Emergency department use among patients from residential aged care facilities under a Hospital in the Nursing Home scheme in public hospitals in Queensland Australia

BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home(Hi NH) program.METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics.RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1 000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio(95%CI): 0.09(0.04, 0.22); P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio(95%CI): 0.22(0.07, 0.66); P=0.007].CONCLUSION: The Hi NH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.

Method to Evaluate the Location of Aged Care Facilitiesin Urban Areas Focusing on the Equity in Terms ofUsers’Accessibility

The present study developed and tested a method to evaluate the location of aged care facilities from the viewpoint of whether they are equitably located for users,using the improved Median Share Ratio(MSR).By evaluating the current location of aged care facilities,it is possible to extract the districts which are short of facilities.The evaluation method was applied to Chofu and Kiyose Cities in Tokyo Metropolis,Japan,and the evaluation result of weighting and that of not weighting by elderly population were compared and discussed.Consequently,adopting the evaluation method with weighting by elderly population,it is possible to adequately examine the districts where new aged care facilities should be constructed.From this evidence,it is significant to evaluate the location of aged care facilities,using the improved MSR with weighting by elderly population in the study.

The Research of Social Organizations Participating in the Urban Community Aged Care＇ s Problems--Base on the City of Shanghai in China

With the deepening of China＇s aging population, the conmmnity aged care gradually become endowment new options. Social organization for its own characteristics, play an important role in participating in community aged care. But the extent to which the current social organizations to participate in the community aged care is still very low, the reason is mainly affected by the community aged care access mechanism. Article in the Shanghai community, for example, starhng fiom the present situation of the current social organizations to participate in the community aged care, analysis of the problems arising fi-om the social organizations in the community aged care, probe into its reasons in access mechanism, put forward the corresponding countermeasures and Suggestions, encourage social organizations play an effective role in the community aged care.

The Construction of the Aged Carers under the Internationa Comparative Perspective

Objective： To explore how to learn from foreign experience to promote the construction of nursing staff in China.Methods：Based on the social background and the problems faced by nursing staffin China, we selected Germany and Japan as the social environment and problems of nursing staffin China. Germany, Japan and Japan to find out how to solve the dilemma of nursing service personnel to meet the pension needs of Germany and Japan to compare whether the strategy adopted by the current development of nursing staff in China, and finally combined with the analysis of China＇s aging care workers How to draw lessons from international experience to promote the construction of nursing staff in China.Conclusion： In drawing on the experience of foreign nursing service personnel, we must first analyze the reasons for such measures, whether our country has the conditions to implement such measures is not able to solve The experience of other countries must be suitable for our country, we must combine the social environment in which our country in contrast, selectivity and targeted research.

Challenges in the provision of community aged care in China

Objective:Population ageing in China is a significant challenge for the Chinese government,the society and Chinese people.The dramatic process of population ageing together with social and economic diversity in China has created issues in the availability,equality and sustainability of social and financial support for older people.The aims of this review are to identify the social and economic challenges to the traditional caregiving system in China,and to examine possible solutions to improve the care of older people in China using the framework of ageing in place.Methods:Electronic literature searches were conducted in May and June 2013 using PubMed,CNKI,and MEDLINE.Statistical data and reports were retrieved from the United Nations,the World Health Organisation,the World Bank and National Bureau of Statistics of China.Government policy documents were found through government websites and formal publications.Results:Family-centred care for older people in China is recognised as a cultural tradition in the Chinese community.However,driven by large-scale social,political and economic changes,this model of caring for older people has dynamically changed over the last 50 years.Traditionally the family has been the most important source of social support for older people followed by neighbour support and support from friends.Today family obligations of caring are still centred in a cultural and practical context;however,support from family and children has weakened incrementally.Community-based aged services are absent in most areas,while older people and their families have to pay out-of-pocket expenses for non-residential services.There is a severe shortage of aged care or nursing home resources in China and those that exist are of low quality and expensive.The staff who work in these facilities rarely have any formal training in aged care.In addition,a market approach to the funding of residential aged care has the potential to create a moral hazard due to the poor regulatory control of aged care in China.While the building of residential aged care homes is seen as the solution to the care of older people in China,older people prefer to age in their own homes and expect the restoration of the family care tradition as well as more government support for them to“age in place”.This approach has the potential to be more cost effective than expensive aged care facilities.Conclusion:Given older people’s preferences,ageing in place,with the provision of community services and family support,potentially provides a fair and financially viable approach to promote healthy ageing and supportive care in China.Further studies are required to identify 1)how ageing in place can be supported by a national strategy,2)the financial arrangements required to fund such an approach,and 3)how to train high quality community-based professionals in both rural and urban areas to support the care of older people.

