Cardiovascular risk factors among older persons with cognitive frailty in middle income country

BACKGROUND Cognitive frailty,characterized by the coexistence of cognitive impairment and physical frailty,represents a multifaceted challenge in the aging population.The role of cardiovascular risk factors in this complex interplay is not yet fully understood.AIM To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.METHODS A comprehensive approach was employed,with a total of 512 communitydwelling older persons aged 60 years and above,involving two cohorts of older persons from previous studies.Datasets related to cardiovascular risks,namely sociodemographic factors,and cardiovascular risk factors,including hypertension,diabetes,hypercholesterolemia,anthropometric characteristics and biochemical profiles,were pooled for analysis.Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score.Cardiovascular risk was determined using Framingham risk score.Statistical analyses were conducted using SPSS version 21.RESULTS Of the study participants,46.3%exhibited cognitive frailty.Cardiovascular risk factors including hypertension(OR:1.60;95%CI:1.12-2.30),low fat-free mass(OR:0.96;95%CI:0.94-0.98),high percentage body fat(OR:1.04;95%CI:1.02-1.06),high waist circumference(OR:1.02;95%CI:1.01-1.04),high fasting blood glucose(OR:1.64;95%CI:1.11-2.43),high Framingham risk score(OR:1.65;95%CI:1.17-2.31),together with sociodemographic factors,i.e.,being single(OR 3.38;95%CI:2.26-5.05)and low household income(OR 2.18;95%CI:1.44-3.30)were found to be associated with cognitive frailty.CONCLUSION Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty,a prodromal stage of dementia.Early identification and management of cardiovascular risk factors,particularly among specific group of the population might mitigate the risk of cognitive frailty,hence preventing dementia.

On the Rule of Law Path for Inclusive Education to Empower Education Assistance for Persons with Disabilities

Inclusive education is the mainstream of developing education for persons with disabilities worldwide.It advocates the recognition and protection of the right of persons with disabilities to receive inclusive education in mainstream schools.From the perspective of inclusive education,the educational assistance system for persons with disabilities represents a theoretical innovation in traditional educational support methods,playing a crucial role in integrating persons with disabilities into society,reversing their disadvantaged status,and maintaining educational equity.At present,China's legal system for inclusive education assistance for persons with disabilities needs improvement,and faces several obstacles,including conceptual“limited capacity”,“monotonous”subjects,“crowding-out”obstacles and supervision“absence”obstacles.It is urgent to begin with the transformation of the rule of law concept,clarify the legal positioning of multiple responsibility subjects,achieve mutual reinforcement of education law and education aid legislation,establish a supervision system for inclusive education assistance,and improve the legal framework for educational assistance for persons with disabilities.This will ensure that persons with disabilities can successfully realize their right to education,share in the benefits of social development,and ultimately contribute to achieving common prosperity.

Challenges and Demands for College English Teachers Raised by Training All-round Qualified Persons

The latest issue of College English Curriculum Requirements has posed challenges and demands for teachers in terms of linguistic competence, academic knowledge, language skills, professional morality, emotional and attitudinal qualifications, etc., which requires teachers to embrace and handle with active and open-minded responses. Hence, teachers ought to strive to develop and improve their own overall qualifications in collaboration with the long-term development of the subject and of the national higher education, with the need of qualified persons demanded by social development and the students＇ learning. Teachers also ought to form a notion of scientific development by keeping pace with the time, so as to discern the trend of subject development, to form appropriate judgments concerning the social development and to properly regulate their own development.

多主体协同开发社区教育课程的PERSONAL模式探索——基于“我爱我家”的个案研究

通过对“我爱我家”这一社区自发课程的跟踪调查,发现社区自发课程开发实质上是一个组织学习过程,经过个体直觉、知识解释、知识整合等环节实现组织的制度化学习,在推动学习型无边界组织生成的同时,生成社区教育课程。在这一过程中,政策(policies)支持、专家(expert)指导、区域需求和区域特征(regional)、社区系统(system)、组织化(organization)等多要素叠加发挥作用,通过不断拓展新鲜(new)领域的积极行动(action)整合所有资源,并推动跨越边界的学习(learning)贯穿始终。因此,多主体协同的社区自发课程可以不完全地概括为PERSONAL模式。要以PERSONAL模式发展社区自发课程,需要以学习者为中心,注重发展人际互动,营造有利于跨组织交互学习的教育生态系统。

