflected higher road collision fatality rates for female cyclists. At older ages the modelled benefits of cycling were much larger than the harms. Using background injury rates in the youngest age

  9. 32. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONN. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    32. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONN. OCTOBER 3, 1932. COMPLETION OF ERECTION OF STEELWORK FOR ELEVATOR. LOOKING NORTH. CONTRACT NO. Y-1539-ELEVATOR, SUBMARINE ESCAPE TANK.' - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  10. 30. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONNECTICUT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONNECTICUT. 2 JUNE 1930. SUBMARINE TRAINING TANK - STEELWORK 98% COMPLETE; BRICKWORK 95% COMPLETE, PIPING 10% IN PLACE. LOOKING NORTH. CONTRACT NO. Y-1539-ELEVATOR, SUBMARINE ESCAPE TANK.' - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  11. Recognising and Developing Urban Teachers: Chartered London Teacher Status

    ERIC Educational Resources Information Center

    Bubb, Sara; Porritt, Vivienne

    2008-01-01

    Chartered London Teacher (CLT) status is a unique scheme designed by London Challenge to recognise and reward teachers' achievements and provide a framework for professional development. As well as having the prestige of being a Chartered London Teacher for life, educators receive a one-time payment of 1,000 British pounds from the school budget…

  12. 113. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    113. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  13. 114. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    114. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  14. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false New London Harbor, Conn. 110.147... ANCHORAGE REGULATIONS Anchorage Grounds § 110.147 New London Harbor, Conn. (a) The anchorage grounds—(1... Thames River southward of New London, bounded by lines connecting points which are the following bearings...

  15. 112. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    112. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  16. Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

    PubMed Central

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

    2016-01-01

    Background Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. Method In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Main Outcome Measures Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. Results We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. Conclusion The results suggest that occupational therapy using the ADOC for older

  17. Are Londoners Prepared for an Emergency? A Longitudinal Study Following the London Bombings

    PubMed Central

    Rubin, James; Amlôt, Richard; Simpson, John; Wessely, Simon

    2008-01-01

    The UK government sees increasing individual preparedness as a priority, but the level of preparedness of people in the UK for a large-scale emergency is not known. The London bombings of July 7, 2005, affected many Londoners and may have altered their sense of vulnerability to a future terrorist attack. We used a longitudinal study design to assess individual preparedness within the same sample of Londoners at 2 points in time: immediately after the bombings (T1) and 7 to 8 months later (T2). A demographically representative sample of 1,010 Londoners participated in a phone interview at T1. Subsequently, at T2, 574 of the same people participated in a follow-up phone interview. At T1 51% of Londoners had made 4 or more relevant emergency plans; 48% had gathered 4 or more relevant supplies in case of emergency. There was evidence of increased preparedness at T2, by which time 90% had made 4 or more emergency plans. Ethnicity, low social status, and having felt a sense of threat during the bombings predicted increased preparedness between T1 and T2. Women in general, and women of low social status in particular, perceived themselves to be unprepared in the event of a future terrorist attack. In summary, Londoners show moderate levels of emergency preparedness, which increased following the London bombings. Although we cannot know whether this association is causal, the prospective nature of the study increases the likelihood that it is. However, preparedness is still patchy, and there are important demographic associations with levels of preparedness and perception of vulnerability. These findings have implications for future development of individual and community emergency preparedness policy. PMID:19117430

  18. Launch of the London Centre for Nanotechnology.

    PubMed

    Aeppli, Gabriel; Pankhurst, Quentin

    2006-12-01

    Is nanomedicine an area with the promise that its proponents claim? Professors Gabriel Aeppli and Quentin Pankhurst explore the issues in light of the new London Centre for Nanotechnology (LCN)--a joint enterprise between Imperial College and University College London--opened on November 7, 2006. The center is a multidisciplinary research initiative that aims to bridge the physical, engineering and biomedical sciences. In this interview, Professor Gabriel Aeppli, LCN co-Director, and Deputy Director Professor Quentin Pankhurst discuss the advent and future role of the LCN with Nanomedicine's Morag Robertson. Professor Aeppli was formerly with NEC, Bell Laboratories and MIT and has more than 15 years' experience in the computer and telecommunications industry. Professor Pankhurst is a physicist with more than 20 years' experience of working with magnetic materials and nanoparticles, who now works closely with clinicians and medics on innovative healthcare applications. He also recently formed the new start-up company Endomagnetics Inc.

  19. The 2015 Pregnancy Summit, London, UK.

    PubMed

    Johansson, Cherynne

    2016-01-01

    Pregnancy Summit, Cineworld, The O2, London, UK, 29 September to 1 October 2015 The 2015 Pregnancy Summit was held over 3 days from 29 September to 1 October at Cineworld, The O2, London, UK. The event brings together a multidisciplinary faculty of international researchers and clinicians to discuss both scientific and clinical aspects of pregnancy-related issues in an informal setting. The goal of the meeting was to provide delegates with an update of recent advances in management of pregnancy-related conditions, to present research data and to discuss the current attitudes and practices in relevant topics. An extensive range of topics were discussed, from preeclampsia and treatment of hypertension, to the psychological impact of termination of pregnancy and feticide. This report will summarize a selection of the lectures presented.

  20. Looking back on the London Olympics: Independent outcome and hindsight effects in decision evaluation.

    PubMed

    Blank, Hartmut; Diedenhofen, Birk; Musch, Jochen

    2015-12-01

    Outcome bias and hindsight bias are related, but how exactly? To remedy theoretical ambiguity and non-existent directly relevant empirical research, we contrast an older idea (Baron & Hershey, 1988, J. Pers. Soc. Psychol., 54, 569) that sees outcome bias as partly mediated through hindsight bias with the idea that the two biases independently affect decision evaluations. In an Internet study of retrospections on the 2012 London Olympics, evaluations of the Games' success and its foreseeability had independent effects on evaluations of the International Olympic Committee's decision to award the Olympics to London; there was no evidence of mediation. Further theoretical discussion emphasizes the need to distinguish between a holistic assessment of decisions and a more specific assessment of the decision-making process in future outcome bias research. © 2015 The British Psychological Society.

  1. The "Dreadful Visitation": public health and public awareness in seventeenth-century London.

    PubMed Central

    Greenberg, S J

    1997-01-01

    The decision was made in Britain three centuries ago that an educated populace was best able to deal with a public health crisis of staggering proportions--outbreaks of bubonic and pneumonic plague. As early as 1603, the printing press was enlisted to educate the public about urgent health issues. This education took several forms. The City of London, with the tacit permission of the Crown, printed bills of mortality that reported who was dying of what in London, detailed by parish, for the years in the seventeenth century when plague deaths were reported. New books about plague prevention and cures were published; older works were reprinted. The resulting wealth of data gave impetus to the evolution of the new field of epidemiological demographics, founded by John Graunt and Sir William Petty. Publishing in the plague years also established a model for informing the general populace that is not without parallel in today's "information society." Images PMID:9431429

  2. Older Urban Migrants in Rural Settings: Problems and Prospects.

    ERIC Educational Resources Information Center

    Sofranko, Andrew J.; And Others

    1982-01-01

    Surveyed older adults (N=158) who migrated from urban to rural areas to explore implications of residential choice. Data showed that while older rural residents have less access to services, they are more satisfied, more likely to perceive improvements over the former residence, and are more attached to their residences. (Author/JAC)

  3. Language Acculturation among Older Vietnamese Refugee Adults.

    ERIC Educational Resources Information Center

    Tran, Thanh V.

    1990-01-01

    Examined English language acculturation among older Vietnamese refugees (aged 40 and older). Found that age, sex, education in Vietnam, health, and length of residence in United States had some significant relationships with language acculturation. Older Vietnamese people had more problems with language acculturation than younger counterparts, and…

  4. Mortality and temperature in Sofia and London

    PubMed Central

    Pattenden, S; Nikiforov, B; Armstrong, B

    2003-01-01

    Study objective: Heat and cold have been associated with increased mortality, independently of seasonal trends, but details are little known. This study explores associations between mortality and temperature in two European capitals—Sofia and London—using four years of daily deaths, air pollution, and weather data. Design: Generalised additive models were used to permit non-linear modelling of confounders such as season and humidity, and to show the shape of mortality-temperature relations—using both two day and two week average temperatures separately. Models with linear terms for heat and cold were used to estimate lags of effect, linear effects, and attributable fractions. Participants: 44 701 all age all cause deaths in Sofia (1996–1999) and 256 464 in London (1993–1996). Main results: In London, for each degree of extreme cold (below the 10th centile of the two week mean temperature), mortality increased by 4.2% (95% CI 3.4 to 5.1), and in Sofia by 1.8% (0.6 to 3.9). For each degree rise above the 95th centile of the two day mean, mortality increased by 1.9% (1.4 to 2.4) in London, and 3.5% (2.2 to 4.8) in Sofia. Cold effects appeared after lags of around three days and lasted—particularly in London—at least two weeks. Main heat effects occurred more promptly. There were inverse associations at later lags for heat and cold in Sofia. Conclusions: Average temperatures over short periods do not adequately model cold, and may be inadequate for heat if they ignore harvesting effects. Cold temperatures in London, particularly, seem to harm the general population and the effects are not concentrated among persons close to death. PMID:12883072

  5. Aircraft observations above London city during a day and a night: ozone and alkyl nitrate formation

    NASA Astrophysics Data System (ADS)

    Aruffo, Eleonora; Di Carlo, Piero; Dari Salisburgo, Cesare; Biancofiore, Fabio; Giammaria, Franco; Busilacchio, Marcella; Lee, James; Moller, Sarah; Bauguitte, Stephane; O'Sullivan, Debbie; Morgan, Will; Ouyang, Bin; Kennedy, Oliver; Jones, Rod; Forster, Grant; Reeves, Claire; Vaughan, Stewart; Heard, Dwayne

    2013-04-01

    Measurements of NO2, ΣPNs, ΣANs and HNO3 have been done using a TD-LIF instrument, installed on board the FAAM BAe-146 research aircraft, during the RONOCO (ROle of Nighttime chemistry in controlling the Oxidising Capacity) campaign. We analyse in detail the chemical mechanisms that have been established during two flights (B536 and B548) characterized by a similar track (flying above the M25 highway around London) and carried out during a day (B548) and a night (B536). In the daytime flight, the chemical species around London present a net spatial distribution defining two distinct areas: the East London region (up-wind) with an older and less polluted (lowest concentrations of NOx) air masses and the West London region (down-wind) with fresh emissions and more polluted (highest concentrations of NOx with peaks of about 30 ppb). In correspondence of these peaks strong ozone tritation phenomena due to the high NOx levels are verified with a corresponding increase of the ΣANs concentrations. In order to verify the impact of the high concentrations of alkyl nitrate (with maximum values of about 3 ppb) on the tropospheric ozone budget, the production and loss of ozone and ΣANs has been studied. The slopes between the production of ozone and alkyl nitrates confirm that around London the ΣANs formation on one side and the relative ozone loss on the other side represent significant processes. Moreover, the loss of the O3 during the nocturnal flight (B536) is less evident that during the B548 flight.

  6. Gonorrhoea in inner London: results of a cross sectional study.

    PubMed Central

    Low, N.; Daker-White, G.; Barlow, D.; Pozniak, A. L.

    1997-01-01

    OBJECTIVES: To estimate population based incidence rates of gonorrhoea in an inner London area and examine relations with age, ethnic group, and socioeconomic deprivation. DESIGN: Cross sectional study. SETTING: 11 departments of genitourinary medicine in south and central London. SUBJECTS: 1978 first episodes of gonorrhoea diagnosed in 1994 and 1995 in residents of 73 electoral wards in the boroughs of Lambeth, Southwark, and Lewisham who attended any of the departments of genitourinary medicine. MAIN OUTCOME MEASURES: Yearly age, sex, and ethnic group specific rates of gonorrhoea per 100,000 population aged 15-59 years; rate ratios for the effects of age and ethnic group on gonorrhoea rates in women and men before and after adjustment for confounding factors. RESULTS: Overall incidence rates of gonorrhoea in residents of Lambeth, Southwark, and Lewisham were 138.3 cases yearly per 100,000 women and 291.9 cases yearly per 100,000 men aged 15-59 years. At all ages gonorrhoea rates were higher in non-white minority ethnic groups. Rate ratios for the effect of age adjusted for ethnic group and underprivilege were 15.2 (95% confidence interval 11.6 to 19.7) for women and 2.0 (1.7 to 2.5) for men aged 15-19 years compared with those over 30. After deprivation score and age were taken into account, women from black minority groups were 10.5 (8.6 to 12.8) times as likely and men 11.0 (9.7 to 12.6) times as likely as white people to experience gonorrhoea. CONCLUSIONS: Gonorrhoea rates in Lambeth, Southwark, and Lewisham in 1994-5 were six to seven times higher than for England and Wales one year earlier. The presentation of national trends thus hides the disproportionate contribution of ongoing endemic transmission in the study area. Teenage women and young adult men, particularly those from black minority ethnic groups, are the most heavily affected, even when socioeconomic underprivilege is taken into account. There is urgent need for resources for culturally

  7. Health effects of the London bicycle sharing system: health impact modelling study

    PubMed Central

    Tainio, Marko; Cheshire, James; O’Brien, Oliver; Goodman, Anna

    2014-01-01

    Objective To model the impacts of the bicycle sharing system in London on the health of its users. Design Health impact modelling and evaluation, using a stochastic simulation model. Setting Central and inner London, England. Data sources Total population operational registration and usage data for the London cycle hire scheme (collected April 2011-March 2012), surveys of cycle hire users (collected 2011), and London data on travel, physical activity, road traffic collisions, and particulate air pollution (PM2.5, (collected 2005-12). Participants 578 607 users of the London cycle hire scheme, aged 14 years and over, with an estimated 78% of travel time accounted for by users younger than 45 years. Main outcome measures Change in lifelong disability adjusted life years (DALYs) based on one year impacts on incidence of disease and injury, modelled through medium term changes in physical activity, road traffic injuries, and exposure to air pollution. Results Over the year examined the users made 7.4 million cycle hire trips (estimated 71% of cycling time by men). These trips would mostly otherwise have been made on foot (31%) or by public transport (47%). To date there has been a trend towards fewer fatalities and injuries than expected on cycle hire bicycles. Using these observed injury rates, the population benefits from the cycle hire scheme substantially outweighed harms (net change −72 DALYs (95% credible interval −110 to −43) among men using cycle hire per accounting year; −15 (−42 to −6) among women; note that negative DALYs represent a health benefit). When we modelled cycle hire injury rates as being equal to background rates for all cycling in central London, these benefits were smaller and there was no evidence of a benefit among women (change −49 DALYs (−88 to −17) among men; −1 DALY (−27 to 12) among women). This sex difference largely reflected higher road collision fatality rates for female cyclists. At older ages the modelled

  8. Permanent resident.

    PubMed

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  9. Presence of Legionella in London's water supplies.

    PubMed

    Colbourne, J S; Trew, R M

    1986-09-01

    Legionella occurs frequently (52 to 54%) in domestic water and cooling water inside commercial, industrial and health care buildings, and these types of water systems are now regarded as a normal habitat for Legionella. The factors that predispose a particular water system to colonization by these organisms are ill-defined, although it is fairly certain that biological and physicochemical environmental factors play an important role in allowing Legionella to multiply in the circulating water. It has been postulated that the organism may gain access to water systems inside buildings by one of three routes: contact with air through open points such as uncovered storage tanks or vents, ingress of soil or surface water during construction or repair, or intermittent seeding with organisms present in low numbers in the public water supply. Three studies in the USA have found Legionella in 0.4 to 8.8% of drinking-water samples, but these were not representative of the public supply network as a whole. The aim of this study was to determine, over a period of 1 year, the frequency of Legionella in London's drinking water--from the treatment plant through to the consumer's tap. To date, Legionella has not been isolated from raw river water entering London's treatment works or from treated water entering the distribution network. Sixty-two monitoring taps in buildings located in 21 supply areas have been sampled twice for Legionella; only 2 (2.4%) have proved positive during the autumn and winter of 1985/86. The strain found was L. pneumophila serotype 1, subgroup Olda, and the numbers ranged from 10(2) to 10(4)/l. Although the survey is incomplete, it is already clear that the public water supplies in London are not a source of strains of Legionella associated with disease.

  10. Parasuicide in central London 1984-1988.

    PubMed Central

    Fuller, G N; Rea, A J; Payne, J F; Lant, A F

    1989-01-01

    Experience of a central London unit dedicated to the care of patients following parasuicide between 1984 and 1988 is reviewed. There were 1160 admissions, which accounted for 11% of all acute adult medical admissions. The female to male ratio was 1.3, with a peak rate for females below 25 years and for males between 20 and 35. Unemployment was found to be a risk factor for parasuicide in men. Benzodiazepines were the most frequently used drug in parasuicide (35%), followed by paracetamol (13%) and aspirin (9%). PMID:2574238

  11. Experiential Approaches to the Global City: London as Social Laboratory

    ERIC Educational Resources Information Center

    Gristwood, Anthony; Woolf, Michael

    2011-01-01

    London is the paramount example of a city that is not bounded by its geography and cannot be grasped in isolation. The U.K.'s national capital and the prime focus for business, finance and creative industries, London also transcends the U.K.'s borders as a hub of the world economy. This paper argues that London, a city riddled by the socioeconomic…

  12. Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

    ERIC Educational Resources Information Center

    Shoemaker, Robert

    2005-01-01

    Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

  13. Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

    ERIC Educational Resources Information Center

    Shoemaker, Robert

    2005-01-01

    Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

  14. Age estimation in Portuguese population: The application of the London atlas of tooth development and eruption.

    PubMed

    Pavlović, Strahinja; Palmela Pereira, Cristiana; Vargas de Sousa Santos, Rui Filipe

    2017-03-01

    Chronological age estimation from the dental parameters is becoming increasingly important. The London atlas of tooth development is the most recent developed method and represents a modification of the previous older methods. The aim of this study was to evaluate the accuracy of the London atlas for the dental age estimation in the Portuguese population. The study sample included 736 radiographic images (498 females and 238 males) of Portuguese origin, patients of Dental Clinic of Superior Institute of Health Sciences Egas Moniz and Dental Medicine Faculty, University of Lisbon. The age range of the individuals was between 3 and 24 years. Estimated age was compared with the chronological age using the paired t-test. The results showed that there was no statistically significant difference between left and right side of the jaw (p>0.05). Both sides showed an average overestimation of age by one month approximately. Moreover, the significant difference between chronological and estimated age was not observed in the females. However, the significant difference was observed in a sample coming from males (right: p=0.008; left: p=0.003). Our results showed that the London atlas can be potentially used as a tool for age estimation. However, the difference between sexes clearly suggests that separate charts should be made for each sex. Further studies, which will have as a final goal the development of a new method for age estimation using dental parameters, are needed.

  15. Optical legacy of Imperial College London

    NASA Astrophysics Data System (ADS)

    Kidger Webb-Moore, Tina E.

    2016-10-01

    The Industrial Revolution, beginning primarily in the UK, generated an increasing need for highly skilled technical people. Throughout the 19th century, technical instruction increased dramatically and the formation of schools specializing in science and technology grew quickly. In England, there was much motivation in favour of a national prestige center for science and technology centered in London. Central among the motivating forces was Queen Victoria's husband, Prince Albert. Although there were already existing specialist science and technology institutions in major English cities, the growth of superior institutions in other countries within Europe, especially Germany and the Charlottenburg area of Berlin (e.g., the Berlin Technical High School), encouraged important English dignitaries to become more competitive with continental Europe. As a result of this strong continental motivation, several science and technology institutions were built in the south Kensington part of London during the latter half of the 19th century. Imperial College, founded at the start of the 20th century, was a culmination and consolidation of several of these 19th century English institutions. Optical science and technology was an early beneficiary of the founding of Imperial College. This paper will attempt to provide the reader with an understanding of how great was the influence of the optical section of Imperial College in the further development of the world's optical science and technology.

  16. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b...

  17. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b...

  18. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b... be conducted for each resident of a Medicaid NF who has mental illness or mental retardation not less...

  19. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State mental health authority must determine in accordance with § 483.130 whether, because of the resident's... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b...

  20. 42 CFR 483.114 - Annual review of NF residents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... residents. (a) Individuals with mental illness. For each resident of a NF who has mental illness, the State... 65 or older; and (2) Specialized services for mental illness, as defined in § 483.120. (b... be conducted for each resident of a Medicaid NF who has mental illness or mental retardation not less...

  1. Satisfaction with Clinical Encounters among Residents and Geriatric Patients.

    ERIC Educational Resources Information Center

    Anderson, Lynda A.; And Others

    1988-01-01

    A study of internal medicine residents' attitudes toward specific older patients' health status, adjustment to medical care, and expected benefits of health education activities found that residents' attitudes correlated with their satisfaction and that patients tended to express greater satisfaction than residents. (Author/MSE)

  2. The London low emission zone baseline study.

    PubMed

    Kelly, Frank; Armstrong, Ben; Atkinson, Richard; Anderson, H Ross; Barratt, Ben; Beevers, Sean; Cook, Derek; Green, Dave; Derwent, Dick; Mudway, Ian; Wilkinson, Paul

    2011-11-01

    On February 4, 2008, the world's largest low emission zone (LEZ) was established. At 2644 km2, the zone encompasses most of Greater London. It restricts the entry of the oldest and most polluting diesel vehicles, including heavy-goods vehicles (haulage trucks), buses and coaches, larger vans, and minibuses. It does not apply to cars or motorcycles. The LEZ scheme will introduce increasingly stringent Euro emissions standards over time. The creation of this zone presented a unique opportunity to estimate the effects of a stepwise reduction in vehicle emissions on air quality and health. Before undertaking such an investigation, robust baseline data were gathered on air quality and the oxidative activity and metal content of particulate matter (PM) from air pollution monitors located in Greater London. In addition, methods were developed for using databases of electronic primary-care records in order to evaluate the zone's health effects. Our study began in 2007, using information about the planned restrictions in an agreed-upon LEZ scenario and year-on-year changes in the vehicle fleet in models to predict air pollution concentrations in London for the years 2005, 2008, and 2010. Based on this detailed emissions and air pollution modeling, the areas in London were then identified that were expected to show the greatest changes in air pollution concentrations and population exposures after the implementation of the LEZ. Using these predictions, the best placement of a pollution monitoring network was determined and the feasibility of evaluating the health effects using electronic primary-care records was assessed. To measure baseline pollutant concentrations before the implementation of the LEZ, a comprehensive monitoring network was established close to major roadways and intersections. Output-difference plots from statistical modeling for 2010 indicated seven key areas likely to experience the greatest change in concentrations of nitrogen dioxide (NO2) (at least 3

  3. 'Well London' and the benefits of participation: results of a qualitative study nested in a cluster randomised trial.

    PubMed

    Derges, Jane; Clow, Angela; Lynch, Rebecca; Jain, Sumeet; Phillips, Gemma; Petticrew, Mark; Renton, Adrian; Draper, Alizon

    2014-04-02

    Well London is a multicomponent community engagement and coproduction programme designed to improve the health of Londoners living in socioeconomically deprived neighbourhoods. To evaluate outcomes of the Well London interventions, a cluster randomised trial (CRT) was conducted that included a longitudinal qualitative component, which is reported here. The aim is to explore in depth the nature of the benefits to residents and the processes by which these were achieved. The 1-year longitudinal qualitative study was nested within the CRT. Purposive sampling was used to select three intervention neighbourhoods in London and 61 individuals within these neighbourhoods. The interventions comprised activities focused on: healthy eating, physical exercise and mental health and well-being. Interviews were conducted at the inception and following completion of the Well London interventions to establish both if and how they had participated. Transcripts of the interviews were coded and analysed using Nvivo. Positive benefits relating to the formal outcomes of the CRT were reported, but only among those who participated in project activities. The extent of benefits experienced was influenced by factors relating to the physical and social characteristics of each neighbourhood. The highest levels of change occurred in the presence of: (1) social cohesion, not only pre-existing but also as facilitated by Well London activities; (2) personal and collective agency; (3) involvement and support of external organisations. Where the physical and social environment remained unchanged, there was less participation and fewer benefits. These findings show interaction between participation, well-being and agency, social interactions and cohesion and that this modulated any benefits described. Pathways to change were thus complex and variable, but personal well-being and local social cohesion emerged as important mediators of change.