Measuring the spatial and social characteristics of the architectural plans of aged care facilities

This paper presents a method that combines visibility graph and isovist analyses to investigate the spatia[ and social properties of architectural plans for aged care facilities. The potential of the combined method is examined by measuring the properties of three sets of plans for residential aged care facilities. The first set is a pair of hypothetical, idealized plans, which allegedly reflect the ＂best practice＂ in the industry. The second set comprises a pair of plans for recent Australian designs, and the third set is a pair of plans for South Korean facilities. Results of the computational anatysis of these six plans suggest that social and cultural factors may shape the design of aged care settings and partially explain their international differences. The application of this methodological approach contributes to the understanding of the relation- ship between spaces and their cultural and social properties in the design of aged care facitities.

Health care exploration work for the military empty nest old cadres

In recent years, the retired veteran cadres have grown older and older, and their numbers have also increased year by year. In this case, how to maintain the physical and mental health of empty nest veteran cadre, and further improve the quality of their life has been a realistic problem many primary health care doctors have to face and solve.

Wisdom and Old --age Pension： Reflections on China＇s Elderly Care Model

The care of the elderly is both a human basic human rights and a manifestation of social civilization. ＂Family pension＂ has always been the main pension model in China for thousands of years. However, with the transformation of social structure and population structure, the traditional ＂family pension＂ model is facing increasing challenges. While other emerging ＂institutions pension＂, ＂community pension＂ and failed to become a ＂family pension＂ alternative options, the role is limited. With the development of a variety of integrated technology, a new integrated technology based on the wisdom of the pension model began to emerge, wisdom pension as a new pension model has been in China with a preliminary attempt, it can maximize the elimination of the Chinese labor force The risk of population loss, the greatest extent to meet the needs of the elderly, the risk of dealing with old age, improve pension efficiency, and give the elderly equalization of power and ability, so as to fundamentally enhance the subjectivity of the elderly. But as a new exploration, but also faced with manyproblems, it is worth our in-depth thinking.

传统灸疗法抗衰老研究进展

抗衰老技术的研究一直是人类热衷于探讨的一个有益于人类自身健康的前沿课题。本文在回顾抗衰老技术研究历史基础上,较为详细地介绍了各种衰老的机理学说,重点对祖国医学中传统灸疗法抗衰老的研究进行了较为详细的综述,包括灸疗抗衰老的作用机理研究,灸疗抗衰老的取穴研究,以及灸疗抗衰老的临床应用等方面研究的现状,尤其指出了中医抗衰老的重要意义,及灸疗抗衰老的广阔发展前景。

早期康复护理对老年肺切除术后康复效果的影响

目的:探讨早期康复护理对老年肺切除术后康复效果的影响。方法:将108例老年肺切除患者随机分为康复组和对照组各54例,对照组给予常规护理,康复组在常规护理的基础上增加早期康复护理,包括呼吸训练、咳嗽训练、体位疗法训练、关节运动训练等,比较两组术后肺部并发症、肺功能检查指标及住院时间。结果:康复组肺部并发症、肺功能检查指标及住院时间与对照组比较均有极显著性差异(P<0.01)。结论:对老年肺切除患者采用早期康复护理,可减少肺部并发症的发生,促进患者康复。