Eligibility of persons who inject drugs for treatment of hepatitis C virus infection

In this decade, an increase is expected in end-stageliver disease and hepatocellular carcinoma, most commonly caused by hepatitis C virus(HCV) infection.Although people who inject drugs(PWID) are the ma-jor source for HCV infection, they were excluded fromantiviral treatments until recently. Nowadays there isincontrovertible evidence in favor of treating these patients, and substitution therapy and active substanceuse are no longer contraindications for antiviral treatment. The viral clearance in PWID after HCV antiviraltreatment with interferon or pegylated interferon combined with ribavirin is comparable to the viral clearancein non-substance users. Furthermore, multidisciplinary approaches to delivering treatment to PWID are advised, and their treatment should be considered on anindividualized basis. To prevent the spread of HCV inthe PWID community, recent active PWID are eligiblefor treatment in combination with needle exchange programs and substitution therapy. As the rate of HCV reinfection is low after HCV antiviral treatment, there is no need to withhold HCV treatment due to concerns about reinfection alone. Despite the advances in treatment efficacies and data supporting their success, HCV assessment of PWID and initiation of antiviral treatment remains low. However, the proportion of PWID assessed and treated for HCV is increasing, which can be further enhanced by understanding the barriers to and facilitators of HCV care. Removing stigmatization and implementing peer support and group treatment strategies, in conjunction with greater involvement by nurse educators/practitioners, will promote greater treatment seeking and adherence by PWID. Moreover, screening can be facilitated by noninvasive methods for detecting HCV antibodies and assessing liver fibrosis stages. Recently, HCV clearance has become a major endpoint in the war against drugs for the Global Commission on Drug Policy. This review highlights the most recent evidence concerning HCV infection and treatment strategies in PWID.

Hepatitis C virus control among persons who inject drugs requires overcoming barriers to care

Despite a high prevalence of hepatitis C virus(HCV)infection,the vast majority of persons who inject drugs(PWID)have not engaged in HCV care due to a large number of obstacles.Education about the infection among both PWID and providers remains an important challenge as does discrimination faced by PWID in conventional health care settings.Many providers also remain hesitant to prescribe antiviral therapy due to concerns about adherence and relapse to drug use resulting in reinfection.Presently,however,as a result of improvements in treatment efficacy combined with professional society and government endorsement of HCV treatment for PWID,a pressing need exists to develop strategies to engage these individuals into HCV care.In this article,we propose several strategies that can be pursued in an attempt to engage PWID into HCV management.We advocate that multidisciplinary approaches that utilize health care practitioners from a wide range of specialties,as well as co-localization of medical services,are strategies likely to result in increased numbers of PWID entering into HCV management.Pursuit of HCV therapy after stabilization through drug treatment is an additional strategy likely to increase PWID engagement into HCV care.The full impact of direct acting antivirals for HCV will only be realized if innovative approaches are pursued to engage all HCV infected individuals into treatment.

Challenges and New Directions of Information Accessibility for Persons with Disabilities in China: From the Perspective of the Convention on the Rights of Persons with Disabilities

Accessibility is the basis and prerequisite for persons with disabilities to enjoy and exercise all human rights and fundamental freedoms With the rapid development of the internet, providing and promoting information accessibility is considered an important obligation for the State In the process of transforming international human rights law into domestic law, how to deal with the human rights protection of persons with disabilities and the obligations of the private sector to ensure persons with disabilities receive services and products that meet the requirements and principles of information accessibility has become a development issue in the new era Against the backdrop of the Convention on the Rights of Persons with Disabilities and in the context of the booming development of the cause of persons with disabilities in China, legal scholars, persons with disabilities, and organizations have jointly proposed the Beijing Initiative on the Principles of Information Accessibility for Science and Technology Products It clarifies that the private sector should embrace the human rights model advocated by the Convention in terms of information accessibility, and provide equal participation for persons with disabilities in the process of designing, producing and selling scientific and technological products The Initiative also states that the private sector should keep pace with the United Nation’s sustainable development goals and the basic national policy of building a well-to-do society in an all round way, ensuring persons with disabilities are included within a moderately well-off society It also provides civil opinions on the formulation and clarification of relevant laws in the future.