  4. Radical observations during the Clean air for London project

    NASA Astrophysics Data System (ADS)

    Whalley, L. K.; Stone, D.; Clancy, N.; Lee, J. D.; Laufs, S.; Kleffmann, J.; Heard, D. E.

    2012-12-01

    With greater than 50 % of the global population residing in urban conurbations, poor urban air quality has a demonstrable effect on human health. OH and HO2 radicals, (collectively termed HOx) together with RO2 radicals, mediate virtually all of the oxidative chemistry in the atmosphere, being responsible for the transformation of primary emissions into secondary pollutants such as NO2, O3 and particulates. Understanding the chemistry of free-radicals in the atmosphere is essential in improving predictions of the lifetimes of pollutants and spatial scales of their transport within urban areas. Results from earlier field campaigns in urban and polluted regions have demonstrated the significance of HONO photolysis and alkene ozonolysis in the production of HOx radicals. In many cases, however, measurements of HONO have not been made, reducing the ability to evaluate model successes for OH in these environments. Here we present measurements of OH, HO2, RO2 and OH reactivity taken during the wintertime (January - February, 2012) and summertime (July - August, 2012) as part of the Clean air for London (ClearfLo) project in London. RO2 was detected using a newly developed flow-reactor laser-induced fluorescence technique which is able to discriminate between HO2 and organic peroxy radicals [1]. Low concentrations of radicals were observed during the wintertime, midday [OH], [HO2] and [RO2] were ~ 0.04, 0.8 and 1.5 pptv respectively, comparable to observations of radicals at other urban locations in winter [2,3,4], and which displayed a negative correlation with NO concentrations. OH reactivity was high and largely tracked the diurnal profiles of NOx and CO, with the highest reactivity ~100 s-1 observed during the morning rush hour. Analysis of factors controlling OH concentrations during the wintertime suggests that the formation of OH from the photolysis of O3 and subsequent reaction of O(1D) with H2O is a minor contribution both under high and low NOx conditions owing

  5. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... emergencies, vessels shall not anchor in New London Harbor or the approaches thereto outside the anchorages... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false New London Harbor, Conn. 110.147 Section 110.147 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY...

  6. Alternative Spaces of Learning in East London: Opportunities and Challenges

    ERIC Educational Resources Information Center

    Sneddon, Raymonde; Martin, Peter

    2012-01-01

    This article emerges from an ongoing exploration into how British minority ethnic communities in the London area create spaces in community-based programs to maintain or develop their languages and literacies. In London, more than one-third of the 850,000 school children speak a language other than English at home (Baker & Eversley, 2000).…

  7. RADIOLOGICAL SURVEY AT THE NEW LONDON HARBOR FACILITIES

    EPA Science Inventory

    A radiological survey done to assess levels of environmental radioactivity in and around navy harbor facilities located on the Thames River near New London, Connecticut. These facilities include the New London Submarine Base at Groton, the Electric Boat Company at Groton, Sound ...

  8. RADIOLOGICAL SURVEY AT THE NEW LONDON HARBOR FACILITIES

    EPA Science Inventory

    A radiological survey done to assess levels of environmental radioactivity in and around navy harbor facilities located on the Thames River near New London, Connecticut. These facilities include the New London Submarine Base at Groton, the Electric Boat Company at Groton, Sound ...

  9. Alternative Spaces of Learning in East London: Opportunities and Challenges

    ERIC Educational Resources Information Center

    Sneddon, Raymonde; Martin, Peter

    2012-01-01

    This article emerges from an ongoing exploration into how British minority ethnic communities in the London area create spaces in community-based programs to maintain or develop their languages and literacies. In London, more than one-third of the 850,000 school children speak a language other than English at home (Baker & Eversley, 2000).…

  10. London air quality: a real world experiment in progress.

    PubMed

    Kelly, Frank J; Kelly, Julia

    2009-07-01

    London currently has the highest nitrogen dioxide (NO2) concentration recorded for any European city and for particulate matter (PM) it has some of the worst hot spots. Therefore overall, for these two pollutants, London is the worst in the UK and amongst the worst in Europe. Exposure to elevated concentrations of air pollutants such as PM and NO2 has well-established heath effects and most countries now have strict guidelines for air quality. London's air quality problems are driven largely by traffic. This, along with the high density of people in an urban area results in air quality guidelines being exceeded on a regular basis and large numbers of people being affected. In an attempt to combat London's air quality problems the Mayor of London introduced a series of measures to decrease traffic emissions. These included both a restriction on the number of vehicles entering central London each day--the Congestions Charging Scheme (CCS), and the discouragement of the most polluting heavy goods vehicles from entering--the London Low Emission Zone (LEZ). Together, it is hoped that these measures will lead to an improvement in air quality and provide a direct health benefit to Londoners. Research underway is charting the progress of this real world experiment.

  11. Practicing Reflexivity in the Study of Italian Migrants in London

    ERIC Educational Resources Information Center

    Seganti, Francesca Romana

    2010-01-01

    This article discusses the centrality of reflexivity in qualitative research through examples from my study on the role new media play in the lives of Italians in London. My hypothesis was that Italians were "in transit" in London and they were using new media to build "temporary" communities. I conducted in-depth interviews…

  12. Education in a Global City: Essays from London

    ERIC Educational Resources Information Center

    Brighouse, Tim, Ed.; Fullick, Leisha, Ed.

    2007-01-01

    This collection of essays by academic and policy experts brings together a wide range of data to offer a clear picture of London's changing education scene. Its mapping of new and developing strategies for successful urban education will be useful to educators and policymakers not only in London but also in other cities operating in similar…

  13. Education in a Global City: Essays from London

    ERIC Educational Resources Information Center

    Brighouse, Tim, Ed.; Fullick, Leisha, Ed.

    2007-01-01

    This collection of essays by academic and policy experts brings together a wide range of data to offer a clear picture of London's changing education scene. Its mapping of new and developing strategies for successful urban education will be useful to educators and policymakers not only in London but also in other cities operating in similar…

  14. Changing the Subject: English in London, 1945-1967

    ERIC Educational Resources Information Center

    Yandell, John

    2014-01-01

    Two recent books, "English Teachers in a Postwar Democracy: Emerging Choice in London Schools, 1945-1965" and "The London Association for the Teaching of English, 1947-67: A History," explore an important period in the development of English as a school subject and in the remaking of the professional identity of English…

  15. Changing the Subject: English in London, 1945-1967

    ERIC Educational Resources Information Center

    Yandell, John

    2014-01-01

    Two recent books, "English Teachers in a Postwar Democracy: Emerging Choice in London Schools, 1945-1965" and "The London Association for the Teaching of English, 1947-67: A History," explore an important period in the development of English as a school subject and in the remaking of the professional identity of English…

  16. London in Space and Time: Peter Ackroyd and Will Self

    ERIC Educational Resources Information Center

    Green, Andrew

    2013-01-01

    This paper explores the treatment of London by two authors who are profoundly influenced by the concept of the power of place and the nature of urban space. The works of Peter Ackroyd, whose writings embody, according to Onega (1997, p. 208) "[a] yearning for mythical closure" where London is "a mystic centre of…

  17. London Trusts proud to describe their work.

    PubMed

    Baillie, Jonathan

    2015-11-01

    'Waste not, Want not' was the title of a recent IHEEM seminar which examined some of the key issues for those responsible for dealing with healthcare waste--from regulatory compliance and correct segregation of waste streams, to the opportunities for more on-site processing. HEJ editor, Jonathan Baillie, reports on the joint presentations given by key environmental and sustainability personnel at two of London's largest NHS Trusts, and their private sector waste management partners. These discussed some of the key initiatives that each Trust and its 'partner' have taken to not only significantly reduce the amount of waste generated on their estate, but also to dispose of it in an environmentally responsible way. These initiatives, the speakers explained, were all part of their organisations' journey on the road to achieving 'Deep Green', a 'nirvana'-like state where their activities have a zero net impact on the environment.

  18. Complaints about dog faeces as a symbolic representation of incivility in London, UK: a qualitative study.

    PubMed

    Derges, Jane; Lynch, Rebecca; Clow, Angela; Petticrew, Mark; Draper, Alizon

    2012-12-01

    During a 'Well London' study, residents were asked about their neighbourhood and its environment. Above all other complaints, 'dog poo' was mentioned as a key concern. Despite low rates of infection and disease among the human population resulting from contact with canine faecal matter, the concerns of the public continue to rate it as a serious public health issue. Most public health studies, therefore, seek to identify processes of transmission and disease pathology as a method of addressing the problem. This study approaches the issue through a contextualised analysis of residents' complaints, using anthropological theory to examine the symbolic representation of 'dog poo'. Analysis of the interviews shows that these specific complaints were located among less easily defined or articulated experiences of social and environmental neglect, where neighbours were estranged from one another and local authorities seen as negligent. This approach has important implications for public health, as it provides not only a strong indicator of the level of dissatisfaction within some of London's more disadvantaged neighbourhoods, but also identifies a need for policies that are grounded in cross-disciplinary research into the relationship between health, 'wellbeing' and experiences of marginalisation among urban populations.

  19. Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data.

    PubMed

    Smith, Catherine M; Maguire, Helen; Anderson, Charlotte; Macdonald, Neil; Hayward, Andrew C

    2017-01-01

    Large outbreaks of tuberculosis (TB) represent a particular threat to disease control because they reflect multiple instances of active transmission. The extent to which long chains of transmission contribute to high TB incidence in London is unknown. We aimed to estimate the contribution of large clusters to the burden of TB in London and identify risk factors. We identified TB patients resident in London notified between 2010 and 2014, and used 24-locus mycobacterial interspersed repetitive units-variable number tandem repeat strain typing data to classify cases according to molecular cluster size. We used spatial scan statistics to test for spatial clustering and analysed risk factors through multinomial logistic regression. TB isolates from 7458 patients were included in the analysis. There were 20 large molecular clusters (with n>20 cases), comprising 795 (11%) of all cases; 18 (90%) large clusters exhibited significant spatial clustering. Cases in large clusters were more likely to be UK born (adjusted odds ratio 2.93, 95% CI 2.28-3.77), of black-Caribbean ethnicity (adjusted odds ratio 3.64, 95% CI 2.23-5.94) and have multiple social risk factors (adjusted odds ratio 3.75, 95% CI 1.96-7.16). Large clusters of cases contribute substantially to the burden of TB in London. Targeting interventions such as screening in deprived areas and social risk groups, including those of black ethnicities and born in the UK, should be a priority for reducing transmission.

  20. Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data

    PubMed Central

    Maguire, Helen; Anderson, Charlotte; Macdonald, Neil; Hayward, Andrew C.

    2017-01-01

    Large outbreaks of tuberculosis (TB) represent a particular threat to disease control because they reflect multiple instances of active transmission. The extent to which long chains of transmission contribute to high TB incidence in London is unknown. We aimed to estimate the contribution of large clusters to the burden of TB in London and identify risk factors. We identified TB patients resident in London notified between 2010 and 2014, and used 24-locus mycobacterial interspersed repetitive units–variable number tandem repeat strain typing data to classify cases according to molecular cluster size. We used spatial scan statistics to test for spatial clustering and analysed risk factors through multinomial logistic regression. TB isolates from 7458 patients were included in the analysis. There were 20 large molecular clusters (with n>20 cases), comprising 795 (11%) of all cases; 18 (90%) large clusters exhibited significant spatial clustering. Cases in large clusters were more likely to be UK born (adjusted odds ratio 2.93, 95% CI 2.28–3.77), of black-Caribbean ethnicity (adjusted odds ratio 3.64, 95% CI 2.23–5.94) and have multiple social risk factors (adjusted odds ratio 3.75, 95% CI 1.96–7.16). Large clusters of cases contribute substantially to the burden of TB in London. Targeting interventions such as screening in deprived areas and social risk groups, including those of black ethnicities and born in the UK, should be a priority for reducing transmission. PMID:28149918

  1. Smoke alarm installation and function in inner London council housing.

    PubMed

    DiGuiseppi, C; Roberts, I; Speirs, N

    1999-11-01

    To determine the prevalence of and predictors for installed, functioning smoke alarms in council (public) housing in a low income, multi-ethnic urban area. Cross sectional study. 40 materially deprived electoral wards in two inner London boroughs. Occupants of 315 addresses randomly selected from council housing lists, with 75% response rate. Installation and function of smoke alarms based on inspection and testing. 39% (95% confidence interval (CI) 33% to 46%) of council tenants owned a smoke alarm, 31% (95% CI 25% to 38%) had an installed alarm (of which 54% were correctly installed), and 16% (95% CI 12% to 22%) had at least one installed, functioning alarm. Alarms most commonly failed because they lacked batteries (72%). In multivariate modelling, having an installed, functioning alarm was most strongly associated with living in a house versus a flat (apartment) (odds ratio (OR) 3.2, 95% CI 1.1 to 10.0), having two resident adults versus one (OR 2.8, 95% CI 1.2 to 6.5), and recognising stills from a Home Office television smoke alarm campaign (OR 2.4, 95% CI 1.1 to 5.5). Fires are a leading cause of child injury and death, particularly among those younger than 5 years of age and those in social classes IV and V. Smoke alarms are associated with a significantly reduced risk of death in residential fires, and are more protective in households with young children. Few council properties in a multi-ethnic, materially deprived urban area had any installed, functioning smoke alarms, despite a high risk of residential fires and fire related injuries in such areas. Effective methods to increase the prevalence of installed and functioning alarms must be identified.

  2. Smoke alarm installation and function in inner London council housing

    PubMed Central

    DiGuiseppi, C.; Roberts, I.; Speirs, N.

    1999-01-01

    AIM—To determine the prevalence of and predictors for installed, functioning smoke alarms in council (public) housing in a low income, multi-ethnic urban area.
DESIGN—Cross sectional study.
SETTING—40 materially deprived electoral wards in two inner London boroughs.
PARTICIPANTS—Occupants of 315 addresses randomly selected from council housing lists, with 75% response rate.
MAIN OUTCOME MEASURES—Installation and function of smoke alarms based on inspection and testing.
RESULTS—39% (95% confidence interval (CI) 33% to 46%) of council tenants owned a smoke alarm, 31% (95% CI 25% to 38%) had an installed alarm (of which 54% were correctly installed), and 16% (95% CI 12% to 22%) had at least one installed, functioning alarm. Alarms most commonly failed because they lacked batteries (72%). In multivariate modelling, having an installed, functioning alarm was most strongly associated with living in a house versus a flat (apartment) (odds ratio (OR) 3.2, 95% CI 1.1 to 10.0), having two resident adults versus one (OR 2.8, 95% CI 1.2 to 6.5), and recognising stills from a Home Office television smoke alarm campaign (OR 2.4, 95% CI 1.1 to 5.5).
CONCLUSIONS—Fires are a leading cause of child injury and death, particularly among those younger than 5 years of age and those in social classes IV and V. Smoke alarms are associated with a significantly reduced risk of death in residential fires, and are more protective in households with young children. Few council properties in a multi-ethnic, materially deprived urban area had any installed, functioning smoke alarms, despite a high risk of residential fires and fire related injuries in such areas. Effective methods to increase the prevalence of installed and functioning alarms must be identified.

 PMID:10519711

  3. East London Experience with Enteric Fever 2007-2012

    PubMed Central

    Dave, Jayshree; Millar, Michael; Maxeiner, Horst; Freedman, Joanne; Meade, Rachel; Rosmarin, Caryn; Jordan, Matthew; Andrews, Nick; Holliman, Richard; Sefton, Armine

    2015-01-01

    Purpose The clinical presentation and epidemiology for patients with enteric fever at two hospitals in East London during 2007–2012 is described with the aim to identify preventive opportunities and to reduce the cost of treatment. Methods A retrospective analysis of case notes from patients admitted with enteric fever during 2007 to 2012 with a microbiologically confirmed diagnosis was undertaken. Details on clinical presentation, travel history, demographic data, laboratory parameters, treatment, patient outcome and vaccination status were collected. Results Clinical case notes were available for 98/129 (76%) patients including 69 Salmonella enterica serovar Typhi (S. Typhi) and 29 Salmonella enterica serovar Paratyphi (S. Paratyphi). Thirty-four patients (35%) were discharged from emergency medicine without a diagnosis of enteric fever and then readmitted after positive blood cultures. Seventy-one of the 98 patients (72%) were UK residents who had travelled abroad, 23 (23%) were foreign visitors/new entrants to the UK and four (4%) had not travelled abroad. Enteric fever was not considered in the initial differential diagnosis for 48/98 (49%) cases. The median length of hospital stay was 7 days (range 0–57 days). The total cost of bed days for managing enteric fever was £454,000 in the two hospitals (mean £75,666/year). Median time to clinical resolution was five days (range 1–20). Seven of 98 (7%) patients were readmitted with relapsed or continued infection. Six of the 71 (8%) patients had received typhoid vaccination, 34 (48%) patients had not received vaccination, and for 31 cases (44%) vaccination status was unknown. Conclusions Further interventions regarding education and vaccination of travellers and recognition of the condition by emergency medicine clinicians in travellers to South Asia is required. PMID:25790017

  4. Comparison of safety equipment between London underground and Beijing subway

    NASA Astrophysics Data System (ADS)

    Chen, T.; Zhang, S. Y.; Zhao, L. Z.; Xia, J. J.; Fu, X. C.; Bao, Z. M.; Chen, Y.; Zhang, X. Z.; Wang, R. J.; Hu, C.; Jing, L. S.; Wang, Y.

    2017-06-01

    The purpose of this paper was to improve the safety equipment’s effectiveness through the comparison. Firstly, the history and safety accident of London Underground and Beijing Subway were shown. Secondly, fire equipment between these two cities was compared including station’s hardware installations and carriage’s hardware installations. Thirdly, the relative software installations were also compared such as emergency drills. The results showed that Beijing Subway’s hardware installations were better than London. However, London Underground’s some installations were more effective than Beijing. Both cities would pay more attention on anti-terrorist in tunnel.

  5. Lidar Observations of Pollution Transport From London to Rural Areas

    NASA Astrophysics Data System (ADS)

    Ricketts, Hugo; Vaughan, Geraint; Wareing, David

    2016-06-01

    The Clean Air for London (ClearfLo) Project took place in and around London, United Kingdom. The aim of the project was to learn how both atmospheric dynamics and chemistry affect air pollution in the south east of England. During the winter and summer of 2012 many different types of instrument including lidars were deployed throughout London city centre, suburbs and into rural areas. Amongst these instruments was the Boundary Layer Aerosol/Ozone Lidar owned by the National Centre for Atmospheric Sciences (NCAS) in the United Kingdom. Ozone and aerosol data are presented from data collected during July and August 2012 and compared to back trajectories to identify their origins.

  6. Teaching the History of Astronomy On Site in London

    NASA Astrophysics Data System (ADS)

    French, Linda M.

    2016-01-01

    In the autumn of 2014, the author had the opportunity to teach a class on the history of astronomy in England as part of a study abroad experience for students at Illinois Wesleyan University. The philosophy of the program is to use the rich cultural environment of London as a setting for active learning. In the classroom, students read and discussed selected works by Ptolemy, Copernicus, Kepler, Galileo, and Herschel. We visited Stonehenge, the Royal Greenwich Observatory, the London Science Museum, the London Monument, and the library of the Royal Astronomical Society. Lessons learned from the experience will be shared.

  7. Aircraft noise and cardiovascular disease near Heathrow airport in London: small area study.

    PubMed

    Hansell, Anna L; Blangiardo, Marta; Fortunato, Lea; Floud, Sarah; de Hoogh, Kees; Fecht, Daniela; Ghosh, Rebecca E; Laszlo, Helga E; Pearson, Clare; Beale, Linda; Beevers, Sean; Gulliver, John; Best, Nicky; Richardson, Sylvia; Elliott, Paul

    2013-10-08

    To investigate the association of aircraft noise with risk of stroke, coronary heart disease, and cardiovascular disease in the general population. Small area study. 12 London boroughs and nine districts west of London exposed to aircraft noise related to Heathrow airport in London. About 3.6 million residents living near Heathrow airport. Risks for hospital admissions were assessed in 12 110 census output areas (average population about 300 inhabitants) and risks for mortality in 2378 super output areas (about 1500 inhabitants). Risk of hospital admissions for, and mortality from, stroke, coronary heart disease, and cardiovascular disease, 2001-05. Hospital admissions showed statistically significant linear trends (P<0.001 to P<0.05) of increasing risk with higher levels of both daytime (average A weighted equivalent noise 7 am to 11 pm, L(Aeq),16 h) and night time (11 pm to 7 am, Lnight) aircraft noise. When areas experiencing the highest levels of daytime aircraft noise were compared with those experiencing the lowest levels (>63 dB v ≤ 51 dB), the relative risk of hospital admissions for stroke was 1.24 (95% confidence interval 1.08 to 1.43), for coronary heart disease was 1.21 (1.12 to 1.31), and for cardiovascular disease was 1.14 (1.08 to 1.20) adjusted for age, sex, ethnicity, deprivation, and a smoking proxy (lung cancer mortality) using a Poisson regression model including a random effect term to account for residual heterogeneity. Corresponding relative risks for mortality were of similar magnitude, although with wider confidence limits. Admissions for coronary heart disease and cardiovascular disease were particularly affected by adjustment for South Asian ethnicity, which needs to be considered in interpretation. All results were robust to adjustment for particulate matter (PM10) air pollution, and road traffic noise, possible for London boroughs (population about 2.6 million). We could not distinguish between the effects of daytime or night time

  8. The Making of Two Readers: Agatha Christie and Jack London.

    ERIC Educational Resources Information Center

    Baghban, Marcia

    1990-01-01

    Looks at the lives of two well-known writers to explore how diverse experiences produce literate adults. Discusses Agatha Christie and Jack London who used reading and writing to earn a living and to gain international reputations. (MG)

  9. The Making of Two Readers: Agatha Christie and Jack London.

    ERIC Educational Resources Information Center

    Baghban, Marcia

    1990-01-01

    Looks at the lives of two well-known writers to explore how diverse experiences produce literate adults. Discusses Agatha Christie and Jack London who used reading and writing to earn a living and to gain international reputations. (MG)

  10. 106. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    106. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  11. 109. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    109. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  12. 108. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    108. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  13. 107. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    107. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  14. 105. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    105. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  15. 96. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    96. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  16. 104. Connecticut River Bridge draw span. Old Lyme, New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    104. Connecticut River Bridge draw span. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  17. 98. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    98. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  18. 101. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    101. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  19. 97. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    97. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  20. 102. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    102. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  1. 99. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    99. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  2. 100. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    100. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  3. 103. Connecticut River Bridge draw span. Old Lyme, New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    103. Connecticut River Bridge draw span. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  4. Contemporary terrorism: risk perception in the London options market.

    PubMed

    Garvey, John; Mullins, Martin

    2008-02-01

    Previous studies have a demonstrated a linkage between terrorist attacks and the operation of financial markets. This article focuses on terrorist events carried out over the last five years and examines how they have been perceived among participants on the London financial market. Data from the London options market suggest a high degree of sensitivity to these events. We argue that this sensitivity reveals a vulnerability in the financial markets should the recent trends in terrorist activity continue.

  5. A history of the gardens of the Royal College of Physicians of London.

    PubMed

    Hollman, Arthur

    2009-06-01

    The Royal College of Physicians of London (RCP) was founded in the City of London in 1518 and at that time many of the royal, religious and lay residences had gardens. The gardens were used, among other things, to grow fruit trees, herbs for the kitchen and for strewing on the floor, and for leisure, with lawns, bowling and flowers. So it would have been natural for the RCP Fellows to wish to have a garden of their own. This was not possible until the College moved into its second and third homes in the City in 1614 and 1674 and good street plans of these sites, and of their gardens, have now become available, though we lack any details of the planting. The fourth home in Pall Mall East in 1815 was landlocked. Therefore when the fifth (and current) home in Regent's Park was opened in 1964 it was splendid to have a large garden, carefully designed, planted and recorded. In 2004 a wonderful transformation took place when the College created a modern physic garden showing the development of medicinal plants through the ages and in many parts of the world.