炎症因子在老年脓毒性休克早期的改变及对预后的评估价值

目的分析炎症因子在老年脓毒性休克早期的改变及对预后的评估价值。方法分析2014年1月至2016年12月在我院接受治疗的脓毒性休克患者的临床资料。依据患者明确诊断脓毒性休克后的治疗过程中是否死亡分为死亡组及存活组。共纳入观察组(存活组)41例,对照组(死亡组)45例。检测两组患者发病后24h内,外周血白介素-6(IL-6)、C-反应蛋白(CRP)、白介素-10(IL-10)及降钙素原(PCT)。结果死亡组患者外周血PCT、CRP及IL-6水平均显著高于存活组(P<0.01)。两组患者外周血IL-10水平无显著性差异(P>0.05)。ROC曲线分析显示,以56.71ng/L为截点值,IL-6预测脓毒性休克患者病死的敏感性为88.89%,特异性为80.49%,曲线下面积为0.866,优于CRP及PCT。死亡组患者外周血IL-6水平与PCT(r=0.788,P<0.01)及CRP(r=0.436,P<0.01)均呈现显著正相关关系。结论外周血炎症相关指标对老年脓毒性休克的预后判断有一定价值,其中IL-6的预测诊断价值较高。

延伸护理服务对老年糖尿病患者夜间低血糖的影响

目的探讨通过开展延伸护理服务，降低老年糖尿病患者夜间低血糖的发生率。方法先取2015年1月至6月门诊及住院的老年2型糖尿病患者80例，随机将其分为观察组和对照组，每组各40例。观察组最终完成研究38例，对照组39例。对照组给予常规教育，观察组在常规教育的基础上开展延伸护理服务，落实延伸护理服务的实施方案。两组患者均随访6个月后，比较干预后糖化血红蛋白（HbAlc）值、低血糖事件的发生率。结果干预前两组患者HbAlc值及低血糖发生率比较差异无统计学意义（P〉0．05）。干预后观察组HbAlc值、低血糖发生率显著低于对照组（P〈0．001）。结论开展延伸护理服务明显地改善了患者糖代谢指标，有效降低了老年糖尿病患者夜间低血糖发生率，为糖尿病患者的治疗提供了安全保障。

居家护理干预对社区老年高血压患者血压和用药依从性的影响

目的对社区老年高血压患者应用居家护理干预的效果展开观察。方法将本社区78例高血压老年患者随机分为两组,应用居家护理干预的为观察组,采取常规社区护理的为对照组。统计两种护理方法的效果,并进行比较。结果观察组患者的血压控制效果及治疗依从性均显著优于对照组,数据差异有统计学意义(P<0.05)。结论通过对社区老年高血压患者展开居家护理干预,可对其血压进行有效控制,并促进其用药依从性的提高。

情景教学法对大专老年服务与管理专业学生人文关怀品质的影响

目的探讨情景教学法对大专老年服务与管理专业学生人文关怀品质的影响，寻找适合该专业学生人文关怀品质培养的实训教学方法。方法以广州卫生职业技术学院大专老年与服务管理专业学生为研究对象，2013级为对照组，2014级为观察组，在《老年护理学》实训教学过程中，对照组采用以病例讨论为主的教学法，观察组采用情景教学法；实训前后对2组学生均使用护士人文关怀品质问卷进行测评，比较、分析、评价情景教学法对大专老年服务与管理专业学生人文关怀品质的影响。结果人文关怀品质总分和理念、能力、知识、感知维度得分，实训前2组得分比较差异无统计学意义（P〉0．05）；实训后，观察组得分分别为（110．52±9．40）、（21．94±5．87）、（23．39±5．38）、（23．06±5．11）、（27．42±6．44）分，高于对照组的（88．24±7．08）、（16．62±5．03）、（16．91±4．61）、（17．06±5．24）、（18．38±5．33）分，2组比较差异有统计学意义（t=-10.0713—-3．903，P〈0．01）；且优于本组实训前得分，差异有统计学意义（t=-0．550--0．232，P〈0．01）。结论情景教学法可以提升大专老年服务与管理专业学生的人文关怀品质，可作为培养该专业学生人文关怀品质的一种实训教学方法。