Basic studies on life circumstances and stress in persons with congenital physical disabilities using always wheelchairs

Many studies about the health problems of persons with physical disabilities have been performed, however few studies have focused on the life circumstances of persons with physical disabilities. This study aimed to clarify the relationship between stress and the life circumstances of persons with congenital physical disabilities who must use wheelchairs. The participants were 70 individuals who used the services of care workers employed by welfare service business offices. Participants used wheelchairs. In addition, those participants who used a standard manual wheelchair were not able to operate it alone. Participants were required to answer a two-part questionnaire with questions about factors related to basic lifestyle and stress, and about life factors related to the stress of individuals with physical disabilities. No significant relationship between lifestyle and stress was found in either males or females. Most persons with congenital physical disabilities using wheelchairs had some kind of stress in daily life. In particular, significantly more level of stress was found in females (90%) than that in males (65%). Levels of stress according to life factor differed between males and females. The most dramatic gender difference was that the level of stress caused by the mental or mind factor in females was significantly higher than that in males (p < 0.05). Most persons who must use wheelchairs have stress resulting from daily life, and in particular, females experience more mental stress than males.

Prevalence of <i>Helicobacter pylori</i>Infection among Internally Displaced Persons from Bakassi Peninsular and Etim Ekpo in South Southern, Nigeria

Helicobacter pylori (H. pylori), is an important global infection with a worldwide prevalence of about 40 percent. This infection is contagious and mostly acquired during childhood through the fecal-oral and oral-oral route. A total of 1560 blood specimens were aseptically collected from Internally Displaced Persons comprising female and male from the warring communities of Bakassi Peninsular and Etim Ekpo Local Government Area in South Southern, Nigeria. The specimens were screened for H. pylori using Elisa kits following standard serological techniques. The overall prevalence rate was 464 (29.7%). There was significant difference (p H. pylori infection;its distribution varied between age group, educational status, habits or behaviors of the subjects with children within 5 to 14 years having the highest rate of 274 (17.6%), followed by 78 (4.99%) from adults (51 years and above) and 17 (1.08%) from active age range of 36 - 45 years old. Subjects with primary and quranic level of education showed a total of 274 (17.56%) positive cases to H. pylori. Analysis of sex-specific distribution revealed that females had the highest prevalence of 312 (20%). The helicobacter infection shows a significant difference at (p H. pylori infection. Crowding in camps and increasing household contact have been considered as risk factors of H. pylori infection. Adequate infrastructural provision and availability of portable water with good hygienic environment will drastically reduce the high rate spread of H. pylori bacterium in the IDPs communities in Nigeria.

Personal Thermal Management by Radiative Cooling and Heating

Maintaining thermal comfort within the human body is crucial for optimal health and overall well-being.By merely broadening the setpoint of indoor temperatures,we could significantly slash energy usage in building heating,ventilation,and air-conditioning systems.In recent years,there has been a surge in advancements in personal thermal management(PTM),aiming to regulate heat and moisture transfer within our immediate surroundings,clothing,and skin.The advent of PTM is driven by the rapid development in nano/micro-materials and energy science and engineering.An emerging research area in PTM is personal radiative thermal management(PRTM),which demonstrates immense potential with its high radiative heat transfer efficiency and ease of regulation.However,it is less taken into account in traditional textiles,and there currently lies a gap in our knowledge and understanding of PRTM.In this review,we aim to present a thorough analysis of advanced textile materials and technologies for PRTM.Specifically,we will introduce and discuss the underlying radiation heat transfer mechanisms,fabrication methods of textiles,and various indoor/outdoor applications in light of their different regulation functionalities,including radiative cooling,radiative heating,and dual-mode thermoregulation.Furthermore,we will shine a light on the current hurdles,propose potential strategies,and delve into future technology trends for PRTM with an emphasis on functionalities and applications.