  6. Older Drivers

    MedlinePlus

    ... Affects Driving Tips for Safe Driving Making Your Vehicle Safe Regulations Affecting Older Drivers When Driving Skills ... Like drivers of any age, they use their vehicles to go shopping, do errands, and visit the ...

  7. The Struggle to Study. Financial Implications for Adults Studying in London. A Research Report Funded by London's Four Open College Networks: ALFA, CAWLOC, GLEAN, and OCSL.

    ERIC Educational Resources Information Center

    Sims, Anne; Goddard, Ty

    The four Open College Networks in London assessed the climate in inner London for adult students who wished to return to education and training. The research focussed on: the extent to which recent legislative changes threatened adult participation in education and training; the abolition of the Inner London Education Authority (ILEA) and…

  8. The Struggle to Study. Financial Implications for Adults Studying in London. A Research Report Funded by London's Four Open College Networks: ALFA, CAWLOC, GLEAN, and OCSL.

    ERIC Educational Resources Information Center

    Sims, Anne; Goddard, Ty

    The four Open College Networks in London assessed the climate in inner London for adult students who wished to return to education and training. The research focussed on: the extent to which recent legislative changes threatened adult participation in education and training; the abolition of the Inner London Education Authority (ILEA) and…

  9. Voting suffrage and the political budget cycle: Evidence from the London Metropolitan Boroughs 1902-1937.

    PubMed

    Aidt, Toke S; Mooney, Graham

    2014-04-01

    We study the opportunistic political budget cycle in the London Metropolitan Boroughs between 1902 and 1937 under two different suffrage regimes: taxpayer suffrage (1902-1914) and universal suffrage (1921-1937). We argue and find supporting evidence that the political budget cycle operates differently under the two types of suffrage. Taxpayer suffrage, where the right to vote and the obligation to pay local taxes are linked, encourages demands for retrenchment and the political budget cycle manifests itself in election year tax cuts and savings on administration costs. Universal suffrage, where all adult residents can vote irrespective of their taxpayer status, creates demands for productive public services and the political budget cycle manifests itself in election year hikes in capital spending and a reduction in current spending.

  10. Suicide patterns on the London Underground railway system, 2000-2010.

    PubMed

    Martin, Susanna; Rawala, Muffazal

    2017-10-01

    Aims and Method Suicidal acts on underground railway networks are an area of public health concern. Our aim was to review recent epidemiological patterns of suicidal acts on the London Underground to inform future preventive interventions. Data from 2000 to 2010 were obtained from the British Transport Police via a Freedom of Information request. Results The mean annual rate of suicidal acts from 2000 to 2010 was 5.8 per 100 million passenger journey stages. Of those who died by suicide, 77.3% were of White Northern European ethnicity. A fifth had a history of mental illness. Clinical implications The widening gap between the number of recorded suicide attempts and completed suicides is encouraging. Further research is required regarding the role of drug and alcohol use, psychiatric history and area of residence. Installation of platform screen doors should be considered in future railway network expansion.

  11. Voting suffrage and the political budget cycle: Evidence from the London Metropolitan Boroughs 1902–1937

    PubMed Central

    Aidt, Toke S.; Mooney, Graham

    2014-01-01

    We study the opportunistic political budget cycle in the London Metropolitan Boroughs between 1902 and 1937 under two different suffrage regimes: taxpayer suffrage (1902–1914) and universal suffrage (1921–1937). We argue and find supporting evidence that the political budget cycle operates differently under the two types of suffrage. Taxpayer suffrage, where the right to vote and the obligation to pay local taxes are linked, encourages demands for retrenchment and the political budget cycle manifests itself in election year tax cuts and savings on administration costs. Universal suffrage, where all adult residents can vote irrespective of their taxpayer status, creates demands for productive public services and the political budget cycle manifests itself in election year hikes in capital spending and a reduction in current spending. PMID:25843984

  12. A 10-year retrospective review of Salmonella infections at the Children's Hospital in London, Ontario.

    PubMed

    Cellucci, Tania; Seabrook, Jamie A; Chagla, Yasmine; Bannister, Susan L; Salvadori, Marina I

    2010-01-01

    To describe Salmonella infections in children presenting to the Children's Hospital (London Health Sciences Centre, London, Ontario), to assess risk factors for infection and to examine whether younger children, particularly infants younger than 12 weeks of age, experience higher morbidity than older children. A 10-year retrospective review of children with Salmonella infections at the Children's Hospital was conducted. Patient demographics, risk factors for infection, clinical characteristics, bacteriology and outcome were collected from the hospital charts and laboratory records. Data were separated into groups based on age and recent use of antibiotics to analyze differences in outcomes. Sixty-six children with Salmonella infections presented to the Children's Hospital over a 10-year period. Common risk factors for Salmonella infection included having sick contacts, living in a rural area, recent travel, contact with pets (especially reptiles) and exposure to local water. Younger age was associated with an increased likelihood of admission to hospital, treatment with antibiotics and a longer course of antibiotic therapy. This was true when comparing older infants with those younger than 12 weeks of age. Patients recently treated with antibiotics and those with significant underlying medical conditions were more likely to be admitted. A wider knowledge of the epidemiological risk factors for Salmonella infection may improve diagnosis. Higher admission rates were expected in children younger than 12 weeks of age, those recently treated with antibiotics and those who had a significant underlying medical condition. A prospective, multicentre study is needed to further address questions regarding increased illness severity and appropriate management of Salmonella infections in children younger than 12 weeks of age.

  13. Exploring anterograde associative memory in London taxi drivers.

    PubMed

    Woollett, Katherine; Maguire, Eleanor A

    2012-10-24

    London taxi drivers are renowned for their navigation ability, spending a number of years acquiring 'The Knowledge' of London's complex layout and having to pass stringent examinations to obtain an operating licence. In several studies, this navigation skill has been associated with increased posterior but also decreased anterior hippocampal grey matter volume. Neuropsychologically, gain and loss has also been documented in taxi drivers; while very skilled at navigation in London, they are significantly poorer than controls at learning and recalling new object-location associations. Here we tested a group of London taxi drivers and matched control participants on this object-location associations task, while also subjecting them to a battery of challenging anterograde associative memory tests involving verbal, visual and auditory material both within and across modalities. Our aim was to assess whether their difficulty in previous studies reflected a general problem with associative memory, or was restricted to the spatial domain. We replicated previous findings of poor learning and memory of object-location associations. By contrast, their performance on the other anterograde associative memory tasks was comparable with controls. This resolves an outstanding question in the memory profile of London taxi drivers following hippocampal plasticity, and underlines the close relationship between space and the hippocampus.

  14. Epidemiology of internal contamination with polonium-210 in the London incident, 2006.

    PubMed

    Fraser, G; Giraudon, I; Cohuet, S; Bishop, L; Maguire, H; Thomas, H L; Mandal, S; Anders, K; Sanchez-Padilla, E; Charlett, A; Evans, B; Gross, R

    2012-02-01

    More than 700 UK residents were tested for possible contamination with polonium-210 ((210)Po) following the alleged poisoning of Mr Alexander Litvinenko in London in November 2006. This paper describes the epidemiology of internal contamination with the radionuclide in this group. 11 locations in London had been identified as sufficiently environmentally contaminated with (210)Po to present a health risk to people associated with them. Public health consultant teams identified individuals at risk and offered 24-h urine testing for (210)Po excretion. Prevalence of internal contamination was estimated, and a retrospective cohort analysis was completed for each location. Overall 139 individuals (prevalence 0.19 (95% CI 0.13 to 0.27)) showed evidence of internal contamination with (210)Po, although none with uptakes likely to cause adverse health effects. Substantial prevalence was seen among specific hotel service staff, customers, staff and other users of a hotel bar, office and hospital staff, staff of one restaurant and residents of and visitors to the family home. Increased risks of contamination were seen for a hotel bar in association with occupational, behavioural and temporal factors. Occupational and guest exposure to contaminated areas of hotels were also associated with increased contamination risk. Nurses were more likely to become contaminated than other staff involved in direct patient care. Uptake of trace amounts of radionuclide in this incident was frequent. Occupational, behavioural and temporal gradients in contamination risk were mostly consistent with a priori site risk assessments. Utility of the investigation methods and findings for future accidental or deliberate environmental contamination incidents are discussed.

  15. Increasing Plasmodium falciparum malaria in southwest London: a 25 year observational study

    PubMed Central

    Williams, J; Chitre, M; Sharland, M

    2002-01-01

    Aims: To identify changes in the presenting number and species of imported malaria in children in southwest London. Methods: A prospective single observer study over 25 years (1975–99) of all cases of paediatric malaria seen at St George's Hospital. Results: A confirmed diagnosis was made in 249 children (56% boys; 44% girls; median age 8.0 years). Of these, 53% were UK residents and 44% were children travelling to the UK. A significant increase was noted in the number of cases over the 25 years (1975–79: mean 4.8 cases/year; 1990–99: mean 13.7 cases/year). Over the 25 years Plasmodium falciparum was seen in 77%, P vivax in 14%, P ovale in 6%, and P malariae in 3% of cases. P falciparum had increased in frequency (1975–79: P falciparum 50%, P vivax 50%; 1990–99: P falciparum 82%, P vivax 6%), associated with an increase in the proportion of children acquiring their infection in sub-Saharan Africa. Median time between arrival in the UK to the onset of fever was: P falciparum, 5 days; P ovale, 25 days; P malariae, 37 days; and P vivax, 62 days. Median time interval between the onset of fever to commencement of treatment was 4 days. This had not improved over the 25 year period. Only 41% of UK resident children presenting to hospital had taken prophylaxis and the overall number of symptomatic children taking no prophylaxis was increasing. Conclusion: Imported childhood P falciparum malaria is increasing in southwest London associated with increasing travel from sub-Saharan Africa. Over the 25 year period there has been no improvement in chemoprophylaxis rates or time to diagnosis. PMID:12023177

  16. Traffic-related Air Pollution in Relation to Cognitive Function in Older Adults

    PubMed Central

    Elbaz, Alexis; Beevers, Sean; Singh-Manoux, Archana

    2014-01-01

    Background: Few epidemiologic studies have investigated associations of air pollution with cognition in older adults, and none has specifically compared associations across particle sources. We investigated whether exposure to particulate air pollution, characterized by size and source, was associated with cognitive function and decline in cognitive function. Methods: We included participants of the Whitehall II cohort who were residents of greater London and who attended the medical examination in study wave 2007–2009 (n = 2867). Annual average concentrations of particulate matter (PM) (PM10 and PM2.5 from all sources and from traffic exhaust) were modeled at resolution of 20 × 20 m for 2003–2009. We investigated the relationship between exposure to particles and a cognitive battery composed of tests of reasoning, memory, and phonemic and semantic fluency. We also investigated exposure in relation to decline in these tests over 5 years. Results: Mean age of participants was 66 (standard deviation = 6) years. All particle metrics were associated with lower scores in reasoning and memory measured in the 2007–2009 wave but not with lower verbal fluency. Higher PM2.5 of 1.1 μg/m3 (lag 4) was associated with a 0.03 (95% confidence interval = −0.06 to 0.002) 5-year decline in standardized memory score and a 0.04 (−0.07 to −0.01) decline when restricted to participants remaining in London between study waves. Conclusions: This study provides support for an association between particulate air pollution and some measures of cognitive function, as well as decline over time in cognition; however, it does not support the hypothesis that traffic-related particles are more strongly associated with cognitive function than particles from all sources. PMID:25036434

  17. Mapping the evolution of 'food deserts' in a Canadian city: Supermarket accessibility in London, Ontario, 1961–2005

    PubMed Central

    Larsen, Kristian; Gilliland, Jason

    2008-01-01

    Background A growing body of research suggests that the suburbanization of food retailers in North America and the United Kingdom in recent decades has contributed to the emergence of urban 'food deserts', or disadvantaged areas of cities with relatively poor access to healthy and affordable food. This paper explores the evolution of food deserts in a mid-sized Canadian city (London, Ontario) by using a geographic information system (GIS) to map the precise locations of supermarkets in 1961 and 2005; multiple techniques of network analysis were used to assess changing levels of supermarket access in relation to neighbourhood location, socioeconomic characteristics, and access to public transit. Results The findings indicate that residents of inner-city neighbourhoods of low socioeconomic status have the poorest access to supermarkets. Furthermore, spatial inequalities in access to supermarkets have increased over time, particularly in the inner-city neighbourhoods of Central and East London, where distinct urban food deserts now exist. Conclusion Contrary to recent findings in larger Canadian cities, we conclude that urban food deserts exist in London, Ontario. Policies aimed at improving public health must also recognize the spatial, as well as socioeconomic, inequities with respect to access to healthy and affordable food. Additional research is necessary to better understand how supermarket access influences dietary behaviours and related health outcomes. PMID:18423005

  18. Mapping the evolution of 'food deserts' in a Canadian city: supermarket accessibility in London, Ontario, 1961-2005.

    PubMed

    Larsen, Kristian; Gilliland, Jason

    2008-04-18

    A growing body of research suggests that the suburbanization of food retailers in North America and the United Kingdom in recent decades has contributed to the emergence of urban 'food deserts', or disadvantaged areas of cities with relatively poor access to healthy and affordable food. This paper explores the evolution of food deserts in a mid-sized Canadian city (London, Ontario) by using a geographic information system (GIS) to map the precise locations of supermarkets in 1961 and 2005; multiple techniques of network analysis were used to assess changing levels of supermarket access in relation to neighbourhood location, socioeconomic characteristics, and access to public transit. The findings indicate that residents of inner-city neighbourhoods of low socioeconomic status have the poorest access to supermarkets. Furthermore, spatial inequalities in access to supermarkets have increased over time, particularly in the inner-city neighbourhoods of Central and East London, where distinct urban food deserts now exist. Contrary to recent findings in larger Canadian cities, we conclude that urban food deserts exist in London, Ontario. Policies aimed at improving public health must also recognize the spatial, as well as socioeconomic, inequities with respect to access to healthy and affordable food. Additional research is necessary to better understand how supermarket access influences dietary behaviours and related health outcomes.

  19. Multifractal to monofractal evolution of the London street network

    NASA Astrophysics Data System (ADS)

    Murcio, Roberto; Masucci, A. Paolo; Arcaute, Elsa; Batty, Michael

    2015-12-01

    We perform a multifractal analysis of the evolution of London's street network from 1786 to 2010. First, we show that a single fractal dimension, commonly associated with the morphological description of cities, does not suffice to capture the dynamics of the system. Instead, for a proper characterization of such a dynamics, the multifractal spectrum needs to be considered. Our analysis reveals that London evolves from an inhomogeneous fractal structure, which can be described in terms of a multifractal, to a homogeneous one, which converges to monofractality. We argue that London's multifractal to monofractal evolution might be a special outcome of the constraint imposed on its growth by a green belt. Through a series of simulations, we show that multifractal objects, constructed through diffusion limited aggregation, evolve toward monofractality if their growth is constrained by a nonpermeable boundary.

  20. Clean Air for London (CLEARFLO) Final Campaign Summary

    SciTech Connect

    Worsnop, D. R.; Williams, L. R.; Herndon, S. C.; Dubey, M.; Ng, N. L.; Thornton, J.; Knighton, B.; Coulter, R.; Prévôt, Ash

    2016-03-01

    This field campaign funded the participation of scientists from seven different research groups and operated over thirty instruments during the Winter Intensive Operating Period (January-February 2012) of the Clean Air for London (ClearfLo) campaign. The campaign took place at a rural site in Detling, UK, 45 kilometers southeast of central London. The primary science questions for the ClearfLo winter IOP (intensive operational periods) were: 1) “what is the urban increment of particulate matter (PM) and other pollutants in the greater London area?” and 2) “what is the contribution of solid fuel use for home heating to wintertime PM?” An additional motivation for the Detling measurements was the question of whether coatings on black carbon particles enhance absorption.

  1. The epidemiology of suicide on the London Underground.

    PubMed

    O'Donnell, I; Farmer, R D

    1994-02-01

    A database containing details of every incident of suicidal behaviour on the London Underground railway system between 1940 and 1990 was assembled from the records of London Underground Ltd and the British Transport Police. The total number of cases was 3240. The mean annual number of suicidal acts on the London Underground system increased from 36.1 (1940-1949) to 94.1 (1980-1989). There were significantly fewer incidents on Sundays than on the other days of the week and the daily rate was highest in the spring. 64% of incidents involved males and the peak age group for both sexes was 25-34 yr. Suicide verdicts were returned for a greater proportion of women than men. Overall case fatality was 55%. However, case fatality rates differed between stations, environmental factors appearing to influence survival. Possible strategies to prevent railway suicides and reduce the lethality of this method are discussed.

  2. Multifractal to monofractal evolution of the London street network.

    PubMed

    Murcio, Roberto; Masucci, A Paolo; Arcaute, Elsa; Batty, Michael

    2015-12-01

    We perform a multifractal analysis of the evolution of London's street network from 1786 to 2010. First, we show that a single fractal dimension, commonly associated with the morphological description of cities, does not suffice to capture the dynamics of the system. Instead, for a proper characterization of such a dynamics, the multifractal spectrum needs to be considered. Our analysis reveals that London evolves from an inhomogeneous fractal structure, which can be described in terms of a multifractal, to a homogeneous one, which converges to monofractality. We argue that London's multifractal to monofractal evolution might be a special outcome of the constraint imposed on its growth by a green belt. Through a series of simulations, we show that multifractal objects, constructed through diffusion limited aggregation, evolve toward monofractality if their growth is constrained by a nonpermeable boundary.

  3. City lights of London, England taken during Expedition Six

    NASA Image and Video Library

    2003-02-04

    ISS006-E-22939 (4 February 2003) --- City lights of London, England were captured with a digital still camera by one of the Expedition Six crewmembers on the International Space Station (ISS). This nighttime view of the British capital shows the city’;s urban density and infrastructure as highlighted by electrical lighting. Beyond lie isolated bright areas marking the numerous smaller cities and towns of the region and as far southeast as Hastings on the coast. London’;s two major airports, Heathrow and Gatwick, are visible to the south of the city.

  4. Pan-London tuberculosis services: a service evaluation

    PubMed Central

    2012-01-01

    Background London has the largest proportion of tuberculosis (TB) cases of any western European capital, with almost half of new cases drug-resistant. Prevalence varies considerably between and within boroughs with research suggesting inadequate control of TB transmission in London. Economic pressures may exacerbate the already considerable challenges for service organisation and delivery within this context. This paper presents selected findings from an evaluation of London’s TB services’ organisation, delivery, professional workforce and skill mix, intended to support development of a strategic framework for a pan-London TB service. These may also interest health service professionals and managers in TB services in the UK, other European cities and countries and in services currently delivered by multiple providers operating independently. Methods Objectives were: 1) To establish how London’s TB services are structured and delivered in relation to leadership, management, organisation and delivery, coordination, staffing and support; 2) To identify tools/models for calculating skill mix as a basis for identifying skill mix requirements in delivering TB services across London; 3) To inform a strategic framework for the delivery of a pan-London TB service, which may be applicable to other European cities. The multi-method service audit evaluation comprised documentary analysis, semi-structured interviews with TB service users (n = 10), lead TB health professionals and managers (n = 13) representing London’s five sectors and focus groups with TB nurses (n = 8) and non-London network professionals (n = 2). Results Findings showed TB services to be mainly hospital-based, with fewer community-based services. Documentary analysis and professionals’ interviews suggested difficulties with early access to services, low suspicion index amongst some GPs and restricted referral routes. Interviews indicated lack of managed accommodation for

  5. Sources and contributions of wood smoke during winter in London

    NASA Astrophysics Data System (ADS)

    Crilley, Leigh; Bloss, William; Yin, Jianxin; Beddows, David; Harrison, Roy; Zotter, Peter; Prevot, Andre; Green, David

    2014-05-01

    Determining the contribution of wood smoke in large urban centres such as London is becoming increasingly important with the changing nature of domestic heating partly due to the installation of biomass burning heaters to meet renewable energy targets imposed by the EU and also a rise in so-called recreational burning for aesthetic reasons (Fuller et al., 2013). Recent work in large urban centres (London, Paris and Berlin) has demonstrated an increase in the contribution of wood smoke to ambient particles during winter that can at times exceed traffic emissions. In Europe, biomass burning has been identified as a major cause of exceedances of European air quality limits during winter (Fuller et al., 2013). In light of the changing nature of emissions in urban areas there is a need for on-going measurements to assess the impact of biomass burning in cities like London. Therefore we aimed to determine quantitatively the contribution of biomass burning in London and surrounding rural areas. We also aimed to determine whether local emissions or regional sources were the main source of biomass burning in London. Sources of wood smoke during winter in London were investigated at an urban background site (North Kensington) and two surrounding rural sites (Harwell and Detling) by analysing selected wood smoke chemical tracers. Concentrations of levoglucosan, elemental carbon (EC), organic carbon (OC) and K+ were generally well correlated, indicating a similar source of these species at the three sites. Based on the conversion factor for levoglucosan, mean wood smoke mass at Detling, North Kensington and Harwell was 0.78, 0.87 and 1.0 µg m-3, respectively. At all the sites, biomass burning was found to be a source of OC and EC, with the largest source of OC and EC found to be secondary organic aerosols and traffic emissions, respectively. Peaks in levoglucosan concentrations at the sites were observed to coincide with low ambient temperature, suggesting domestic heating as

  6. Comparative effectiveness of high-dose versus standard-dose influenza vaccines in US residents aged 65 years and older from 2012 to 2013 using Medicare data: a retrospective cohort analysis

    PubMed Central

    Izurieta, Hector S; Thadani, Nicole; Shay, David K; Lu, Yun; Maurer, Aaron; Foppa, Ivo M; Franks, Riley; Pratt, Douglas; Forshee, Richard A; MaCurdy, Thomas; Worrall, Chris; Howery, Andrew E; Kelman, Jeffrey

    2016-01-01

    Summary Background A high-dose trivalent inactivated influenza vaccine was licensed in 2009 by the US Food and Drug Administration (FDA) on the basis of serological criteria. We sought to establish whether high-dose inactivated influenza vaccine was more effective for prevention of influenza-related visits and hospital admissions in US Medicare beneficiaries than was standard-dose inactivated influenza vaccine. Methods In this retrospective cohort study, we identified Medicare beneficiaries aged 65 years and older who received high-dose or standard-dose inactivated influenza vaccines from community pharmacies that offered both vaccines during the 2012–13 influenza season. Outcomes were defined with billing codes on Medicare claims. The primary outcome was probable influenza infection, defined by receipt of a rapid influenza test followed by dispensing of the neuraminidase inhibitor oseltamivir. The secondary outcome was a hospital or emergency department visit, listing a Medicare billing code for influenza. We estimated relative vaccine effectiveness by comparing outcome rates in Medicare beneficiaries during periods of high influenza circulation. Univariate and multivariate Poisson regression models were used for analyses. Findings Between Aug 1, 2012 and Jan 31, 2013, we studied 929 730 recipients of high-dose vaccine and 1 615 545 recipients of standard-dose vaccine. Participants enrolled in each cohort were well balanced with respect to age and presence of underlying medical disorders. The high-dose vaccine (1·30 outcomes per 10 000 person-weeks) was 22% (95% CI 15–29) more effective than the standard-dose vaccine (1·01 outcomes per 10 000 person-weeks) for prevention of probable influenza infections (rapid influenza test followed by oseltamivir treatment) and 22% (95% CI 16–27%) more effective for prevention of influenza hospital admissions (0·86 outcomes per 10 000 person-weeks in the high-dose cohort vs 1·10 outcomes per 10 000 person-weeks in the

  7. Diabetes mellitus in older adults.

    PubMed

    Mooradian, Arshag D; Chehade, Joe M

    2012-03-01

    The prevalence of diabetes mellitus increases with age and causes significant morbidity and poor quality of life in older adults. To review the current literature on the diagnosis and management of diabetes in the elderly, the relevant manuscripts were identified through a MEDLINE (2000-September 1, 2010) search of the English literature. The key phrase used was diabetes in older adults or diabetes in the elderly. The literature search was limited to core clinical journals that have accessible full texts. A total of 480 manuscripts were reviewed. Managing diabetes in older adults is a challenging task. Some features of the disease are unique to the older patient. Several new antidiabetic agents are now available for clinical use, and yet very few clinical trials have been carried out in this age group. For many older adults, maintaining independence is more important than adherence to published guidelines to prevent diabetes complications. The goals of diabetes care in older adults are to enhance quality of life without subjecting the residents to inappropriate interventions.

  8. Battersea: Education in a London Parish since 1750

    ERIC Educational Resources Information Center

    Saint, Andrew

    2010-01-01

    This paper examines the development of educational institutions and buildings in one slice of a big city over a long timescale. The city is London and the slice Battersea, an inner suburb of mixed character and volatile fortunes. The narrative explores the shifts and interactions between state and voluntary provision, local community needs and…

  9. Exploring anterograde associative memory in London taxi drivers

    PubMed Central

    Woollett, Katherine; Maguire, Eleanor A.

    2013-01-01

    London taxi drivers are renowned for their navigation ability, spending a number of years acquiring ‘The Knowledge’ of London’s complex layout and having to pass stringent examinations to obtain an operating licence. In several studies, this navigation skill has been associated with increased posterior but also decreased anterior hippocampal grey matter volume. Neuropsychologically, gain and loss has also been documented in taxi drivers; while very skilled at navigation in London, they are significantly poorer than controls at learning and recalling new object-location associations. Here we tested a group of London taxi drivers and matched control participants on this object-location associations task, while also submitting them to a battery of challenging anterograde associative memory tests involving verbal, visual and auditory material both within and across modalities. Our aim was to assess whether their difficulty in previous studies reflected a general problem with associative memory, or was restricted to the spatial domain. We replicated previous findings of poor learning and memory of object-location associations. By contrast, their performance on the other anterograde associative memory tasks was comparable to controls. This resolves an outstanding question in the memory profile of London taxi drivers following hippocampal plasticity, and underlines the close relationship between space and the hippocampus. PMID:22955143

  10. Intergenerational Learning between Children and Grandparents in East London

    ERIC Educational Resources Information Center

    Kenner, Charmian; Ruby, Mahera; Jessel, John; Gregory, Eve; Arju, Tahera

    2007-01-01

    This study investigates the learning exchange between three- to six-year-old children and their grandparents, in Sylheti/Bengali-speaking families of Bangladeshi origin and monolingual English-speaking families living in east London. The following concepts from sociocultural theory are applied to this new area of intergenerational learning:…

  11. In London, a Working-Class University Wrestles with Change

    ERIC Educational Resources Information Center

    Labi, Aisha

    2012-01-01

    Patrick McGhee, vice chancellor of the University of East London, has a lot in common with many of the 28,000 students at the large urban institution he leads. He was the first in his family to attend university. And he dislikes much about the government's higher-education reform efforts, which he has deemed "misguided, premature, unproven…

  12. The University College London Archive of Stuttered Speech (UCLASS)

    ERIC Educational Resources Information Center

    Howell, Peter; Davis, Stephen; Bartrip, Jon

    2009-01-01

    Purpose: This research note gives details of 2 releases of audio recordings available from speakers who stutter that can be accessed on the Web. Method: Most of the recordings are from school-age children. These are available on the University College London Archive of Stuttered Speech (UCLASS) Web site, and information is provided about how to…

  13. A Community Approach to Youth Work in East London.

    ERIC Educational Resources Information Center

    Cox, Derek M.

    Instituted as part of "Avenues Unlimited" (The Tower Hamlets Youth Project), a community development approach to youth services was attempted in the cosmopolitan inner city slum district of Spitalfields, East London. Efforts began in 1966 with a clean up campaign, a neighborhood club for parents and youth, and other activities by the…

  14. Multicultural Music in the London Borough of Harrow.

    ERIC Educational Resources Information Center

    Murphy, Frank

    1991-01-01

    A project to introduce the music of different cultures into primary and secondary classrooms in London is reported. The six cultures are Indian music and dance, Latin American rock and steel pans, jazz, Indian drums, and Chinese music and movement. The project model is related to multicultural education in general. (Author/LB)

  15. Autistic Disorder in Nineteenth-Century London. Three Case Reports

    ERIC Educational Resources Information Center

    Waltz, Mitzi; Shattock, Paul

    2004-01-01

    This article examines the existence, description, perception, treatment, and outcome of symptoms consistent with autistic disorder in nineteenth-century London, England, based on case histories from the notes of Dr William Howship Dickinson at Great Ormond Street Hospital for Children. Three cases meeting the DSM-IV criteria for autistic disorder…

  16. Martha Whiteley of Imperial College, London: A Pioneering Woman Chemist

    ERIC Educational Resources Information Center

    Nicholson, Rafaelle M.; Nicholson, John W.

    2012-01-01

    Martha Whiteley (1866-1956) was one of the most important women chemists in the United Kingdom in the first half of the 20th century. In a male-dominated field, she was an academic on the staff of a co-educational university, Imperial College, London, where she carried out research of her own choosing, rather than assisting a male professor. She…

  17. Multicultural Music in the London Borough of Harrow.

    ERIC Educational Resources Information Center

    Murphy, Frank

    1991-01-01

    A project to introduce the music of different cultures into primary and secondary classrooms in London is reported. The six cultures are Indian music and dance, Latin American rock and steel pans, jazz, Indian drums, and Chinese music and movement. The project model is related to multicultural education in general. (Author/LB)

  18. A fatal case of Lassa fever in London, January 2009.

    PubMed

    Kitching, A; Addiman, S; Cathcart, S; Bischop, L; Krahé, D; Nicholas, M; Coakley, J; Lloyd, G; Brooks, T; Morgan, D; Turbitt, D

    2009-02-12

    In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified.

  19. Nicholas Culpeper (1616-1654): London's first general practitioner?

    PubMed

    Farthing, Michael J G

    2015-08-01

    Nicholas Culpeper is often regarded as an ill-disciplined, maverick, mid-17th century herbalist and the father of contemporary alternative medicine. There are elements of this statement that have some truth but to dismiss his contribution to the development of health provision in London at the time would be a great injustice. Culpeper did not complete his apprenticeship as an apothecary and was not a formally trained physician, but he developed a clinical practice for the poor of London, indistinguishable from the role of the present day general practitioner. Observers at the time recognised his concern and compassion and his commitment to treat the whole patient and not just the disease. His enduring contribution was his translation from Latin of the physicians' Pharmacopoeia Londinensis which could be regarded as the first major step towards the demystification of medicine. Culpeper's London Dispensatory and the many other medical treatises that followed were affordable and widely available to the common man. Culpeper antagonised both apothecaries and physicians because he breached the regulations of the day by accepting patients directly. So perhaps Culpeper was, de facto, London's first general practitioner, at least 150 years before the role was formally recognised in the Apothecaries Act 1815.

  20. In London, a Working-Class University Wrestles with Change

    ERIC Educational Resources Information Center

    Labi, Aisha

    2012-01-01

    Patrick McGhee, vice chancellor of the University of East London, has a lot in common with many of the 28,000 students at the large urban institution he leads. He was the first in his family to attend university. And he dislikes much about the government's higher-education reform efforts, which he has deemed "misguided, premature, unproven…

  1. The London Lighthouse. A centre for people with AIDS.

    PubMed

    1988-12-01

    In October last year an Evian Health Award was presented to Mr Christopher Spence, director of London Lighthouse, for pioneering the first independent aids hospice against much opposition. The Lighthouse is now open and although the hospice is the core of its work it also provides a range of other services.

  2. Fit for What? Special Education in London, 1890-1914

    ERIC Educational Resources Information Center

    Read, Jane

    2004-01-01

    This paper presents a case study of the implementation by the London School Board of special education for children designated 'feeble-minded' or 'mentally defective' in the period from 1890 to the passing of the Elementary Education (Defective and Epileptic Children) Act in 1914. Through an analysis of the choice of pedagogy for special schools,…

  3. Martha Whiteley of Imperial College, London: A Pioneering Woman Chemist

    ERIC Educational Resources Information Center

    Nicholson, Rafaelle M.; Nicholson, John W.

    2012-01-01

    Martha Whiteley (1866-1956) was one of the most important women chemists in the United Kingdom in the first half of the 20th century. In a male-dominated field, she was an academic on the staff of a co-educational university, Imperial College, London, where she carried out research of her own choosing, rather than assisting a male professor. She…

  4. Gender Politics and Privatization in the London Borough of Camden.

    ERIC Educational Resources Information Center

    Brush, Lisa D.

    1986-01-01

    This article examines the differential impact of the privatization of social services on women in the London borough of Camden. Concludes that women will suffer greater decline than men in employment, wages, and status as a result of the privatization taking place in Great Britain. (JDH)

  5. Intergenerational Learning between Children and Grandparents in East London

    ERIC Educational Resources Information Center

    Kenner, Charmian; Ruby, Mahera; Jessel, John; Gregory, Eve; Arju, Tahera

    2007-01-01

    This study investigates the learning exchange between three- to six-year-old children and their grandparents, in Sylheti/Bengali-speaking families of Bangladeshi origin and monolingual English-speaking families living in east London. The following concepts from sociocultural theory are applied to this new area of intergenerational learning:…

  6. Battersea: Education in a London Parish since 1750

    ERIC Educational Resources Information Center

    Saint, Andrew

    2010-01-01

    This paper examines the development of educational institutions and buildings in one slice of a big city over a long timescale. The city is London and the slice Battersea, an inner suburb of mixed character and volatile fortunes. The narrative explores the shifts and interactions between state and voluntary provision, local community needs and…

  7. Joseph Clover and the cobra: a tale of snake envenomation and attempted resuscitation with bellows in London, 1852.

    PubMed

    Ball, C

    2010-07-01

    The Industrial Revolution saw the creation of many new jobs, but probably none more curious than that of zookeeper. The London Zoological Gardens, established for members in 1828, was opened to the general public in 1847. In 1852 the "Head Keeper in the Serpent Room", Edward Horatio Girling, spent a night farewelling a friend departing for Australia. He arrived at work in an inebriated state and was bitten on the face by a cobra that he was handling in a less than sensible manner. He was taken by cab to University College Hospital where he was resuscitated by a number of doctors, including Joseph Clover then the resident medical officer to the hospital and later to become the leading anaesthetist in London. Clover recorded this event in his diary along with the resuscitation method used. The patient eventually died but his treatment created a flurry of correspondence in the medical and lay press. Interestingly, the attempted resuscitation was with bellows, which had been abandoned by the Royal Humane Society twenty years earlier Clover records other cases of resuscitation with bellows at University College Hospital during his time as a resident medical officer there (1848 to 1853). There is a casebook belonging to Joseph Clover in the Geoffrey Kaye Museum, in Melbourne. This story is one of the many interesting stories uncovered during a study of this book and Clover's other personal papers.

  8. Life After Residency.

    PubMed

    Sorrel, Amy Lynn

    2016-04-01

    Many residents don't receive any formal business training. The University of Texas at Austin Dell Medical School created a crash course to teach residents some of the business and job-hunting basics they'll need.

  9. Does sleep disturbance predict depression in elderly people? A study in inner London.

    PubMed Central

    Livingston, G; Blizard, B; Mann, A

    1993-01-01

    Insomnia in elderly people has traditionally been regarded as inevitable and trivial. A longitudinal study was undertaken to examine the prevalence of sleep disturbance among elderly people in an inner London community and its association with demographic variables, depression, dementia and disability. Those aged 65 years and over living at home were interviewed using a validated and reliable semi-structured interview schedule. A total of 705 people were interviewed in 1987-88 and 524 were re-interviewed in 1990. Subjective sleep disturbance was found to be common (33% and 43%, respectively). Sleep disturbance was associated with being a woman, being unmarried, living alone, disability, and current and future depression, but not with dementia or older age. The best predictor of future depression in elderly people who were not depressed was current sleep disturbance. In the presence of current sleep disturbance, the traditional predictors of depression--being a woman, having a disability, being unmarried, living alone and being older--did not contribute further. This study has shown that sleep disorder is associated with pathology. Insomnia in elderly people requires assessment and this must be accompanied by the treatment of underlying disorders and monitoring of future health. PMID:8292414

  10. The social impact of dizziness in London and Siena.

    PubMed

    Bronstein, Adolfo M; Golding, John F; Gresty, Michael A; Mandalà, Marco; Nuti, Daniele; Shetye, Anu; Silove, Yvonne

    2010-02-01

    Although dizziness is a common presenting symptom in general and hospital practice, its social cost is not known. We assessed the social and work life impact of dizziness on patients in two contrasting European cities, Siena and London. First, we developed the 'Social life & Work Impact of Dizziness questionnaire' (SWID), which was validated by administering it to 43 patients with dizziness and 45 normal controls and by correlating the results with the EQ-5D (Europe quality of life) questionnaire. The SWID and EQ-5D scores were worse in patients than controls (p < 0.001) and the two correlated significantly (r = 0.50 p < 0.001). Then two hundred consecutive patients per city attending tertiary specialised 'dizzy patient' clinics, one in London led by a neurologist, one in Siena led by an ear, nose and throat specialist (ENT), were investigated with SWID. Amongst the 400 patients, 27% reported changing their jobs and 21% giving up work as a result of the dizziness. Over 50% of patients felt that their efficiency at work had dropped considerably. The mean number of days off work attributed to the dizziness in the previous 6 months was 7.15 days. Social life was disrupted in 57% of all 400 patients. Factor analysis identified that detrimental effects on work, travel, social and family life combine to create a single factor accounting for much of the overall impact of their dizziness. Significant differences in some measures of handicap between London and Siena emerged, with London patients often faring worse. Reasons for these location differences include, as expected, a higher proportion of neurological patients in London than in Siena. However, factors related to city demographics and social cohesion may also modulate the impact on quality of life and working practice. Regardless of inter-city differences, these findings highlight the high social and economic impact of dizziness.

  11. Deaths of cyclists in london: trends from 1992 to 2006

    PubMed Central

    2010-01-01

    Background Cycling is an increasingly important mode of transport for environmental and health reasons. Cycling fatalities in London were previously investigated in 1994 using routinely collected data. Since then, there have been shifts in the modes of transport used, and in transport policies. We sought to replicate the previous work using data on cyclist deaths in London between 1992 and 2006, specifically investigating whether heavy goods vehicles continued to pose a threat. Methods Observational study based on analysis of time series of police road casualties data, 1992 to 2006, in London, UK. The main outcome measures were cyclists killed in road traffic collisions. Poisson regression and chi-squared test for homogeneity were used to assess time effects. Travel flow data was then used to estimate annual fatality rates per 100,000 cyclists per kilometre. Results From 1992 to 2006 there was a mean of 16 cycling fatalities per year (range 8-21). 146 deaths (60%) were in inner London and 96 in outer London. There was no evidence for a decline over time (p = 0.7) other than a pronounced dip in 2004 when there were 8 fatalities. Freight vehicles were involved in 103 of 242 (43%) of all incidents and the vehicle was making a left turn in over half of these (53%). The fatality rate ranged from 20.5 deaths in 1992 to 11.1 deaths in 2006 per 100,000 estimated cyclists per kilometre (rate ratio 0.54, 95% confidence interval 0.28 to 1.03). Conclusions There is little evidence fatality rates have fallen. Freight vehicles over 3.5 tonnes continue to present a disproportionate threat; they should be removed from urban roads and more appropriate means of delivery of essential goods found. PMID:21078190

  12. Putting partnership into practice: participatory wellbeing assessment on a south London housing estate

    PubMed Central

    Cornwall, Andrea; Lall, Pawan; Kennedy, Ken; Owen, Felicity

    2003-01-01

    Abstract Purpose  Bridging the gap between professionals and communities and establishing new forms of partnership is essential if service provision is to be made more responsive and accountable. This article describes an innovative approach to creating the basis for partnerships to address community wellbeing on an estate in south London. Methods  Drawing on participatory appraisal and action planning methods, and drawing together residents and professionals within and beyond the health service, a participatory wellbeing assessment exercise was carried out on a housing estate with a population of around 6000 people, involving just under 10% of residents. Results  The participatory wellbeing assessment exercise served as a means of seeking to bridge different perceptions, priorities and perspectives on wellbeing and forge new relationships, alliances and partnerships for change. Creating this vehicle for change also created opportunities for local people to participate in community wellbeing issues. This, in turn, strengthened connections between health policy, provision and grassroots community health development, broadening opportunities for service responsiveness and citizen involvement. Conclusion  Broadening involvement in assessing and determining priorities for improving wellbeing can serve to do more than enable citizens to engage more directly in making and shaping the policies that affect their lives. It can also serve as a way of establishing new kinds of partnerships across and within the statutory and non‐statutory services, opening up space for new, more ‘joined up’ forms of work that help to bridge the gap between citizens and services. PMID:12603626

  13. Plasma phospholipid fatty acids and CHD in older men: Whitehall study of London civil servants.

    PubMed

    Clarke, Robert; Shipley, Martin; Armitage, Jane; Collins, Rory; Harris, William

    2009-07-01

    Dietary fatty acids (FA) are the major determinants of blood lipids, and measurements of plasma phospholipid FA (PL-FA) composition that reflect the dietary intake of FA may provide insights into the relationships between diet and CHD. We assessed CHD mortality associations with PL-FA (SFA, PUFA and MUFA) levels measured in a nested case-control study of 116 cases of CHD death and 239 controls that were frequency-matched for age and employment grade. The participants had plasma levels of total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol, apo B and apo A1, C-reactive protein (CRP) and fibrinogen recorded. SFA levels were significantly positively correlated with total cholesterol, LDL-C, apo B, CRP protein and fibrinogen. By contrast, phospholipid-PUFA were inversely associated with CRP, but not with any of the lipids. A higher SFA content (top v. bottom quarter) was associated with a 2-fold higher risk of CHD (OR and 95 % CI: OR 2.12; 95 % CI: 1.13, 3.99), and an equivalent difference in PUFA was associated with a halving in CHD risk (OR 0.49; 95 % CI: 0.26, 0.94), but MUFA was unrelated to CHD risk. These associations were substantially attenuated, after additional adjustment for lipids and inflammatory markers. Higher levels of saturated fat and lower levels of polyunsaturated fats were each associated with a higher risk of CHD in elderly men, and these associations were partly explained by their effects on blood lipids and biomarkers of inflammation.

  14. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use of...

  15. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use of...

  16. 20 CFR 628.320 - Services for older individuals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., taking into account the relative share of the population of eligible older individuals residing in each... to assisting programs involving training for jobs in growth industries and jobs reflecting the use of...

  17. London through Rose-Colored Graphics: Visual Rhetoric and Information Graphic Design in Charles Booth's Maps of London Poverty

    ERIC Educational Resources Information Center

    Kimball, Miles A.

    2006-01-01

    In this article, I examine a historical information graphic--Charles Booth's maps of London poverty (1889-1902)--to analyze the cultural basis of ideas of transparency and clarity in information graphics. I argue that Booth's maps derive their rhetorical power from contemporary visual culture as much as from their scientific authority. The visual…

  18. Inner London's Education Authority: Reflections on ILEA Twenty-Five Years after Closure

    ERIC Educational Resources Information Center

    Mitchell, Peter

    2015-01-01

    It is 25 years since the Inner London Education Authority (ILEA) was abolished and management of education in central London transferred to 13 London boroughs. The author reflects on the experience of being an ex-ILEA head teacher, and of managing one of the new local education authorities in the immediate post-ILEA period. He begins by commenting…

  19. Inner London's Education Authority: Reflections on ILEA Twenty-Five Years after Closure

    ERIC Educational Resources Information Center

    Mitchell, Peter

    2015-01-01

    It is 25 years since the Inner London Education Authority (ILEA) was abolished and management of education in central London transferred to 13 London boroughs. The author reflects on the experience of being an ex-ILEA head teacher, and of managing one of the new local education authorities in the immediate post-ILEA period. He begins by commenting…

  20. Building a Hypertextual Digital Library in the Humanities: A Case Study on London.

    ERIC Educational Resources Information Center

    Crane, Gregory; Smith, David A.; Wulfman, Clifford E.

    This paper describes the creation of a new humanities digital library collection: 11,000,000 words and 10,000 images representing books, images, and maps on pre-twentieth century London and its environs. The London collection contained far more dense and precise information than the materials from the Greco-Roman world. The London collection thus…

  1. Psychotropic medications in older adults: a review.

    PubMed

    Ćurković, Mario; Dodig-Ćurković, Katarina; Erić, Anamarija Petek; Kralik, Kristina; Pivac, Nela

    2016-03-01

    Prevalence of prescribing psychotropic medications, particularly inappropriate prescription, is widespread in older adults, both in nursing home residents as well as community-dwelling older adults. This review describes prevalence and prevention of inappropriate prescribing and risk factors associated with psychotropic medications. MEDLINE and GOOGLE SCHOLAR data base were searched for the key words "older adults", "psychotropic drugs", "inappropriate prescribing", "nursing home residents", "community-dwelling older adults". The study was limited to the articles published in English in the period from 2007 to 2014. The list of references includes additional articles that were searched manually. The utilization of different psychotropic medications is prevalent among older adults worldwide, regardless of whether they live in nursing homes or in the community. Among older adults, nursing home residents are the most vulnerable individuals for potentially inappropriate drug prescription. The most common potentially inappropriate prescribed medications in the elderly are benzodiazepines, particularly long-acting, antipsychotics and antidepressants, particularly SSRIs. All classes of listed medications have been associated with different adverse events, particularly falls and falls-related fractures and increased risk for mortality. Many different pharmacological and non-pharmacological interventions, such as monitoring polypharmacy, reviewing medications, spending more time in the institution by a physician, reducing the number of prescribers in the institution as well as greater involvement of geriatricians, general practitioners and pharmacists should be implemented to reduce this health issue. The prevalence of prescribing psychotropic medications to older adults is high. Inappropriate prescribing of psychotropic drugs and polypharmacy are present in institutionalized and non-institutionalized older adults and can cause adverse health events, and can significantly

  2. Traffic pollution and the incidence of cardiorespiratory outcomes in an adult cohort in London

    PubMed Central

    Anderson, H R; Atkinson, R W; Beevers, S; Cook, D G; Dajnak, D; Gulliver, J; Kelly, F J

    2016-01-01

    Objectives The epidemiological evidence for adverse health effects of long-term exposure to air and noise pollution from traffic is not coherent. Further, the relative roles of background versus near traffic pollution concentrations in this process are unclear. We investigated relationships between modelled concentrations of air and noise pollution from traffic and incident cardiorespiratory disease in London. Methods Among 211 016 adults aged 40–79 years registered in 75 Greater London practices between 2005 and 2011, the first diagnosis for a range of cardiovascular and respiratory outcomes were identified from primary care and hospital records. Annual baseline concentrations for nitrogen oxide (NOx), particulate matter with a median aerodynamic diameter <2.5 μm (PM2.5) attributable to exhaust and non-exhaust sources, traffic intensity and noise were estimated at 20 m2 resolution from dispersion models, linked to clinical data via residential postcode. HRs were adjusted for confounders including smoking and area deprivation. Results The largest observed associations were between traffic-related air pollution and heart failure (HR=1.10 for 20 μg/m3 change in NOx, 95% CI 1.01 to 1.21). However, no other outcomes were consistently associated with any of the pollution indicators, including noise. The greater variations in modelled air pollution from traffic between practices, versus within, hampered meaningful fine spatial scale analyses. Conclusions The associations observed with heart failure may suggest exacerbatory effects rather than underlying chronic disease. However, the overall failure to observe wider associations with traffic pollution may reflect that exposure estimates based on residence inadequately represent the relevant pattern of personal exposure, and future studies must address this issue. PMID:27343184

  3. Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians.

    PubMed Central

    Strachan, D. P.; Powell, K. J.; Thaker, A.; Millard, F. J.; Maxwell, J. D.

    1995-01-01

    BACKGROUND--In a previous retrospective study of tuberculosis in south London among Asian immigrants from the Indian subcontinent Hindu Asians were found to have a significantly increased risk for tuberculosis compared with Muslims. This finding has been further investigated by examining the role of socioeconomic and lifestyle variables, including diet, as risk factors for tuberculosis in Asian immigrants from the Indian subcontinent resident in south London. METHODS--Using a case-control study technique Asian immigrants from the Indian subcontinent diagnosed with tuberculosis during the past 10 years and two Asian control groups (community and outpatient clinic controls) from the Indian subcontinent were investigated. Cases and community controls were approached by letter. A structured questionnaire concerning a range of demographic, migration, socioeconomic, dietary, and health topics was administered by a single trained interviewer to subjects (56 cases and 100 controls) who agreed to participate. RESULTS--The results confirmed earlier findings that Hindu Asians had an increased risk of tuberculosis compared with Muslims. However, further analysis revealed that religion had no independent influence after adjustment for vegetarianism (common among Hindu Asians). Unadjusted odds ratios for tuberculosis among vegetarians were 2.7 (95% CI 1.1 to 6.4) using community controls, and 4.3 (95% CI 1.8 to 10.4) using clinic controls. There was a trend of increasing risk of tuberculosis with decreasing frequency of meat or fish consumption. Lactovegetarians had an 8.5 fold risk (95% CI 1.6 to 45.4) compared with daily meat/fish eaters. Adjustment for a range of other socioeconomic, migration, and lifestyle variables made little difference to the relative risks derived using either community or clinic controls. CONCLUSIONS--These results indicate that a vegetarian diet is an independent risk factor for tuberculosis in immigrant Asians. The mechanism is unexplained. However

  4. Resident interactions at mealtime: an exploratory study.

    PubMed

    Curle, Leah; Keller, Heather

    2010-09-01

    Social interaction is thought to be important for psychological wellbeing and is necessary for developing relationships between older adults living in facilities. This study seeks to describe the social interaction that occurs amongst tablemates at mealtime in retirement homes, as well those things that influence resident-to-resident interaction. Fourteen lunch time periods were the basis for qualitative participant observation. Two or three researchers collected data in each period, with each observing two tables, resulting in 63 individual table observations at a retirement living facility dining room in a medium-sized city in Southern Ontario. Residents attending mealtime in the dining room were (~ 100). The type, extent and influences on social interactions amongst tablemates were recorded in detailed field notes. Qualitative thematic analysis, using a constant comparison procedure, was used to summarize and make sense of the data. A variety of social interactions occurred amongst tablemates including: making conversation, providing assistance, sharing, humouring, showing appreciation and affection, and rebuffing/ignoring/excluding. Interactions were influenced by tablemate roles, resident characteristics, and the social and physical environment, including staff. Social interactions or lack thereof are important for relationship development and mealtime environment. Describing the types of interaction and what influences them is a first step towards promoting social engagement which can enhance quality of life for residents. Further investigation through interviews with residents on the meaning of mealtime and companionship at meals will build a deeper understanding of the importance and influences on social interaction in this setting.

  5. A mathematical model of the London riots and their policing.

    PubMed

    Davies, Toby P; Fry, Hannah M; Wilson, Alan G; Bishop, Steven R

    2013-01-01

    In August 2011, several areas of London experienced episodes of large-scale disorder, comprising looting, rioting and violence. Much subsequent discourse has questioned the adequacy of the police response, in terms of the resources available and strategies used. In this article, we present a mathematical model of the spatial development of the disorder, which can be used to examine the effect of varying policing arrangements. The model is capable of simulating the general emergent patterns of the events and focusses on three fundamental aspects: the apparently-contagious nature of participation; the distances travelled to riot locations; and the deterrent effect of policing. We demonstrate that the spatial configuration of London places some areas at naturally higher risk than others, highlighting the importance of spatial considerations when planning for such events. We also investigate the consequences of varying police numbers and reaction time, which has the potential to guide policy in this area.

  6. Intussusception and the great smog of London, December 1952.

    PubMed

    Black, J

    2003-12-01

    To discuss the possible significance of the increased incidence of intussusception in children in relation to the "Great Smog" of London in December 1952. Cases of intussusception were recorded in two hospitals in East London for the years 1951, 1952, 1953, and 1954. For 1952 the actual dates of admission were recorded. During the year 1952 the total number of cases of intussusception greatly exceeded that in the previous and succeeding years. Immediately during and after the fog there was a clustering of cases, which only occurred during this period. The increased incidence of cases during 1952 is thought to reflect the annual variation in incidence resulting from changes in the prevalence of viruses capable of causing intussusception. The clustering of cases in relation to the fog may reflect a facilitated entry of virus through the wall of the terminal ileum due to the effect of swallowed irritants such as sulphurous acid and smoke particles.

  7. Intussusception and the great smog of London, December 1952

    PubMed Central

    Black, J

    2003-01-01

    Aim: To discuss the possible significance of the increased incidence of intussusception in children in relation to the "Great Smog" of London in December 1952. Methods: Cases of intussusception were recorded in two hospitals in East London for the years 1951, 1952, 1953, and 1954. For 1952 the actual dates of admission were recorded. Results: During the year 1952 the total number of cases of intussusception greatly exceeded that in the previous and succeeding years. Immediately during and after the fog there was a clustering of cases, which only occurred during this period. Conclusions: The increased incidence of cases during 1952 is thought to reflect the annual variation in incidence resulting from changes in the prevalence of viruses capable of causing intussusception. The clustering of cases in relation to the fog may reflect a facilitated entry of virus through the wall of the terminal ileum due to the effect of swallowed irritants such as sulphurous acid and smoke particles. PMID:14670763

  8. Popular opinion leaders in London: a response to Kelly.

    PubMed

    Elford, J; Bolding, G; Sherr, L

    2004-02-01

    Controlled trials conducted in the USA provide clear evidence that peer education can bring about a reduction in high risk sexual behaviour among gay men. HIV prevention interventions that systematically identified, recruited, trained and engaged popular opinion leaders (POLs) made a significant impact on sexual behaviour at a community level in small US towns. However, recent trials conducted in the UK have failed to replicate these findings. A POL intervention in London made no significant impact at a community level on the risk behaviours of gay men. Jeffrey Kelly, one of the authors of the US studies, has identified nine core elements central to the popular opinion leader model. In Kelly's view 'the UK projects were not tests of the popular opinion leader model because they did not employ most of these POL core elements'. The absence of any significant impact of the UK programmes on sexual risk behaviour at a community level was not, therefore, surprising. In fact, the London POL project incorporated all the core elements into its design and succeeded in employing seven out of nine in its delivery. Attempts to employ all the core elements, however, were hampered by problems in recruiting popular opinion leaders as well as barriers to communication. Process evaluation revealed that it was these obstacles which limited diffusion. This in turn explained the absence of any impact of the London POL project on sexual risk behaviour at a community level. The obstacles to successful diffusion in London have provided a valuable opportunity for examining the processes that underlie the POL model. Our study raises the question as to whether social interventions shown to be effective in one setting, place or moment in time can be replicated in another.

  9. Modelling of hydrogen infrastructure for vehicle refuelling in London

    NASA Astrophysics Data System (ADS)

    Joffe, D.; Hart, D.; Bauen, A.

    One of the principal barriers to the widespread use of hydrogen as a road transport fuel is the need for a refuelling infrastructure to be established. The lack of an adequate refuelling infrastructure would severely inhibit an uptake of hydrogen vehicles. On the other hand, without significant penetration of these vehicles, the demand for hydrogen would be insufficient to make a widespread conventional refuelling infrastructure economic. The infrastructure is likely to develop initially in cities, due to the high concentration of vehicles and the anticipated air quality benefits of a switch to hydrogen as a road transport fuel. While trial schemes such as the Clean Urban Transport for Europe (CUTE) bus project will establish initial hydrogen refuelling sites, it is not clear how a transition to a widespread refuelling infrastructure will occur. Indeed, the number of possible different ways and scales of producing and distributing hydrogen means that the possible configurations for such an infrastructure are almost endless. Imperial College London is examining transition strategies for a hydrogen infrastructure for vehicle refuelling in London under a project funded by the UK Engineering and Physical Sciences Research Council (EPSRC). Imperial has five project partners from industry and local government to assist in this study: the Greater London Authority (GLA), BP, BOC, BMW and Air Products. This paper presents initial results from technical modelling of hydrogen infrastructure technologies and how they could be deployed to provide an initial facility for the refuelling of hydrogen fuel-cell buses in London. The results suggest that the choice of H 2 production technology can have significant effects on when the infrastructure would be installed, and the timing of hydrogen production, and bus refuelling.

  10. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (4) Anchorage D. In Long Island Sound approximately two miles west-southwest of New London Ledge...,460 yards; 009°, 2,480 yards; 026°, 1,175 yards; and 008°, 1,075 yards. (3) Anchorage C. In the Thames... Ledge Light: 246°, 2.6 miles; 247°, 2.1 miles; 233°, 2.1 miles; and 235°, 2.6 miles. (5) Anchorage...

  11. Lay Meanings of Health among Rural Older Adults in Appalachia

    ERIC Educational Resources Information Center

    Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly

    2011-01-01

    Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…

  12. Off-Time Events and Life Quality of Older Adults.

    ERIC Educational Resources Information Center

    Goodhart, Darlene; Zautra, Alex

    Many previous studies have found that daily life events influence community residents' perceived quality of life, which refers to the relative goodness of life as evaluated subjectively. A subsample population of 539 older residents, aged 55 and over, were interviewed in their homes. A 60-item scale was devised to measure the effects of…

  13. Lay Meanings of Health among Rural Older Adults in Appalachia

    ERIC Educational Resources Information Center

    Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly

    2011-01-01

    Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…

  14. Managing the Environment for Older Students.

    ERIC Educational Resources Information Center

    Gelwicks, Louis E.; Weinstock, Ruth

    1980-01-01

    The environmental adjustments required to make campuses responsive to the needs of older persons are seen as tending to fall in the realm of environmental management. Security, orientation, sight, sound, ambient temperature, seating, time, transportation, lounges, and campus residence halls are some environmental needs which are discussed. (MLW)

  15. Districts Adjust to Growth in Older Population

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2012-01-01

    The 1,000-student Allegheny Valley district in Pennsylvania boasts generations of alumni and a community so involved with the schools that high school graduation becomes an open celebration in downtown Springdale Borough. Yet the district hasn't asked for a tax increase in three years, and it is pushing out a message to older residents about…

  16. Districts Adjust to Growth in Older Population

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2012-01-01

    The 1,000-student Allegheny Valley district in Pennsylvania boasts generations of alumni and a community so involved with the schools that high school graduation becomes an open celebration in downtown Springdale Borough. Yet the district hasn't asked for a tax increase in three years, and it is pushing out a message to older residents about…

  17. Managing the Environment for Older Students.

    ERIC Educational Resources Information Center

    Gelwicks, Louis E.; Weinstock, Ruth

    1980-01-01

    The environmental adjustments required to make campuses responsive to the needs of older persons are seen as tending to fall in the realm of environmental management. Security, orientation, sight, sound, ambient temperature, seating, time, transportation, lounges, and campus residence halls are some environmental needs which are discussed. (MLW)

  18. Millennium-long recession of limestone facades in London

    NASA Astrophysics Data System (ADS)

    Brimblecombe, Peter; Grossi, Carlota M.

    2008-12-01

    Historical data on the temperature and precipitation data for London has been combined with output from the Hadley Model to estimate the climate of London for the period 1100-2100 CE. This has been converted to other parameters such as freeze-thaw frequency and snowfall relevant to the weathering of stone facades. The pollutant concentrations have been estimated for the same period, with the historical values taken from single box modelling and future values from changes likely given current policy within the metropolis. These values are used in the Lipfert model to show that the recession from karst weathering dominates across the period, while the contributions of sulphur deposition seem notable only across a shorter period 1700-2000 CE. Observations of the late seventeenth century suggest London architects witnessed a notable increase in the recession rate and attributed “fretting quality” to “smoaks of the sea-coal”. The recession rates measured in the late twentieth century lend some support to the estimates from the Lipfert model. The recession looks to increase only slightly, and frost shattering will decrease while salt weathering is likely to increase.

  19. The ClearfLo project - Understanding London's meteorology and composition

    NASA Astrophysics Data System (ADS)

    Belcher, Stephen; Bohnenstengel, Sylvia

    2014-05-01

    ClearfLo is a large multi-institutional project funded by the UK Natural Environment Research Council (NERC). ClearfLo established integrated measurements of meteorology, gaseous and particulate composition/loading of London's (UK) urban atmosphere in 2011 and 2012 to understand the processes underlying poor air quality. A new and unique long-term measurement infrastructure was established in London at street level, urban background and elevated sites and contrasted against rural locations to determine the urban increment in meteorology and pollution. This approach enables understanding the seasonal variations in the meteorology and composition together with the controlling processes. In addition two intensive observation periods (IOPs) provide more detail in winter 2012 and during the Olympics in summer 2012 focusing upon the vertical structure and evolution of the urban boundary layer, chemical controls on nitrogen dioxide and ozone production, in particular the role of volatile organic compounds, and processes controlling the evolution, size, distribution and composition of particulate matter. In this talk we present early analysis of the meteorology and air quality measurements within ClearfLo. In particular we show measurements that indicate the dominant regimes of London's boundary layer.

  20. Place and provision: mapping mental health advocacy services in London.

    PubMed

    Foley, Ronan; Platzer, Hazel

    2007-02-01

    The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

  1. Staff Member Reactions to Same-Gender, Resident-to-Resident Sexual Behavior Within Long-Term Care Facilities.

    PubMed

    Ahrendt, Andrew; Sprankle, Eric; Kuka, Alex; McPherson, Keagan

    2016-10-13

    The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval. Furthermore, an interaction effect between vignette and facility types was also discovered for caregivers' approval of sexual activity among residents. Additionally, a strong overall approval rating of older adult sexuality was reported by staff members. The results of this study warrant that further research is necessary regarding older adults' perception of caregiver bias, as well as further investigation of caregivers' perceptions of older adults' sexual activity.

  2. Asymptomatic bacteriuria and urinary tract infection in older adults.

    PubMed

    Juthani-Mehta, Manisha

    2007-08-01

    Asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are common in older community dwellers (ages 65 and older) and nursing home residents. The challenge involved in distinguishing ASB from UTI in this population results from other comorbid illnesses that may present with symptoms similar to UTI and from elderly adults who have cognitive impairment not being able to report their symptoms. This article reviews the most updated information on diagnosis, microbiology, management, and prevention of ASB and UTI as they pertain to older community dwellers and nursing home residents.

  3. Optimizing the customized residency plan.

    PubMed

    Phillips, Holly; Wilkinson, Samaneh T; Buck, Brian

    2013-06-01

    Residents and residency program directors (RPDs) understand that the goal of the residency year is to earn a residency certificate through achievement of established goals and objectives. The customized residency plan provides a map for the resident and RPD to follow throughout the course of the residency year, helping to keep everyone on track to accomplish the established goals and objectives of the program. It also provides information that allows preceptors to take the individual resident's plan into consideration when customizing a learning experience. This article will focus on the process for developing a customized residency plan and implementing it over the course of the residency year.

  4. [Comparing the Health Needs of Older Aboriginal and Older Ethnic Chinese Individuals in Taiwan].

    PubMed

    Lee, Ling-Ling; Lin, Shu-Shuan; Yen, Chia-Feng; Chuang, Jui-Ling

    2016-04-01

    Providing healthcare to older people is an essential policy in Taiwan. Previous studies have assessed the health needs of older people residing in urban areas. Evidence related to the differences in healthcare needs between older aboriginal and older ethnic Chinese people in Taiwan is insufficient. As both groups exhibit mutually distinct physical and socio-cultural attributes, understanding their different health needs is necessary to provide tailored and effective healthcare. To investigate the distinct health needs of older aboriginal and older ethnic Chinese using a comprehensive health-needs assessment tool. A cross-sectional study design was used. Older people aged 65 or over were proportionally sampled from communities. The Elderly Assessment System Care Standard instrument was used to collect data through interviews held in participant homes or in community activity centers between October 20th and December 20th, 2011. A total of 180 older people were recruited. A majority of participants had at least one chronic disease, disability, or frailty. Across a range of dimensions and categories of health needs, older aboriginal people had statistically significant higher health needs than non-aboriginal ones. However, older ethnic Chinese participants had higher levels of need in the domains of housing/financing and social participation/isolation. Regression analysis found that independence, risk of frailty, and risk of falls explained the majority of health needs, with R2 values of 64% and 69.6% for older aboriginal and older ethnic Chinese participants, respectively. However, the respective impact of these three categories on overall health needs varied between the two groups. Based on our findings, healthcare providers should focus on improving the self-care capabilities of older aboriginal people and on reducing the risk of breakdowns in care for older ethnic Chinese people in order to enhance the quality of elderly care in Taiwan.

  5. Rain Forest Dance Residency.

    ERIC Educational Resources Information Center

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  6. Rewarding the Resident Teacher

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Drake, Richard L.

    2011-01-01

    Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents…

  7. Rewarding the Resident Teacher

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Drake, Richard L.

    2011-01-01

    Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents…

  8. Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

    PubMed

    Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

    2017-10-01

    Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to

  9. Nursing home residents in emergency departments: a Foucauldian analysis.

    PubMed

    McCloskey, Rose; van den Hoonaard, Deborah

    2007-07-01

    This paper is a critical review of current knowledge about use of emergency departments by nursing home residents. A great deal of literature focuses on the challenges presented by older adults in acute care environments. Nursing home residents who transfer to emergency departments have been identified as being particularly problematic because they use considerable resources and their needs are not always amenable to acute interventions. A literature search was conducted in May 2006 using the CINAHL, Medline and Cochrane databases and Google Scholar with the keywords 'nursing home resident', 'long-term care resident', 'hospital transfer', and 'acute illness and emergency room'. No date restrictions were imposed. Foucault's concept of subjectivity was used to demonstrate how power derived from medical knowledge is used by emergency department personnel to construct nursing home residents as problematic. Knowledge about the use of emergency departments by nursing home residents has been derived mainly from retrospective record reviews, while the events in nursing homes that lead to transfers have been virtually ignored. Moreover, the primary focus of these investigations has been the effect of residents on emergency departments, rather than how residents themselves were affected. Current understanding of the care of nursing home residents in emergency departments is embedded in a complex web of social, historical and political factors. Research is needed that considers multiple perspectives, including those of both emergency department and nursing home staff, residents and ambulance personnel who act as mediators between the two settings.

  10. Life stage differences in resident coping with restart of the Three Mile Island nuclear generating facility

    SciTech Connect

    Prince-Embury, S.; Rooney, J.F.

    1990-12-01

    A study of residents who remained in the vicinity of Three Mile Island (TMI) immediately following the restart of the nuclear generating plant revealed that older residents employed a more emotion-focused coping style in the face of this event than did younger residents. Coping style was, however, unrelated to the level of psychological symptoms for these older residents, whereas demographic variables were related. Among younger residents, on the other hand, coping style was related to the level of psychological symptoms, whereas demographic variables were not. Among younger residents, emotion-focused coping was associated with more symptoms and problem-focused coping was associated with fewer symptoms, contradicting previous findings among TMI area residents.

  11. Epidemiology of Anemia in Older Adults

    PubMed Central

    Patel, Kushang V.

    2008-01-01

    Anemia is a common, multifactorial condition among older adults. The World Health Organization (WHO) definition of anemia (hemoglobin concentration <12 g/dL in women and <13 g/dL in men) is most often used in epidemiologic studies of older adults. More than 10% of community-dwelling adults age 65 years and older has WHO-defined anemia. After age 50 years, prevalence of anemia increases with advancing age and exceeds 20% in those 85 years and older. In nursing homes, anemia is present in 48–63% of residents. Incidence of anemia in older adults is not well characterized. Among older adults with anemia, approximately one-third have evidence of iron, folate, and/or vitamin B12 deficiency, another third have renal insufficiency and/or chronic inflammation, and the remaining third have anemia that is unexplained. Several studies demonstrate that anemia is associated with poorer survival in older adults. This review details the distribution and consequences of anemia in older adults and identifies future epidemiologic research needs. PMID:18809090

  12. Epidemiology of anemia in older adults.

    PubMed

    Patel, Kushang V

    2008-10-01

    Anemia is a common, multifactorial condition among older adults. The World Health Organization (WHO) definition of anemia (hemoglobin concentration <12 g/dL in women and <13 g/dL in men) is most often used in epidemiologic studies of older adults. More than 10% of community-dwelling adults age 65 years and older has WHO-defined anemia. After age 50 years, prevalence of anemia increases with advancing age and exceeds 20% in those 85 years and older. In nursing homes, anemia is present in 48% to 63% of residents. Incidence of anemia in older adults is not well characterized. Among older adults with anemia, approximately one third have evidence of iron, folate, and/or vitamin B(12) deficiency, another third have renal insufficiency and/or chronic inflammation, and the remaining third have anemia that is unexplained. Several studies demonstrate that anemia is associated with poorer survival in older adults. This review details the distribution and consequences of anemia in older adults and identifies future epidemiologic research needs.

  13. 'A place for men to come and do their thing': constructing masculinities in betting shops in London.

    PubMed

    Cassidy, Rebecca

    2014-03-01

    During fieldwork conducted with workers and customers in betting shops in London research participants consistently conceptualized betting shops as masculine spaces in contrast to the femininity of other places including home and the bingo hall. According to this argument, betting on horses and dogs was 'men's business' and betting shops were 'men's worlds'. Two explanations were offered to account for this situation. The first suggested that betting was traditionally a pastime enjoyed by men rather than women. The second was that betting is intrinsically more appealing to men because it is based on calculation and measurement, and women prefer more intuitive, simpler challenges. I use interviews with older people to describe how the legalisation of betting in cash in 1961 changed the geography of betting. I then draw upon interviews with regular customers in order to show how knowledge about betting is shared within rather than between genders. Finally, I use my experience of training and working as a cashier to describe how the particular hegemonic masculinity found in betting shops in London is maintained through myriad everyday practices which reward certain kinds of gendered performances while at the same time suppressing alternatives. The article shows how particular spaces may become gendered as an unanticipated consequence of legislation and how contingent gendered associations are both naturalized and, at the same time, subjected to intense attention.

  14. "I don't know how I'm still standing" a Bakhtinian analysis of social housing and health narratives in East London.

    PubMed

    Thompson, C; Lewis, D J; Greenhalgh, T; Smith, N R; Fahy, A E; Cummins, S

    2017-03-01

    Housing is a significant determinant of health and substandard housing is a public health issue. East London has long had a shortage of social and affordable housing, worsened in recent years by a combination of stressors. In one of East London's most deprived boroughs, Newham, changes brought about by the 2011 Localism Act and the unique demands of being the host Olympic borough in 2012 have brought considerable pressures to bear on social infrastructure. This paper examines how these pressures were experienced by local residents via their narratives of social housing and health. The data reported here are from a qualitative study comprising two waves of data collection. Narrative family interviews and go-along interviews were conducted with 40 Newham residents at wave one and 28 at wave two. A narrative analysis with a Bakhtinian interpretation was undertaken. This revealed that residents framed experiences of social housing in terms of an inherent system-level ideology based on notions of need and waiting. A particularly striking feature of this ideology was the extent to which descriptions of ill health and impairment were implicated in constructions of housing need; participants directly attributed a range of health complaints to their housing predicaments, including stress, depression, cancer scares, panic attacks and loss of sleep. Understanding the contested ideology of social housing can illuminate both the dynamic processes of social exclusion and the ways in which its subjects seek to resist it.

  15. Depression in Older Adults

    MedlinePlus

    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  16. Medical Malpractice Lawsuits Involving Surgical Residents.

    PubMed

    Thiels, Cornelius A; Choudhry, Asad J; Ray-Zack, Mohamed D; Lindor, Rachel A; Bergquist, John R; Habermann, Elizabeth B; Zielinski, Martin D

    2017-08-30

    Medical malpractice litigation against surgical residents is rarely discussed owing to assumed legal doctrine of respondeat superior, or "let the master answer." To better understand lawsuits targeting surgical trainees to prevent future litigation. Westlaw, an online legal research database containing legal records from across the United States, was retrospectively reviewed for malpractice cases involving surgical interns, residents, or fellows from January 1, 2005, to January 1, 2015. Infant-related obstetric and ophthalmologic procedures were excluded. Involvement in a medical malpractice case. Data were collected on patient demographics, case characteristics, and outcomes and were analyzed using descriptive statistics. During a 10-year period, 87 malpractice cases involving surgical trainees were identified. A total of 50 patients were female (57%), and 79 were 18 years of age or older (91%), with a median patient age of 44.5 years (interquartile range, 45-56 years). A total of 67 cases (77%) resulted in death or permanent disability. Most cases involved elective surgery (61 [70%]) and named a junior resident as a defendant (24 of 35 [69%]). Cases more often questioned the perioperative medical knowledge, decision making errors, and injuries (53 [61%]: preoperative, 19 of 53 [36%]) and postoperative, 34 of 53 [64%]) than intraoperative errors and injuries (43 [49%]). Junior residents were involved primarily with lawsuits related to medical decision making (21 of 24 [87%]). Residents' failure to evaluate the patient was cited in 10 cases (12%) and lack of direct supervision by attending physicians was cited in 48 cases (55%). A total of 42 cases (48%) resulted in a jury verdict or settlement in favor of the plaintiff, with a median payout of $900 000 (range, $1852 to $32 million). This review of malpractice cases involving surgical residents highlights the importance of perioperative management, particularly among junior residents, and the importance of

  17. Controls of carbon dioxide concentrations and fluxes above central London

    NASA Astrophysics Data System (ADS)

    Helfter, C.; Famulari, D.; Phillips, G. J.; Barlow, J. F.; Wood, C. R.; Grimmond, C. S. B.; Nemitz, E.

    2011-03-01

    Eddy-covariance measurements of carbon dioxide fluxes were taken continuously between October 2006 and May 2008 at 190 m height in central London (UK) to quantify emissions and study their controls. Inner London, with a population of 8.2 million (~5000 inhabitants per km2) is heavily built up with 8% vegetation cover within the central boroughs. CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). The measurement period allowed investigation of both diurnal patterns and seasonal trends. Diurnal averages of CO2 fluxes were found to be correlated with traffic but also exhibited an inverse dependency on atmospheric stability in the near-neutral range, with higher fluxes coinciding with unstable stratification during most seasons and perhaps reflecting how changes in heating-related natural gas consumption and, to a lesser extent, photosynthetic activity controlled the seasonal variability. Despite measurements being taken at ca. 22 times the mean building height, coupling with street level was adequate, especially during daytime. Night-time saw a higher occurrence of stable or neutral stratification, especially in autumn and winter, which resulted in data loss in post-processing and caused the tower to become decoupled from street level. CO2 fluxes observed at night were not always correlated with traffic counts, probably reflecting this decoupling, but also the fact that at night heating was always a larger source than traffic. No significant difference was found between the annual estimate of net exchange of CO2 for the expected measurement footprint and the values derived from the National Atmospheric Emissions Inventory (NAEI), with daytime fluxes differing by only 3%. This agreement with NAEI data also supported the use of the simple flux footprint model which was applied to the London site; this also suggests that individual roughness elements did not significantly affect the measurements due

  18. Controls of carbon dioxide concentrations and fluxes above central London

    NASA Astrophysics Data System (ADS)

    Helfter, C.; Famulari, D.; Phillips, G. J.; Barlow, J. F.; Wood, C. R.; Grimmond, C. S. B.; Nemitz, E.

    2010-10-01

    Eddy-covariance measurements of carbon dioxide fluxes were taken semi-continuously between October 2006 and May 2008 at 190 m height in central London (UK) to quantify emissions and study their controls. Inner London, with a population of 8.2 million (~5000 inhabitants per km2) is heavily built up with 8% vegetation cover within the central boroughs. CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). The measurement period allowed investigation of both diurnal patterns and seasonal trends. Diurnal averages of CO2 fluxes were found to be highly correlated to traffic. However changes in heating-related natural gas consumption and, to a lesser extent, photosynthetic activity that controlled the seasonal variability. Despite measurements being taken at ca. 22 times the mean building height, coupling with street level was adequate, especially during daytime. Night-time saw a higher occurrence of stable or neutral stratification, especially in autumn and winter, which resulted in data loss in post-processing. No significant difference was found between the annual estimate of net exchange of CO2 for the expected measurement footprint and the values derived from the National Atmospheric Emissions Inventory (NAEI), with daytime fluxes differing by only 3%. This agreement with NAEI data also supported the use of the simple flux footprint model which was applied to the London site; this also suggests that individual roughness elements did not significantly affect the measurements due to the large ratio of measurement height to mean building height.

  19. Religion and HIV diagnosis among Africans living in London.

    PubMed

    Fakoya, I; Johnson, Am; Fenton, Ka; Anderson, J; Nwokolo, N; Sullivan, Ak; Munday, P; Burns, Fm

    2012-11-01

    The aim of the paper was to describe the association of religion with HIV outcomes in newly diagnosed Africans living in London. A survey of newly diagnosed HIV-positive Africans attending 15 HIV treatment centres across London was carried out between April 2004 and February 2006. Confidential self-completed questionnaires were used, linked to clinical records. Bivariate analyses were conducted to ascertain whether religious beliefs were associated with late diagnosis, antiretroviral therapy, and immunological and virological outcome 6 months post diagnosis. A total of 246 Black Africans were eligible and included in the analysis: 62.6% were women, and the median age was 34 years. The median CD4 count at diagnosis was 194 cells/μL (range 0-1334 cells/μL) and 75.6% presented late, as defined as a CD4 count < 350 cells/μL. Most participants were religious: non-Roman Catholic Christians (55.7%), Roman Catholics (35.2%) and Muslims (6.1%). Only 1.2% stated that they did not have a religion. Participants who attended religious services at least monthly were more likely to believe that 'faith alone can cure HIV' than those who attended less frequently (37.7% vs. 15.0%; P = 0.002). A small proportion (5.2%) believed that taking antiretroviral therapy implied a lack of faith in God. Bivariate analysis found no relationship between religiousness (as measured using frequency of attendance at religious services and religious attitudes or beliefs) and late diagnosis, changes in CD4 count/viral load 6 months post diagnosis, or initiation of antiretroviral therapy. Strong religious beliefs about faith and healing are unlikely to act as a barrier to accessing HIV testing or antiretroviral treatment for Black Africans living in London. © 2012 British HIV Association.

  20. Air pollution dispersion models for human exposure predictions in London.

    PubMed

    Beevers, Sean D; Kitwiroon, Nutthida; Williams, Martin L; Kelly, Frank J; Ross Anderson, H; Carslaw, David C

    2013-01-01

    The London household survey has shown that people travel and are exposed to air pollutants differently. This argues for human exposure to be based upon space-time-activity data and spatio-temporal air quality predictions. For the latter, we have demonstrated the role that dispersion models can play by using two complimentary models, KCLurban, which gives source apportionment information, and Community Multi-scale Air Quality Model (CMAQ)-urban, which predicts hourly air quality. The KCLurban model is in close agreement with observations of NO(X), NO(2) and particulate matter (PM)(10/2.5), having a small normalised mean bias (-6% to 4%) and a large Index of Agreement (0.71-0.88). The temporal trends of NO(X) from the CMAQ-urban model are also in reasonable agreement with observations. Spatially, NO(2) predictions show that within 10's of metres of major roads, concentrations can range from approximately 10-20 p.p.b. up to 70 p.p.b. and that for PM(10/2.5) central London roadside concentrations are approximately double the suburban background concentrations. Exposure to different PM sources is important and we predict that brake wear-related PM(10) concentrations are approximately eight times greater near major roads than at suburban background locations. Temporally, we have shown that average NO(X) concentrations close to roads can range by a factor of approximately six between the early morning minimum and morning rush hour maximum periods. These results present strong arguments for the hybrid exposure model under development at King's and, in future, for in-building models and a model for the London Underground.

  1. The international follow-up of individuals potentially exposed to polonium-210 in London 2006.

    PubMed

    Shaw, K; Anders, K; Olowokure, B; Fraser, G; Maguire, H; Bailey, M; Smith, J; Frossell, S; Yap, K; Evans, B

    2010-06-01

    Following a death from polonium-210 ((210)Po), contamination was found at several sites in London. This paper describes the UK Health Protection Agency's follow-up and assessment of individuals resident overseas who were potentially exposed to (210)Po. Descriptive follow-up study. Individuals were classified into three exposure groups (higher, lower and unknown). Presence and degree of internal contamination were measured by 24-h urinary (210)Po activity (mBq/day). Results over 30mBq/day were taken to indicate probable contact with (210)Po in this incident. Dose assessments were conducted to determine degree of exposure and to identify individuals requiring further follow-up. Overall, 664 potentially exposed persons from 52 countries and territories were identified. Of these, 157 (24%) were in the higher exposure category, and urinary measurements were reported for 31% (48/157). Results for 19% (9/48) of those at higher exposure were more than 30mBq/day. For those at lower exposure, the percentage was 4% (3/68). Results above 30mBq/day were significantly more likely to be reported for the higher exposure category than the lower exposure category (Fisher's exact test P=0.010). Reported dose assessments suggested that identified individuals were not at increased health risk in the long term. Challenges and practical lessons were identified during the investigation. The results suggest that it is unlikely that any overseas resident had significant internal contamination with (210)Po. However, this incident clearly demonstrated the scale of international involvement likely to be necessary in other public health emergencies in large cities. The lessons identified have implications for the international health community, particularly with regard to the follow-up of individuals exposed to radiation in one country who then travel to another. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. A review of social housing regeneration in the London Borough of Brent.

    PubMed

    Stewart, J; Rhoden, M

    2003-03-01

    Council high-rise estates sprang up rapidly during the 1960s and 1970s, with cross-governmental support to resolve the nation's housing crisis. It soon became apparent that many such new estates, designed by remote architects, and sometimes constructed rapidly and unsatisfactorily, did not provide the ideal living initially perceived. Many estates had early problems with architecture, construction and design. They proved an inhumane environment for many residents and there were frequent problems with communal features. Such estates were soon stigmatised and difficult to let as increasingly residual households were placed there, creating majority welfare-dependent estates. This created a downward spiral that traditional, and remote, housing management found difficult to address, and was too wide-scale to rectify financially within existing regimes. Prior to the 1980s, there were no specific government policies to tackle housing regeneration on high-rise estates. Problems became wider than traditional housing management and poor housing environments, encompassing social and economic exclusion. This paper, based on historical and contemporary literature as well as estate visits, reviews regeneration policy in three council housing estates within the London Borough of Brent. It traces successive government approaches since the 1980s from one that challenged the very status of council housing--notably at Stonebridge Park and Chalkhill, to one of partnership with the local authority--at South Kilburn. Housing policy is now concerned with more than just housing--it is about moving toward social inclusion, which requires initiative, flair, resource and commitment. It is about new accountabilities--not just numbers of bricks and mortar constructions, but about the lives, opportunities and health of those who live in an area. This fundamentally involves a partnership approach with residents at the centre of regeneration. This paper finds that sustainable estate regeneration

  3. Risk factors for meningococcal disease in university halls of residence.

    PubMed Central

    Nelson, S. J.; Charlett, A.; Orr, H. J.; Barker, R. M.; Neal, K. R.; Taylor, C.; Monk, P. N.; Evans, M. R.; Stuart, J. M.

    2001-01-01

    A retrospective ecological study was undertaken to identify social and environmental factors associated with increased incidence of meningococcal disease in university halls of residence. A standardized questionnaire was sent to UK universities and colleges of higher education outside London, for distribution to halls containing at least 50 students. Incidence rate ratios of invasive meningococcal disease were obtained for a range of social and environmental variables. Multi-variable Poisson regression analysis identified 3 factors as having a strong association: a high proportion of first year undergraduate residents (P = 0.0008), decreasing smokiness of the hall bar (P < 0.0001), and opening of hall bar before 1990 (P = 0.0001). The inverse relationship between disease incidence and smokiness of bars was an unexpected finding, and may be due to confounding factors. Universities should continue to promote awareness of meningococcal disease, encourage vaccination of first year students against serogroup C disease, and where appropriate, take measures to reduce overcrowding. PMID:11349971

  4. Challenges of monitoring use of secondary care at local level: a study based in London, UK.

    PubMed Central

    Chenet, L; McKee, M

    1996-01-01

    STUDY OBJECTIVE: To provide those working at district level with practical guidance on using hospital data linked to small geographic areas to explore patterns of care. DESIGN: Examination of the association between age standardised hospital episode rates for the commonest diagnostic categories and deprivation levels (Carstairs index) of the electoral ward of residence. SETTING: An inner London district, Kensington, Chelsea and Westminster, with a population of approximately 325,000. POPULATION: All finished consultant episodes recorded in NHS hospitals for the district population in the year to April 1994. MAIN RESULTS: Many, but not all, disease categories were associated strongly with deprivation, with high episode rates in the most deprived electoral wards. This is partly due to more of those in deprived areas being admitted to hospital and to them being admitted more often. CONCLUSIONS: A wide range of factors needs to be taken into account in interpreting these data. They include the contribution of the private sector and artifacts of both the numerator and denominator. This paper provides a framework for those working at district level to begin to analyse the association between hospitalisation and deprivation locally. It also identifies some of the issues that must be taken into account when seeking to interpret these data. PMID:8935471

  5. Assessing public health risk in the London polonium-210 incident, 2006.

    PubMed

    Maguire, H; Fraser, G; Croft, J; Bailey, M; Tattersall, P; Morrey, M; Turbitt, D; Ruggles, R; Bishop, L; Giraudon, I; Walsh, B; Evans, B; Morgan, O; Clark, M; Lightfoot, N; Gilmour, R; Gross, R; Cox, R; Troop, P

    2010-06-01

    Mr Alexander Litvinenko died in a London hospital on 23 November 2006, allegedly from poisoning with the radionuclide polonium-210 ((210)Po). Associated circumstances required an integrated response to investigate the potential risk of internal contamination for individuals exposed to contaminated environments. Descriptive study. Contaminated locations presenting a potential risk to health were identified through environmental assessment by radiation protection specialists. Individuals connected with these locations were identified and assessed for internal contamination with (210)Po. In total, 1029 UK residents were identified, associated with the 11 most contaminated locations. Of these, 974 were personally interviewed and 787 were offered urine tests for (210)Po excretion. Overall, 139 individuals (18%) showed evidence of probable internal contamination with (210)Po arising from the incident, but only 53 (7%) had assessed radiation doses of 1mSv or more. The highest assessed radiation dose was approximately 100mSv. Although internal contamination with (210)Po was relatively frequent and was most extensive among individuals associated with locations judged a priori to pose the greatest risk, a high degree of assurance could be given to UK and international communities that the level of health risk from exposure to the radionuclide in this incident was low. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Inequalities in the use of dental services among adults in inner South East London.

    PubMed

    Al-Haboubi, Mustafa; Klass, Charlotte; Jones, Kate; Bernabé, Eduardo; Gallagher, Jennifer E

    2013-06-01

    Improving access to National Health Service (NHS) dentistry is a public health issue that has been a focus for successive governments and policy makers in the UK. To inform this process, commissioners of services need to understand trends in service use and demands of the local population. This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not according to borough of residence. The most common areas identified by respondents for service improvement were availability of dentists, affordability of care, and accommodation of services. Among those who visited the dentist in the last 24 months, 90% were satisfied with the quality of care provided. However, there were inequalities in satisfaction with care according to borough and reason for the last dental visit. © 2013 Eur J Oral Sci.

  7. Complaints about dog faeces as a symbolic representation of incivility in London, UK: a qualitative study

    PubMed Central

    Derges, Jane; Lynch, Rebecca; Clow, Angela; Petticrew, Mark; Draper, Alizon

    2012-01-01

    During a ‘Well London’ study, residents were asked about their neighbourhood and its environment. Above all other complaints, ‘dog poo’ was mentioned as a key concern. Despite low rates of infection and disease among the human population resulting from contact with canine faecal matter, the concerns of the public continue to rate it as a serious public health issue. Most public health studies, therefore, seek to identify processes of transmission and disease pathology as a method of addressing the problem. This study approaches the issue through a contextualised analysis of residents’ complaints, using anthropological theory to examine the symbolic representation of ‘dog poo’. Analysis of the interviews shows that these specific complaints were located among less easily defined or articulated experiences of social and environmental neglect, where neighbours were estranged from one another and local authorities seen as negligent. This approach has important implications for public health, as it provides not only a strong indicator of the level of dissatisfaction within some of London's more disadvantaged neighbourhoods, but also identifies a need for policies that are grounded in cross-disciplinary research into the relationship between health, ‘wellbeing’ and experiences of marginalisation among urban populations. PMID:23335839

  8. The psychological and psychiatric effects of terrorism: lessons from London.

    PubMed

    Rubin, G James; Wessely, Simon

    2013-09-01

    The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

  9. Miscellanea: Survey of nameplates in a well known London Street

    PubMed Central

    Bickerton, Richard C; Milton, Catherine M

    1986-01-01

    In 1951 a well known otolaryngologist recorded 798 brass nameplates in a well known London street. In the 35 years since this last survey was conducted the number has decreased by 23. This surprising finding is attributed to the communal entryphone and to the emergence of the shoddy plate. A definition of a plate is proposed, the concentration described, and the geographical distribution of plates summarised. A new phenomenon is encountered, the ghost plate, type A and type B. Further study is required to elucidate the significance of ghost plates. Imagesp1680-a PMID:20742754

  10. Lessons for climate policy from The Great Stink of London

    NASA Astrophysics Data System (ADS)

    Skuce, A.

    2012-12-01

    A rapidly growing population and the introduction of the flush toilet in nineteenth-century London caused a crisis with sewage pollution in the River Thames (Halliday, 1999). There were decades of delays in implementing solutions owing to: inadequate governance institutions; political inertia; difficulties with financing; opposition from vested interests; scientific uncertainties; and technological challenges. Effective counter-measures were started only once the problem arose, quite literally, under the noses of parliamentarians. There are parallels, some of them pointed out earlier by Alley et al (2010), between the sewage crisis in Victorian London and the current problem with climate change. Both involve the unsustainable use of a common resource (a river, the atmosphere) for the unconstrained disposal of human waste products. Alley (2011) estimated that the costs of providing clean water and sanitation are comparable to the expected costs of reducing greenhouse gas emissions. Despite the similarities, the climate change issue is actually much more difficult because of: a) the unequal and uncertain global distribution of cause and effect; b) its long, intergenerational time lines; c) the insufficiency of adequate institutions, conventions or the tools— political, moral or economic—for tackling the climate crisis. This analysis is consistent with the model proposed by Gardiner (2011) in his book A Perfect Moral Storm. The three "storms" he identifies, the global, intergenerational and theoretical storms, combine in a powerful synergy to create a challenge of unprecedented intractability, providing opportunities for what Gardiner calls moral corruption: the obscuring of the buck-passing and procrastination that characterizes climate policy today. In Victorian London, the crucial steps to solve the sewage crises were not taken until the stench from the River Thames during the hot summer of 1858 rendered the House of Commons uninhabitable. A greater stink of a

  11. Two daily smoke maxima in eighteenth century London air

    NASA Astrophysics Data System (ADS)

    Harrison, R. Giles

    Varied electrostatics experiments followed Benjamin Franklin's pioneering atmospheric investigations. In Knightsbridge, Central London, John Read (1726-1814) installed a sensing rod in the upper part of his house and, using a pith ball electrometer and Franklin chimes, monitored atmospheric electricity from 1789 to 1791. Atmospheric electricity is sensitive to weather and smoke pollution. In calm weather conditions, Read observed two daily electrification maxima in moderate weather, around 9 am and 7 pm. This is likely to represent a double diurnal cycle in urban smoke. Before the motor car and steam railways, one source of the double maximum smoke pattern was the daily routine of fire lighting for domestic heating.

  12. Changing geographies of access to medical education in London.

    PubMed

    Brown, Gavin; Garlick, Pamela

    2007-06-01

    This paper highlights the need for health geographers to consider the social and cultural geographies of who gets to train as a doctor. The paper presents a case study of a scheme intended to widen access to medical education for working class students from inner London. This work examines the role of local education markets and cultures of education in shaping the aspirations and achievements of potential future doctors. It employs ethnographic data to consider how 'non-traditional' learners acclimatise to medical school. Our findings indicate that the students who succeed best are those who can see themselves as belonging within the education system, regardless of their social and cultural background.

  13. Space in Pentecostal healing practices among Ghanaian migrants in London.

    PubMed

    Krause, Kristine

    2014-01-01

    In this article I analyze different spatial practices related to Pentecostal healing, drawing on fieldwork with Pentecostal believers who have migrated from Ghana to London, UK. I explore the relationship between space and the manifestation of the Holy Spirit by looking at how points of contact with the divine are created in the personal life of people and at the sites where the casting out of demons takes place. Unlike in other spirit-centered healing traditions, the Christian Holy Spirit is not conceived of as embodied in specific places, but rather is spatially unbound. To manifest, however, the Holy Spirit requires specific spatial qualities and esthetics.

  14. The Contribution of a Social Enterprise to the Building of Social Capital in a Disadvantaged Urban Area of London

    PubMed Central

    Bertotti, Marcello; Harden, Angela; Renton, Adrian; Sheridan, Kevin

    2016-01-01

    There has been much enthusiasm over the past 10 years for the potential contribution of social enterprises to the regeneration of disadvantaged urban areas. This enthusiasm has far outstripped the availability of empirical evidence. This paper reports a qualitative study of one social enterprise, a community café, and its contribution to building social capital in a disadvantaged urban area in London. The analysis reveals how the café builds ‘bonding’ and ‘bridging’ social capital whilst also addressing ‘downside’ social capital. Overall, the manager of the social enterprise played a considerable role in facilitating the development of social capital, thus emphasising the importance of individuals and their attitudes, skills, and background in urban regeneration. However, the role of the social enterprise in building ‘linking’ social capital was minor. In this instance, more effective mechanisms of community engagement need to be put in place in order to empower local residents and organisations. PMID:27746483

  15. The Contribution of a Social Enterprise to the Building of Social Capital in a Disadvantaged Urban Area of London.

    PubMed

    Bertotti, Marcello; Harden, Angela; Renton, Adrian; Sheridan, Kevin

    2012-04-01

    There has been much enthusiasm over the past 10 years for the potential contribution of social enterprises to the regeneration of disadvantaged urban areas. This enthusiasm has far outstripped the availability of empirical evidence. This paper reports a qualitative study of one social enterprise, a community café, and its contribution to building social capital in a disadvantaged urban area in London. The analysis reveals how the café builds 'bonding' and 'bridging' social capital whilst also addressing 'downside' social capital. Overall, the manager of the social enterprise played a considerable role in facilitating the development of social capital, thus emphasising the importance of individuals and their attitudes, skills, and background in urban regeneration. However, the role of the social enterprise in building 'linking' social capital was minor. In this instance, more effective mechanisms of community engagement need to be put in place in order to empower local residents and organisations.

  16. The disaster flood experience: Older people's poetic voices of resilience.

    PubMed

    Miller, Evonne; Brockie, Lauren

    2015-08-01

    This paper explores the experiences of older community-dwelling Australians evacuated from their homes during the 2011 and 2013 Queensland floods, applying the novel creative methodology of poetic inquiry as an analysis and interpretative tool. As well as exploring how older adults managed during a natural disaster, the paper documents the process and potential of poetic inquiry in gerontological research. The first and second poems highlight the different social resources older people have to draw on in their lives, especially during a crisis. Poem 1 ("Nobody came to help me") illustrates how one older resident felt all alone during the flood, whereas Poem 2 ("They came from everywhere"), Poem 3 ("The Girls") and Poem 5 ("Man in Blue Shirt") shows how supported--from both family and the wider community--other older residents felt. Poem 4 ("I can't swim") highlights one participant's fear as the water rises. To date, few studies have explicitly explored older adult's disaster experience, with this paper the first to utilise a poetic lens. We argue that poetic presentation enhances understanding of older residents' unique experiences during a disaster, and may better engage a wider audience of policy-makers, practitioners, the general community and older people themselves in discussion about, and reflection on, the impact and experience of disasters.

  17. A 10-year retrospective review of Salmonella infections at the Children’s Hospital in London, Ontario

    PubMed Central

    Cellucci, Tania; Seabrook, Jamie A; Chagla, Yasmine; Bannister, Susan L; Salvadori, Marina I

    2010-01-01

    OBJECTIVES: To describe Salmonella infections in children presenting to the Children’s Hospital (London Health Sciences Centre, London, Ontario), to assess risk factors for infection and to examine whether younger children, particularly infants younger than 12 weeks of age, experience higher morbidity than older children. METHODS: A 10-year retrospective review of children with Salmonella infections at the Children’s Hospital was conducted. Patient demographics, risk factors for infection, clinical characteristics, bacteriology and outcome were collected from the hospital charts and laboratory records. Data were separated into groups based on age and recent use of antibiotics to analyze differences in outcomes. RESULTS: Sixty-six children with Salmonella infections presented to the Children’s Hospital over a 10-year period. Common risk factors for Salmonella infection included having sick contacts, living in a rural area, recent travel, contact with pets (especially reptiles) and exposure to local water. Younger age was associated with an increased likelihood of admission to hospital, treatment with antibiotics and a longer course of antibiotic therapy. This was true when comparing older infants with those younger than 12 weeks of age. Patients recently treated with antibiotics and those with significant underlying medical conditions were more likely to be admitted. CONCLUSIONS: A wider knowledge of the epidemiological risk factors for Salmonella infection may improve diagnosis. Higher admission rates were expected in children younger than 12 weeks of age, those recently treated with antibiotics and those who had a significant underlying medical condition. A prospective, multicentre study is needed to further address questions regarding increased illness severity and appropriate management of Salmonella infections in children younger than 12 weeks of age. PMID:21629615

  18. Observation of the London moment and trapped flux in precision gyroscopes

    NASA Technical Reports Server (NTRS)

    Xiao, Y. M.; Felson, W.; Wu, C. H.; Keiser, G. M.; Turneaure, J. P.

    1993-01-01

    The London-moment readout has been observed in flight quality gyroscopes and it has been demonstrated that it is possible to reduce magnetic field trapped in these gyroscopes to levels as low as 1.5 x 10 exp -11 T. A preliminary analysis shows that the horizontal component of the London-moment signal is 60 percent of the total expected London-moment signal and is proportional to the gyro spin speed. Experiments were carried out in a unique ground test facility which was designed to provide the conditions necessary to observe the London moment of the spinning gyroscope.

  19. Why do some people look older than they should?

    PubMed

    Bulpitt, C J; Markowe, H L; Shipley, M J

    2001-09-01

    As a component of studies on biological age, the age of subjects from their appearance (perceived age) was estimated. To determine the factors associated with looking older. Cross sectional study of London civil servants (318 men, 129 women) in the Department of the Environment study. Perceived age was recorded by an observer and the difference between this age and chronological age was analysed according to 20 different variables. Men had an average perceived age of 0.37 years older than their actual age and women a perceived age of 0.54 years younger. In men, looking older was related to greying of the hair, grade of arcus senilis, and grade of baldness. Less expected, looking older was positively related to total serum cholesterol (p=0.03) and blood haemoglobin (p<0.01). In women, looking older was related to greying of the hair, positively to blood erythrocyte sedimentation rate (ESR), and negatively to serum bilirubin (p=0.01). Looking older was not related to alcohol consumption, employment grade, serum high density lipoprotein cholesterol, glucose, albumin, and calcium in either sex. The relationships between looking older and total cholesterol and haemoglobin in men and ESR and bilirubin in women, require further investigation.

  20. Why do some people look older than they should?

    PubMed Central

    Bulpitt, C; Markowe, H; Shipley, M

    2001-01-01

    BACKGROUND—As a component of studies on biological age, the age of subjects from their appearance (perceived age) was estimated.
OBJECTIVE—To determine the factors associated with looking older.
METHODS—Cross sectional study of London civil servants (318 men, 129 women) in the Department of the Environment study. Perceived age was recorded by an observer and the difference between this age and chronological age was analysed according to 20 different variables.
RESULTS—Men had an average perceived age of 0.37 years older than their actual age and women a perceived age of 0.54 years younger. In men, looking older was related to greying of the hair, grade of arcus senilis, and grade of baldness. Less expected, looking older was positively related to total serum cholesterol (p=0.03) and blood haemoglobin (p<0.01). In women, looking older was related to greying of the hair, positively to blood erythrocyte sedimentation rate (ESR), and negatively to serum bilirubin (p=0.01). Looking older was not related to alcohol consumption, employment grade, serum high density lipoprotein cholesterol, glucose, albumin, and calcium in either sex.
CONCLUSION—The relationships between looking older and total cholesterol and haemoglobin in men and ESR and bilirubin in women, require further investigation.
 PMID:11524516

  1. Public health assessment for US Naval Submarine Base, New London, Groton, New London County, Connecticut, Region 1. CERCLIS No. CTD980906515. Final report

    SciTech Connect

    Not Available

    1993-05-26

    The New London Submarine Base was divided by the town boundaries of Groton to the south and Ledyard to the north in New London County, Connecticut. In 1983, the Navy identified 16 potential source areas of environmental contamination during their investigations. The submarine base was listed on the US Environmental Protection Agency's National Priorities List in August 1990 because of the potential for on-base groundwater contamination to migrate to off-base residential wells that are close to the New London Submarine Base.

  2. Combined heat and power for the City of London

    SciTech Connect

    Mullins, P.

    1994-06-01

    The first phase of an innovative combined heat and power (CHP) system for the City of London is now almost complete and should be operating at full capacity by the end of 1994. Test runs are taking place. The system is powered by two large 18-cylinder Waertsilae Vasa 46GD multifuel engines developing a total of just under 32 MW of power. The engines drive ABB Stromberg HSG 160O water-cooled generators with electrical efficiencies exceeding 97%. The station will use natural gas and heavy fuel oil to generate electricity for the grid, hot water for district heating and chilled water for air conditioning. In the first phase of the project, underground pipework and cabling will connect the power station to various buildings in the City including the Barbican Center, Guildhall and the Museum of London/Bastion House. State-of-the-art emission control equipment has been installed to reduce NO[sub x] and SO[sub 2] by over 90%. 5 figs.

  3. Ethnic inequalities in dental caries among adults in East London.

    PubMed

    Delgado-Angulo, Elsa K; Bernabé, Eduardo; Marcenes, Wagner

    2016-06-01

    This study explored ethnic inequalities in dental caries among adults and assessed the role of socioeconomic position (SEP) in explaining those inequalities. We analysed data on 2013 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults and children living in East London in 2009-10. Participants completed a questionnaire and were clinically examined for dental caries at home. Dental caries was measured using the number of decayed, missing and filled teeth or DMFT index. Ethnic inequalities in dental caries were assessed in negative binomial regression models before and after adjustment for demographic (sex and age groups) and SEP measures (education and socioeconomic classification). White Eastern European and White Other had higher DMFT, whereas all Asian (Pakistani, Indian, Bangladeshi and Other) and all Black (African, Caribbean and Other) ethnic groups had lower DMFT than White British. Similar inequalities were found for the number of filled and missing teeth, but there were no differences in the number of decayed teeth between ethnic groups. This study showed considerable disparities in dental caries between and within the major ethnic categories, which were independent of demographics and SEP. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. On the exchange-hole model of London dispersion forces

    NASA Astrophysics Data System (ADS)

    Ángyán, János G.

    2007-07-01

    First-principles derivation is given for the heuristic exchange-hole model of London dispersion forces by Becke and Johnson [J. Chem. Phys. 122, 154104 (2005)]. A one-term approximation is used for the dynamic charge density response function, and it is shown that a central nonempirical ingredient of the approximate nonexpanded dispersion energy is the charge density autocorrelation function, a two-particle property, related to the exchange-correlation hole. In the framework of a dipolar approximation of the Coulomb interaction around the molecular origin, one obtains the so-called Salem-Tang-Karplus approximation to the C6 dispersion coefficient. Alternatively, by expanding the Coulomb interaction around the center of charge (centroid) of the exchange-correlation hole associated with each point in the molecular volume, a multicenter expansion is obtained around the centroids of electron localization domains, always in terms of the exchange-correlation hole. In order to get a formula analogous to that of Becke and Johnson, which involves the exchange-hole only, further assumptions are needed, related to the difficulties of obtaining the expectation value of a two-electron operator from a single determinant. Thus a connection could be established between the conventional fluctuating charge density model of London dispersion forces and the notion of the "exchange-hole dipole moment" shedding some light on the true nature of the approximations implicit in the Becke-Johnson model.

  5. Characterization and reconstruction of historical London, England, acidic aerosol concentrations.

    PubMed Central

    Ito, K; Thurston, G D

    1989-01-01

    Several past studies of the historical London air pollution record have reported an association between daily mortality and British Smoke levels. However, this pollution index does not give direct information on particulate mass or its chemical composition. A more specific particulate matter index, aerosol acidity, was measured at a site in central London, and daily data are available for the period 1963-1972. British Smoke and SO2 were also measured at the same site. Also, meteorological parameters were routinely measured at a nearby British Meteorological Office. Thus, daily fluctuation of the acidic aerosols was characterized in terms of other environmental parameters. Each of the other parameters analyzed seems necessary, but not sufficient to explain a high level of acidic aerosol. Overall, about half of the variance of log-transformed daily fluctuations of acidic aerosols can be explained by a combination of parameters including SO2 and British Smoke concentrations, temperature, ventilation by wind, and humidity. The rest of the variance cannot be explained by the parameters included in this analysis. Potential factors responsible for this unique variance would be variations in the availability of basic gases to cause neutralization and variation in the availability of catalytic metal salts. Because the acidic aerosol has a unique component of variation, it may be possible to distinguish health effects due to this specific pollutant from other available pollution indices or environmental factors. PMID:2651105

  6. The decline of adult smallpox in eighteenth-century London.

    PubMed

    Davenport, Romola; Schwarz, Leonard; Boulton, Jeremy

    2011-01-01

    Smallpox was probably the single most lethal disease in eighteenth-century Britain, but was a minor cause of death by the mid-nineteenth century. Although vaccination was crucial to the decline of smallpox, especially in urban areas, from the beginning of the nineteenth century, it remains disputed the extent to which smallpox mortality declined before vaccination. Analysis of age-specific changes in smallpox burials within the large west London parish of St Martin-in-the-Fields revealed a precipitous reduction in adult smallpox risk from the 1770s, and this pattern was duplicated in the east London parish of St Dunstan's. Most adult smallpox victims were rural migrants, and such a drop in their susceptibility is consistent with a sudden increase in exposure to smallpox in rural areas. We investigated whether this was due to the spread of inoculation, or an increase in smallpox transmission, using changes in the age patterns of child smallpox burials. Smallpox mortality rose among infants, and smallpox burials became concentrated at the youngest ages, suggesting a sudden increase in infectiousness of the smallpox virus. Such a change intensified the process of smallpox endemicization in the English population, but also made cities substantially safer for young adult migrants.

  7. Space-Time Analysis of Crime Patterns in Central London

    NASA Astrophysics Data System (ADS)

    Cheng, T.; Williams, D.

    2012-07-01

    Crime continues to cast a shadow over citizen well-being in big cities today, while also imposing huge economic and social costs. Timely understanding of how criminality emerges and how crime patterns evolve is crucial to anticipating crime, dealing with it when it occurs and developing public confidence in the police service. Every day, about 10,000 crime incidents are reported by citizens, recorded and geo-referenced in the London Metropolitan Police Service Computer Aided Dispatch (CAD) database. The unique nature of this dataset allows the patterns to be explored at particularly fine temporal granularity and at multiple spatial resolutions. This study provides a framework for the exploratory spatio-temporal analysis of crime patterns that combines visual inquiry tools (interactive animations, space-time cubes and map matrices) with cluster analysis (spatial-temporal scan statistics and the self-organizing map). This framework is tested on the CAD dataset for the London Borough of Camden in March 2010. Patterns of crime through space and time are discovered and the clustering methods were evaluated on their ability to facilitate the discovery and interpretation of these patterns.

  8. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 2001

    2001-01-01

    Explores the designs of three university residence halls that are intended to stimulate social and academic interaction, create a sense of community, and foster a feeling of belonging among students. Includes eleven photographs and a typical floor plan. (GR)

  9. Facilty Focus: Residence Halls.

    ERIC Educational Resources Information Center

    Hunnewell, James F., Jr.

    2002-01-01

    Describes the Western Ridge Residence at Colorado College and Beard Hall at Wheaton College. The buildings feature multiple levels that take advantage of views and also help create a "homey" feeling. (EV)

  10. Facilty Focus: Residence Halls.

    ERIC Educational Resources Information Center

    Hunnewell, James F., Jr.

    2002-01-01

    Describes the Western Ridge Residence at Colorado College and Beard Hall at Wheaton College. The buildings feature multiple levels that take advantage of views and also help create a "homey" feeling. (EV)

  11. Technology in Residence.

    ERIC Educational Resources Information Center

    Fox, Jordan

    1999-01-01

    Discusses the necessity for incorporating current technology in today's college residence halls to meet the more diverse and continued activities of its students. Technology addressed covers data networking and telecommunications, heating and cooling systems, and fire-safety systems. (GR)

  12. Social Support and Successful Aging in Assisted Living Residents

    ERIC Educational Resources Information Center

    Howie, Laura Odell; Troutman-Jordan, Meredith; Newman, Ann M.

    2014-01-01

    Successful aging has been associated with adequate social support. However, impaired functionality, increased dependence, multiple comorbidities, and reduced social interactions place older assisted living community (ALC) residents at risk for poorer social support and less successful aging. This cross-sectional descriptive study used the revised…

  13. Social Support and Successful Aging in Assisted Living Residents

    ERIC Educational Resources Information Center

    Howie, Laura Odell; Troutman-Jordan, Meredith; Newman, Ann M.

    2014-01-01

    Successful aging has been associated with adequate social support. However, impaired functionality, increased dependence, multiple comorbidities, and reduced social interactions place older assisted living community (ALC) residents at risk for poorer social support and less successful aging. This cross-sectional descriptive study used the revised…

  14. Older people in Canada: their victimization and fear of crime.

    PubMed

    Hayman, Stephanie

    2011-09-01

    Older people are more affected by fear of crime and the possibility of victimization, despite their being at lower risk of harm, than any other population group in Canada. Crime, victimization, and fear are not experienced uniformly among older Canadian citizens and residents, partly because older people do not form a homogeneous group. Being part of an ethnic, religious, or sexual minority, or being mentally frail, can have an impact on an individual's perceptions and experience of risk. This analysis explores older people's victimization and fear of crime, while it highlights the lack of consistency in the available data.

  15. Residents' Perspectives on Professionalism

    PubMed Central

    Krain, Lewis P.; Lavelle, Ellen

    2009-01-01

    Background Research defining professionalism exists, yet little is known about how residents view this important attribute for medical practice. Knowing more about residents' interpretations of professionalism and about how they value professionalism would enhance definitions and facilitate support for the development of professionalism skills and behaviors at the graduate level. Purpose The purpose of this phenomenological study was to investigate how residents think about professionalism, how they value it, and how it plays out in their educational lives. Methods This study uses qualitative methods, employing 5 focus groups representative of a range of disciplines. Methods include providing unstructured prompts, member checking and informant feedback to support credibility, and content analysis to discern significant patterns. Results Content analysis supported that residents highly value professionalism and see it as a complex construct, dependent on the situation, discipline, and on personal experience. Challenges to professionalism are common in graduate medical education and a great concern for residents. Conclusions Physician educators often discuss professionalism as an overarching concept in medicine, especially in classes during the preclinical years. Although some general principles are applicable, residents relate more deeply to aspects of professionalism that concern their own clinical practice, situation, and specialty. Implications for measurement of professional skills and for further research are included in this report. PMID:21975982

  16. Short-term associations between particle oxidative potential and daily mortality and hospital admissions in London.

    PubMed

    Atkinson, Richard W; Samoli, Evangelia; Analitis, Antonis; Fuller, Gary W; Green, David C; Anderson, H Ross; Purdie, Esme; Dunster, Chrissi; Aitlhadj, Layla; Kelly, Frank J; Mudway, Ian S

    2016-08-01

    Particulate matter (PM) from traffic and other sources has been associated with adverse health effects. One unifying theory is that PM, whatever its source, acts on the human body via its capacity to cause damaging oxidation reactions related to its content of pro-oxidants components. Few epidemiological studies have investigated particle oxidative potential (OP) and health. We conducted a time series analysis to assess associations between daily particle OP measures and numbers of deaths and hospital admissions for cardiovascular and respiratory diseases. During 2011 and 2012 particles with an aerodynamic diameter less than 2.5 and 10μm (PM2.5 and PM10 respectively) were collected daily on Partisol filters located at an urban background monitoring station in Central London. Particulate OP was assessed based on the capacity of the particles to oxidize ascorbate (OP(AA)) and glutathione (OP(GSH)) from a simple chemical model reflecting the antioxidant composition of human respiratory tract lining fluid. Particulate OP, expressed as % loss of antioxidant per μg of PM, was then multiplied by the daily concentrations of PM to derive the daily OP of PM mass concentrations (% loss per m(3)). Daily numbers of deaths and age- and cause-specific hospital admissions in London were obtained from national registries. Poisson regression accounting for seasonality and meteorology was used to estimate the percentage change in risk of death or admission associated with an interquartile increment in particle OP. We found little evidence for adverse associations between OP(AA) and OP(GSH) and mortality. Associations with cardiovascular admissions were generally positive in younger adults and negative in older adults with confidence intervals including 0%. For respiratory admissions there was a trend, from positive to negative associations, with increasing age although confidence intervals generally included 0%. Our study, the first to analyse daily particle OP measures and

  17. Satisfaction among residents in ASHP-accredited pharmacy residency programs.

    PubMed

    VanDenBerg, C; Murphy, J E

    1997-07-01

    The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores < 3) with the positively worded statements or agreement (scores > 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

  18. Museums and Older Adults .

    ERIC Educational Resources Information Center

    Sharpe, Elizabeth M.; And Others

    1984-01-01

    This issue contains articles on characteristics of the older adult population and how one museum program addressed them; an analysis of sensory changes in older adulthood and their implications for museum facilities and programing; what older adults can contribute to the museum; older adults as museum volunteers; and case studies of museum…

  19. Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

    PubMed

    Adra, Marina Gharibian; Hopton, John; Keady, John

    2015-12-01

    Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

  20. 'I don't think they knew we could do these sorts of things': social representations of community and participation in community arts by older people.

    PubMed

    Murray, Michael; Crummett, Amanda

    2010-07-01

    As people age the character of their social relationships change. There is evidence that older people who reside in disadvantaged communities often experience social isolation, which in turn has been found to be associated with a variety of health problems. This article reports the initial findings from a participatory arts project with a group of older residents of a disadvantaged urban community. It describes how the older residents represented their community and how they perceived the community arts intervention.

  1. A tale of two cities: Comparison of impacts on CO2 emissions, the indoor environment and health of home energy efficiency strategies in London and Milton Keynes

    NASA Astrophysics Data System (ADS)

    Shrubsole, C.; Das, P.; Milner, J.; Hamilton, I. G.; Spadaro, J. V.; Oikonomou, E.; Davies, M.; Wilkinson, P.

    2015-11-01

    Dwellings are a substantial source of global CO2 emissions. The energy used in homes for heating, cooking and running electrical appliances is responsible for a quarter of current total UK emissions and is a key target of government policies for greenhouse gas abatement. Policymakers need to understand the potential impact that such decarbonization policies have on the indoor environment and health for a full assessment of costs and benefits. We investigated these impacts in two contrasting settings of the UK: London, a predominantly older city and Milton Keynes, a growing new town. We employed SCRIBE, a building physics-based health impact model of the UK housing stock linked to the English Housing Survey, to examine changes, 2010-2050, in end-use energy demand, CO2 emissions, winter indoor temperatures, airborne pollutant concentrations and associated health impacts. For each location we modelled the existing (2010) housing stock and three future scenarios with different levels of energy efficiency interventions combined with either a business-as-usual, or accelerated decarbonization of the electricity grid approach. The potential for CO2 savings was appreciably greater in London than Milton Keynes except when substantial decarbonization of the electricity grid was assumed, largely because of the lower level of current energy efficiency in London and differences in the type and form of the housing stock. The average net impact on health per thousand population was greater in magnitude under all scenarios in London compared to Milton Keynes and more beneficial when it was assumed that purpose-provided ventilation (PPV) would be part of energy efficiency interventions, but more detrimental when interventions were assumed not to include PPV. These findings illustrate the importance of considering ventilation measures for health protection and the potential variation in the impact of home energy efficiency strategies, suggesting the need for tailored policy

  2. Burnout Syndrome During Residency.

    PubMed

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  3. Burnout Syndrome During Residency

    PubMed Central

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-01-01

    Objective The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. Methods After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Results Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. Conclusion BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects. PMID:27909607

  4. "But I Am Not Moving": Residents' Perspectives on Transitions within a Continuing Care Retirement Community

    ERIC Educational Resources Information Center

    Shippee, Tetyana Pylypiv

    2009-01-01

    Purpose: This article investigates how continuing care retirement community (CCRC) residents define transitions between levels of care. Although older adults move to CCRCs to "age in place," moving between levels of care is often stressful. More than half a million older adults live in CCRCs, with numbers continually increasing; yet, no studies…

  5. Rural residence and risk of dementia.

    PubMed

    St John, Philip D; Seary, Judith; Menec, Verena H; Tyas, Suzanne L

    2016-01-01

    We sought to determine whether residence in a rural region is associated with a higher risk of dementia and a higher risk of developing dementia over a 5-year period than residence in an urban region. This was a secondary analysis of a prospective cohort study. In 1991 and 1992, 1751 adults aged 65 years and older and residing in the community were sampled from a representative population-based registry, which included the entire province (time 1). Follow-up occurred 5 years later (time 2). Age, sex and education were selfreported. Rurality was determined by the population of the Census subdivision, with a population greater than 19 999 considered urban. Cognition was assessed using the Modified Mini-Mental State Examination, with those scoring below 78 invited to undergo a clinical examination to determine the presence of dementia. Cross-sectional analyses were conducted for participants with complete data at time 1. Prospective analyses were conducted for participants with normal cognition at time 1, who had complete data and survived until time 2. Logistic regression models were constructed for the outcome of dementia at times 1 and 2. Residence in a rural region was not associated with dementia in the cross-sectional analyses (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 0.61-1.91) and did not predict dementia 5 years later (adjusted OR 1.05, 95% CI 0.66-1.68). We found no difference in the risk of dementia among older adults living in urban and rural regions of Manitoba.

  6. Social Support among Nursing Home Residents: Evaluation of a Peer Counselor Training Program.

    ERIC Educational Resources Information Center

    Scharlach, Andrew E.

    Although research has demonstrated the potentially salutary effects of peer support among older persons, salutary peer support and significant interpersonal bonds are often lacking within the confines of a nursing home. A program was designed to train nursing home residents to serve as peer counselors for newly-admitted residents in an effort to…

  7. Resident identification using kinect depth image data and fuzzy clustering techniques.

    PubMed

    Banerjee, Tanvi; Keller, James M; Skubic, Marjorie

    2012-01-01

    As a part of our passive fall risk assessment research in home environments, we present a method to identify older residents using features extracted from their gait information from a single depth camera. Depth images have been collected continuously for about eight months from several apartments at a senior housing facility. Shape descriptors such as bounding box information and image moments were extracted from silhouettes of the depth images. The features were then clustered using Possibilistic C Means for resident identification. This technology will allow researchers and health professionals to gather more information on the individual residents by filtering out data belonging to non-residents. Gait related information belonging exclusively to the older residents can then be gathered. The data can potentially help detect changes in gait patterns which can be used to analyze fall risk for elderly residents by passively observing them in their home environments.

  8. Did the London Initiative Zone investment programme affect general practice structure and performance in East London? A time series analysis of cervical screening coverage and asthma prescribing.

    PubMed

    Naish, J; Eldridge, S; Moser, K; Sturdy, P

    2002-11-01

    A programme of incentives was set up in the London Initiative Zones to improve primary care in inner London based on the findings of the Tomlinson Enquiry in 1992. This descriptive study is a 4-y time series analysis of changes in general practice structure in East London as the result of London Initiative Zone investment, and an exploration of the possible effect of investment on practice performance. We used routinely available administrative data for the whole analysis. General practice characteristics and two selected performance indicators: the asthma prophylaxis to bronchodilator ratio and cervical cytology screening rate, for all practices in the East London and the City Health Authority for 4 y, 1993-1996, were used. Both reflect practice efficiency, but relate to different aspects of practice performance. The prescribing indicator is more indicative of the quality of clinical practise, whereas cervical screening coverage relates more to the characteristics of the practice population and to practice organisation. Repeated measures analyses were used to identify trends and to explore the relationship between changes in practice characteristics and performance. Graphical methods were used to compare East London trends with the rest of England. There were significant improvements in practice structure as the consequence of London Initiative Zone investment. There was a positive association with improvements in practice performance, but East London still lagged some way behind national patterns. The findings suggest that while improvements in asthma prescribing follow the national trend, practices have difficulty in achieving and sustaining the 80% target for cervical cytology screening, and that an overall population coverage of 80% may be in doubt.Increased investment in practice staffing may be influential in improving some aspects of performance. However, in common with other inner cities, a greater effort and more innovative strategies may be needed to

  9. Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community

    PubMed Central

    Gazard, Billy; Frissa, Souci; Nellums, Laura; Hotopf, Matthew; Hatch, Stephani L.

    2015-01-01

    Objectives. This study aimed to investigate the associations between migration status and health-related outcomes and to examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language, reason for migration and combined with ethnicity. Design. A total of 1698 adults were interviewed from 1076 randomly selected households in two South London boroughs. We described the socio-demographic and socio-economic differences between migrants and non-migrants and compared the prevalence of health-related outcomes by migration status, length of residence, first language, reason for migration and migration status within ethnic groups. Unadjusted models and models adjusted for socio-demographic and socio-economic indicators are presented. Results. Migrants were disadvantaged in terms of socio-economic status but few differences were found between migrant and non-migrants regarding health or health service use indicators; migration status was associated with decreased hazardous alcohol use, functional limitations due to poor mental health and not being registered with a general practitioner. Important differences emerged when migration status was disaggregated by length of residence in the UK, first language, reason for migration and intersected with ethnicity. The association between migration status and functional limitations due to poor mental health was only seen in White migrants, migrants whose first language was not English and migrants who had moved to the UK for work or a better life or for asylum or political reasons. There was no association between migration status and self-rated health overall, but Black African migrants had decreased odds for reporting poor health compared to their non-migrant counterparts [odds ratio = 0.15 (0.05–0.48), p < 0.01]. Conclusions. Disaggregating migration status by length of residence, first language and reason for migration as well as intersecting it with ethnicity leads

  10. 33 CFR 334.75 - Thames River, Naval Submarine Base New London, restricted area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Thames River, Naval Submarine....75 Thames River, Naval Submarine Base New London, restricted area. (a) The area: The open waters of... notified by personnel of the New London Submarine Base that such use will interfere with...

  11. Engendering City Politics and Educational Thought: Elite Women and the London Labour Party, 1914-1965

    ERIC Educational Resources Information Center

    Martin, Jane

    2008-01-01

    This article uses biographical approaches to recover the contribution of hitherto neglected figures in the history of education and the political history of the Left in London. Place and location are important since it is important to grasp the uniqueness of the London County Council within the framework of English local government and of the…

  12. The Increasing Presence of Spanish-Speaking Latinos in London: An Emergent Community?

    ERIC Educational Resources Information Center

    Block, David

    2008-01-01

    In recent years, the number of Spanish-speaking Latinos in Britain and London has grown considerably. Estimates from different sources put the population in London as high as 300,000. Unfortunately, this growing ethnolinguistic group is an underresearched minority, and information of any kind is hard to come by. In this article, my aim is to…

  13. 33 CFR 334.75 - Thames River, Naval Submarine Base New London, restricted area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....75 Thames River, Naval Submarine Base New London, restricted area. (a) The area: The open waters of... restricted area provided their vessels display registration numbers issued by the Naval Submarine Base, New... above, providing: (i) The Commanding Officer, Naval Submarine Base New London, and the Coast...

  14. Psychoanalysis of Jack London's "The Call of the Wild" and "White Fang"

    ERIC Educational Resources Information Center

    Yang, Hongyan

    2015-01-01

    "The Call of the Wild" and "White Fang" both are masterpieces of Jack London. The protagonists Buck and White Fang are the incarnation of Jack himself to some extent for the two novels reveal a great deal of the writer. This essay aims at psychoanalyzing Jack London's creative process, the Oedipus complex and the confliction…

  15. 33 CFR 334.75 - Thames River, Naval Submarine Base New London, restricted area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Base New London, restricted area. 334.75 Section 334.75 Navigation and Navigable Waters CORPS OF....75 Thames River, Naval Submarine Base New London, restricted area. (a) The area: The open waters of... channel to a point located at latitude 41°24′04.1″ N, longitude 72°05′51.2″ W then southerly along...

  16. 33 CFR 334.75 - Thames River, Naval Submarine Base New London, restricted area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Base New London, restricted area. 334.75 Section 334.75 Navigation and Navigable Waters CORPS OF....75 Thames River, Naval Submarine Base New London, restricted area. (a) The area: The open waters of... channel to a point located at latitude 41°24′04.1″ N, longitude 72°05′51.2″ W then southerly along...

  17. 33 CFR 334.75 - Thames River, Naval Submarine Base New London, restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Base New London, restricted area. 334.75 Section 334.75 Navigation and Navigable Waters CORPS OF....75 Thames River, Naval Submarine Base New London, restricted area. (a) The area: The open waters of... channel to a point located at latitude 41°24′04.1″ N, longitude 72°05′51.2″ W then southerly along...

  18. 77 FR 67566 - Regulated Navigation Area; Thames River Degaussing Range Replacement Operations; New London, CT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... Coast Guard is temporarily establishing a regulated navigation area (RNA) on the navigable waters of the Thames River in New London Harbor, New London, CT. The RNA will establish speed and wake restrictions and allow the Coast Guard to prohibit all vessel traffic through the RNA during degaussing range replacement...

  19. Report to the Vincent Astor Foundation; New York/London Middle School Conference.

    ERIC Educational Resources Information Center

    New York Urban Coalition, NY.

    The New York-London Middle Schools Project of 1976 provided an opportunity for a representative group of London educators to study New York City's public school system in terms of school community relations, school based planning and staff development at the junior high/intermediate school level. In this report, British educators provide a brief…

  20. Schools Library Services: Their Changing Value to the Education of London's Children

    ERIC Educational Resources Information Center

    Collins, Judith

    2005-01-01

    In the history of education Schools Library Services are relative newcomers. The London County Council and its successor, the Inner London Education Authority, developed Schools Library Services for their own schools from the 1950s onwards. After the Education Reform Act 1988 became law, responsibility for education passed to the inner London…

  1. The New Education and the Institute of Education, University of London, 1919-1945

    ERIC Educational Resources Information Center

    Aldrich, Richard

    2009-01-01

    The London Day Training College (LDTC), founded in 1902, soon became the leading institution for the study of education and for the training of teachers in England. In 1932 it was transmuted into the Institute of Education of the University of London. Its title and pre-eminence have continued to this day. In the period 1919-1945 it was closely,…

  2. Diversity in Adoption of Linguistic Features of London English by Chinese and Bangladeshi Adolescents

    ERIC Educational Resources Information Center

    Pennington, Martha C.; Lau, Lawrence; Sachdev, Itesh

    2011-01-01

    This comparative study, conducted in multicultural London, investigates the occurrence in interviews with a researcher and in constructed same-sex peer conversations of five linguistic features characteristic of London English in the speech of two groups of British-born adolescents: ethnic Bangladeshis and ethnic Chinese of Cantonese heritage. The…

  3. 77 FR 54495 - Regulated Navigation Area; Thames River Degaussing Range Replacement Operations; New London, CT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-05

    ... operates a fixed degaussing range in New London Harbor, New London, CT. This range is buried in sand on the... sensors and cables encompasses a much larger area of the river bottom, from the river's west shore by Fort... supporting system's boundaries are outlined with a magenta dotted line and labeled ``Cable Area''. The Navy...

  4. Diversity in Adoption of Linguistic Features of London English by Chinese and Bangladeshi Adolescents

    ERIC Educational Resources Information Center

    Pennington, Martha C.; Lau, Lawrence; Sachdev, Itesh

    2011-01-01

    This comparative study, conducted in multicultural London, investigates the occurrence in interviews with a researcher and in constructed same-sex peer conversations of five linguistic features characteristic of London English in the speech of two groups of British-born adolescents: ethnic Bangladeshis and ethnic Chinese of Cantonese heritage. The…

  5. Mental health among younger and older caregivers of dementia patients.

    PubMed

    Koyama, Asuka; Matsushita, Masateru; Hashimoto, Mamoru; Fujise, Noboru; Ishikawa, Tomohisa; Tanaka, Hibiki; Hatada, Yutaka; Miyagawa, Yusuke; Hotta, Maki; Ikeda, Manabu

    2017-03-01

    Caregiver burden in dementia is an important issue, but few studies have examined the mental health of younger and older family caregivers by comparing them with age- and gender-matched community residents. We aimed to compare the mental health of dementia caregivers with that of community residents and to clarify factors related to mental health problems in younger and older caregivers. We studied 104 dementia caregivers; 46 were younger (<65 years) and 58 were older (≥65 years). A total of 104 community residents who were matched for age and gender were selected. We compared depression (Center for Epidemiologic Studies Depression Scale for younger participants; Geriatric Depression Scale for older participants), health-related quality of life (QOL) short-form health survey (SF-8), sleep problems, and suicidal ideation between the caregivers and community residents by age. Behavioural and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL were assessed among patients with dementia using the Neuropsychiatric Inventory, Physical Self-Maintenance Scale, and Lawton Instrumental ADL Scale, respectively. According to SF-8 results, both younger and older caregivers had significantly worse mental QOL than community residents (younger caregivers: 46.3 vs community residents: 49.7, P = 0.017; older caregivers: 48.2 vs community residents: 51.1, P = 0.024) but were not more depressive. Sleep problems were significantly more frequent in younger caregivers (39.1%) than in community residents (17.0%) (P = 0.017). Multiple regression analysis revealed that caregivers' deteriorated mental QOL was associated with patients' behavioural and psychological symptoms of dementia in younger caregivers and with dementia patients' instrumental ADL and female gender in older caregivers. Dementia caregivers had a lower mental QOL than community residents. To maintain caregivers' mental QOL, it is necessary to provide younger

  6. Acheiving speech intelligibility at Paddington Station, London, UK

    NASA Astrophysics Data System (ADS)

    Goddard, Helen M.

    2002-11-01

    Paddington Station in London, UK is a large rail terminus for long distance electric and diesel powered trains. This magnificent train shed has four arched spans and is one of the remaining structural testaments to the architect Brunel. Given the current British and European legislative requirements for intelligible speech in public buildings AMS Acoustics were engaged to design an electroacoustic solution. In this paper we will outline how the significant problems of lively natural acoustics, the high operational noise levels and the strict aesthetic constraints were addressed. The resultant design is radical, using the most recent dsp controlled line array loudspeakers. In the paper we detail the acoustic modeling undertaken to predict both even direct sound pressure level coverage and STI. Further it presents the speech intelligibility measured upon handover of the new system. The design has proved to be successful and given the nature of the space, outstanding speech intelligibility is achieved.

  7. Herald waves of cholera in nineteenth century London.

    PubMed

    Tien, Joseph H; Poinar, Hendrik N; Fisman, David N; Earn, David J D

    2011-05-06

    Deaths from cholera in London, UK, were recorded weekly from 1824 to 1901. Three features of the time series stand out: (i) cholera deaths were strongly seasonal, with peak mortality almost always in the summer, (ii) the only non-summer outbreaks occurred in the spring of 1832, the autumn of 1848 and the winter of 1853, and (iii) extraordinarily severe summer outbreaks occurred in 1832, 1849, 1854 and 1866 (the four 'great' cholera years). The non-summer outbreaks of 1832, 1848 and 1853 appear to have been herald waves of newly invading cholera strains. In addition, a simple mathematical model confirms that a non-summer introduction of a new cholera strain can result in an initial herald wave, followed by a severe outbreak the following summer. Through the analysis of the genomes of nineteenth-century specimens, it may be possible to identify the strains that caused these herald waves and the well-known cholera epidemics that followed.

  8. Attraction or Repulsion? London Dispersion Forces Control Azobenzene Switches.

    PubMed

    Schweighauser, Luca; Strauss, Marcel A; Bellotto, Silvia; Wegner, Hermann A

    2015-11-02

    Large substituents are commonly seen as entirely repulsive through steric hindrance. Such groups have additional attractive effects arising from weak London dispersion forces between the neutral atoms. Steric interactions are recognized to have a strong influence on isomerization processes, such as in azobenzene-based molecular switches. Textbooks indicate that steric hindrance destabilizes the Z isomers. Herein, we demonstrate that increasing the bulkiness of electronically equal substituents in the meta-position decreases the thermal reaction rates from the Z to the E isomers. DFT computations revealed that attractive dispersion forces essentially lower the energy of the Z isomers. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Cosmic Rays & ULF Waves: Research in Schools Projects in London

    NASA Astrophysics Data System (ADS)

    Archer, Martin

    2017-04-01

    Research in Schools (RiS) projects offer school students opportunities to experience scientific research over prolonged periods within their school environment. Over the past two years we have piloted a RiS programme with five London schools across two research areas: the cosmic ray muons which serve as backgrounds to current neutrino experiments; and the magnetospheric ultra-low frequency waves that play a key role within space weather. From the evaluation of this pilot programme we have found that RiS can have significantly positive results on students' understanding and appreciation of science, as well as equipping them with vital skills. Teachers are also found to benefit from the projects, reconnecting them with their subject at an academic level, challenging them and aiding towards their professional development. It is important to note that supervision from current researchers was key to these outcomes. Finally, a number of recommendations on project structure, resources and workloads are presented.

  10. Interoceptive Ability Predicts Survival on a London Trading Floor.

    PubMed

    Kandasamy, Narayanan; Garfinkel, Sarah N; Page, Lionel; Hardy, Ben; Critchley, Hugo D; Gurnell, Mark; Coates, John M

    2016-09-19

    Interoception is the sensing of physiological signals originating inside the body, such as hunger, pain and heart rate. People with greater sensitivity to interoceptive signals, as measured by, for example, tests of heart beat detection, perform better in laboratory studies of risky decision-making. However, there has been little field work to determine if interoceptive sensitivity contributes to success in real-world, high-stakes risk taking. Here, we report on a study in which we quantified heartbeat detection skills in a group of financial traders working on a London trading floor. We found that traders are better able to perceive their own heartbeats than matched controls from the non-trading population. Moreover, the interoceptive ability of traders predicted their relative profitability, and strikingly, how long they survived in the financial markets. Our results suggest that signals from the body - the gut feelings of financial lore - contribute to success in the markets.

  11. Cost benefit analysis of 20 mph zones in London.

    PubMed

    Steinbach, Rebecca; Cairns, John; Grundy, Chris; Edwards, Phil

    2013-06-01

    Evidence suggests that 20 mph zones are an effective intervention to reduce casualties from road traffic crashes in urban areas. This analysis compares the costs of construction of the 20 mph zone intervention in high and low casualty areas in London to the value of casualties avoided over 5 and 10 year time horizons. Probabilistic sensitivity analyses were conducted to quantify uncertainty in the results associated with model parameters. Results indicate a net present value (NPV) of £18 947 (90% credible limits -£75 252 to £82 021 2005 prices) after 5 years and £67 306 (£-29 157 to £137 890) after 10 years when 20 mph zones are implemented in areas with one or more casualty per kilometre of road. Simulations from our model suggest that the 'threshold of casualties' where NPVs become positive using a 10 year time horizon is 0.7 casualties per kilometre.

  12. Brachial plexus injury: the London experience with supraclavicular traction lesions.

    PubMed

    Birch, Rolfe

    2009-01-01

    In this article, the author details the experiences of his hospital and other London hospitals in treating brachial plexus injury. As noted, important advances have been made in methods of diagnosis and repair. Myelography was replaced by CT scan and later by MRI. Among the topics the author explores are diagnosis (including pain, the presence or absence of the Tinel sign, and the irradiation of pins and needles) and the principles of repair. The author emphasizes that it is imperative that ruptured nerves be repaired as soon as possible, with the closed traction lesion coming, in urgency, close behind reattachment of the amputated hand or repair of a great artery and a trunk nerve in the combined lesion. Finally, the article concludes that the surgeon must be actively engaged in the whole process of rehabilitation and treatment of pain. This is part of a Point-Counterpoint discussion with Dr. David G. Kline's presentation of "A Personal Experience."

  13. A cluster of suicides at a London psychiatric unit.

    PubMed

    Haw, C M

    1994-01-01

    In an epidemiologically based study, a spate of 14 suicides among current patients of a London psychiatric unit was investigated. Statistical analysis showed it to be a discrete cluster of suicides, rather than a chance occurrence. There was no evidence of direct linkage or "contagion" between the suicides. Thirteen of the patients suffered from severe, chronic mental illness and all but 2 had been known to the psychiatric unit for at least a year. Twelve used violent methods, in 8 cases jumping from a high place. Although no definite cause for the cluster could be established, it coincided with a period of uncertainty concerning the future of the hospital and with changes in and absenteeism of senior medical staff.

  14. Dr. William Briggs: ophthalmic physician at St. Thomas' Hospital, London.

    PubMed

    Winstanley, J

    2001-01-01

    William Briggs, MD, established himself as one of the first ophthalmic physicians, whom today we would call a neuro-ophthalmologist, to practice in the United Kingdom. After graduating with an MD from Cambridge in 1677, and while a Fellow of Corpus Christi College, he carried out original studies in visual anatomy and physiology. He described and named the optic papilla and the retinal nerve fibers in his book Ophthalmographia, published in 1676. He published his New Theory of Vision in 1682. While at Cambridge, he was a contemporary and a friend of Isaac Newton, with whom Briggs worked but who, in matters of visual anatomy and physiology, came to reach different conclusions from Briggs. In 1683, Briggs came to London to practice as a physician at St. Thomas' Hospital, where he established a considerable reputation as an ophthalmologist. For political reasons he was forced to resign from the Hospital prematurely.

  15. Polonium-210 poisoning in London: hypochondriasis and public health.

    PubMed

    Morgan, Oliver W; Page, Lisa; Forrester, Sarah; Maguire, Helen

    2008-01-01

    In November 2006, a Russian dissident died from radioactive Polonium-210 (210Po) poisoning in London. Providing reassuring messages during a public health incident may be ineffective for individuals with high health anxiety (hypochondriasis). Members of the public who called a 24-hour telephone helpline were offered a follow-up call by a health protection specialist for reassurance. A psychiatrist attempted to contact those callers who were unable to be reassured by the health protection specialist. Of 872 individuals contacted for reassurance, seven (0.6%) could not be reassured. The psychiatrist contacted four of these individuals. Three had a history of health-related anxiety and two attributed somatic symptoms to 210Po exposure. For individuals with hypochondriasis, reassurance during major public health incidents may be ineffective. Having a psychiatrist available was helpful in managing individuals with excessive health anxiety.

  16. Clostridium botulinum in the lakes and waterways of London.

    PubMed Central

    Smith, G. R.; Moryson, C. J.

    1975-01-01

    Mud samples collected during 1974 from a large proportion of the lakes and waterways of London were examined for Clostridium botulinum. Of 69 such sites, 50 (72.5%) contained at least one type of the organism. Of the 50 positive sites, 31, 12, 1 and 10 contained, respectively, types B, C, D and E. Most of the demonstrations of type B required trypsinization of culture filtrates. An examination of 7 lakes in Edinburgh, made for the purpose of comparison, showed that 4 contained type B and one type C. An analysis of the results gave quantitative information on the value of (1) resampling apparently negative lakes, (2) the use of both heated and unheated culture inocula, and (3) trypsinization of culture filtrates. PMID:1104711

  17. Interoceptive Ability Predicts Survival on a London Trading Floor

    PubMed Central

    Kandasamy, Narayanan; Garfinkel, Sarah N.; Page, Lionel; Hardy, Ben; Critchley, Hugo D.; Gurnell, Mark; Coates, John M.

    2016-01-01

    Interoception is the sensing of physiological signals originating inside the body, such as hunger, pain and heart rate. People with greater sensitivity to interoceptive signals, as measured by, for example, tests of heart beat detection, perform better in laboratory studies of risky decision-making. However, there has been little field work to determine if interoceptive sensitivity contributes to success in real-world, high-stakes risk taking. Here, we report on a study in which we quantified heartbeat detection skills in a group of financial traders working on a London trading floor. We found that traders are better able to perceive their own heartbeats than matched controls from the non-trading population. Moreover, the interoceptive ability of traders predicted their relative profitability, and strikingly, how long they survived in the financial markets. Our results suggest that signals from the body - the gut feelings of financial lore - contribute to success in the markets. PMID:27641692

  18. The prevalence of cervical ribs in a London population.

    PubMed

    Brewin, James; Hill, Martin; Ellis, Harold

    2009-04-01

    Cervical ribs are an important cause of neurovascular compression at the thoracic outlet. Previous studies have shown the prevalence of cervical ribs to be between 0.05 and 3%, depending on the sex and race of the population studied. We examined 1,352 chest radiographs to determine the prevalence of cervical ribs in a London population of mixed sex and ethnicity. Our study found that the overall prevalence of cervical ribs was 0.74% with a higher rate in females compared with males (1.09 and 0.42%, respectively). Of the 10 individuals with a cervical rib, five were on the left, three were on the right and two were bilateral. The presence of elongated C7 transverse processes (transverse apophysomegaly) was also noted. We found a total of 30 elongated transverse processes with an overall prevalence of 2.21%. They were also more common in females (3.43%) than males (1.13%).

  19. Carbon dioxide and methane emission dynamics in central London (UK)

    NASA Astrophysics Data System (ADS)

    Helfter, Carole; Nemitz, Eiko; Barlow, Janet F.; Wood, Curtis R.

    2013-04-01

    London, with a population of 8.2 million, is the largest city in Europe. It is heavily built-up (typically 8% vegetation cover within the central boroughs) and boasts some of the busiest arteries in Europe despite efforts to reduce traffic in the city centre with the introduction of a congestion charging scheme in 2007. We report on two substantial pollution monitoring efforts in the heart of London between October 2006 and present. Fluxes of carbon dioxide (CO2) and water (H2O) were measured continuously by eddy-covariance in central London from October 2006 until May 2008 from a 190 m telecommunication tower (BT tower; 51° 31' 17.4'' N 0° 8' 20.04'' W). The eddy-covariance system consisted of a Gill R3-50 ultrasonic anemometer operated at 20 Hz and a LI-COR 6262 infrared gas analyser. Air was sampled 0.3 m below the sensor head of the ultrasonic anemometer - which was itself mounted on a 3 m mast to the top of a 15 m lattice tower situated on the roof of the tower (instrument head at 190 m above street level) - and pulled down 45 m of 12.7 mm OD Teflon tubing. In addition, meteorological variables (temperature, relative humidity, pressure, precipitation, wind speed and direction) were also measured with a multi-sensor (Weather Transmitter WXT510, Vaisala). Eddy-covariance measurements at the BT tower location were reinstated in July 2011 and include methane (CH4), CO2 and H2O concentrations measured by a Picarro fast methane analyser (G2301-f). CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). Diurnal averages of CO2 fluxes were found to be highly correlated to traffic. However changes in heating-related natural gas consumption and, to a lesser extent, photosynthetic activity in two large city centre green spaces (Hyde Park and Regent's Park) explained the seasonal variability. Annual estimates of net exchange of CO2 obtained by eddy-covariance agreed well with up-scaled data from the UK

  20. European Society of Cardiology (ESC) Congress Report from London 2015.

    PubMed

    Nishiguchi, Tsuyoshi; Akasaka, Takashi

    2015-01-01

    The Annual Congress of the European Society of Cardiology (ESC) was held in London from 29 August to 2 September 2015. It is the leading conference in cardiology in the world, with presentations on the latest scientific discoveries, innovations, technology, education, and clinical practices. More than 32,000 delegates and 5,000 exhibitors from 140 countries participated, sharing a number of scientific presentations, including 28 clinical hot lines, 18 clinical trial updates, 20 registry studies, 12 basic and translational science hot line studies, and 4,533 abstract studies. Japan had the highest number of accepted abstracts at the Congress, indicating the great contribution of Japanese scientists and the Japanese Circulation Society.