Shareholding Networks for Care in Rural Thailand: Experiences of Older Persons and Their Family Members

Most members of the older population in Thailand live in rural areas while their children live in cities. With the joint family system separated, elderly Thai persons often have to care for themselves, and opportunities for them to get involved in community care remain limited. In response, the aim of this study was to describe older persons’ and their family members’ experiences with shareholding networks for the care of older people in rural Thailand. Paired interviews with five older persons and five of their family members were conducted, and collected data were subjected to content analysis, which yielded results organized around two themes: older persons’ outsider status and disregard for older persons’ individuality. Whereas the theme of outsider status describes shortcomings in healthcare encounters, the theme of disregard for individuality describes the lack of engagement of authorities and caregivers in older persons’ care. In that sense, the concept of participation emerged as a framework for understanding interviewees’ experiences. Given findings from local authorities, older individuals and their family members should engage in dialogue in order to support healthcare based on shared understanding.

Critical Appraisal Focusing on Tuberculosis Risks among Displaced Persons: Do We Have a Smoking Gun?

The UNHCR 2017 report stated that about 44,400 people are displaced from their homes daily and about 68.5 million people are currently displaced globally. This article aims at critically analyzing the tuberculosis risks among displaced people especially as there is an increase in the number of migrants globally and proliferation of man-made and natural disasters. Research conducted among displaced persons and most of the studies concluded that active surveillance and proper case follow-up are the best ways to ensure adequate tuberculosis case management. In conclusion, the application of diverse methods in tackling tuberculosis risks should be especially through a culturally, acceptable precise and feasible plans without compromising international standards.

Accessibility and availability of health care services to internally displaced persons, in Kitgum and Pader districts, northern Uganda

Introduction: During 1986-2009, an estimated 1.6 million persons were internally displaced from northern and eastern regions of Uganda due to civil war. We investigated accessibility to and availability of health care services for the internally displaced persons in Kitgum and Pader districts, northern Uganda. Methods: This was a cross-sectional study conducted in Kitgum and Pader districts, northern Uganda. We interviewed a total of 1383 respondents comprising 968 (70%) adults and 415 (30%) adolescents;60% were females and 40% males, randomly selected from 35 of 67 (52.2%) internally displaced persons (IDP) camps. We held 27 key informant interviews and 52 focus group discussions. Data were entered in EPI data version 3.02 and analysed using SPSS version 12.00 statistical packages. Findings: Two thirds of the respondents 67.5% lived within 5 km distance of a health facility. The majority 62.9% of respondents mentioned that health related information was readily provided. 43.5% of health providers were always available in a health facility. A quarter 25.1% of health facilities always had drugs available, while 56.9% of the drugs prescribed were always available. Two thirds of the respondents 65.9% were satisfied with the health care services provided. The main reasons for the choice of a health facility were proximity 29.6%, provision of free treatment 24.7% and availability of drugs 17.2%. Main barriers to health care access were due to the lack of financial resources, trained personnel, and inadequate drugs and supplies in the health facilities. Conclusions and Recommendations: The majority of IDPs lived in close proximity to health facilities and obtained health care services from public health facilities. Access to health care was determined mainly by proximity and availability of free services and drugs. Although geographic accessibility to health services was high, lack of finances, information and decision power hindered access to health care services.

Caring for Older Persons in a Technologically Advanced Nursing Future

As people live longer, a larger percentage will live with multiple chronic conditions and functional impairments such as difficulties with activities of daily living, mobility, and the management of one’s household. The purpose of this paper is to examine the care of older persons in a technologically advanced nursing future by discussing roles and responsibilities of nurses who practice gerontological nursing, and explaining how a technologically advanced future would change the delivery of home health care for older persons in the community. The theory of Technological Competency as Caring in Nursing grounds 3 processes of nursing as knowing persons as caring, wholeness is oneness, and caring as a multi-dimensional process. Harnessing technology for the health of older persons would enable them to live independently, socially engaged, and safely. A technologically advanced nursing future leads to concomitant sustainable disruptive and frugal innovations in healthcare. Nurses in practice must take advantage of these disruptions and consider frugal innovations as the futures of nursing education, practice, and research are here.

Does Facility Based Sexual and Reproductive Health Services Meet the Needs of Young Persons? Views from Cross Section of Ghanaian Youth

The focus on facility based health setting to provide sexual and reproductive health to the youth has been tested in several settings and achieved varying results. This study examined whether facility based sexual and reproductive health services met the needs of Ghanaian youth. Adopting the descriptive cross sectional design, 170 youths between the ages of 10 and 24 were sampled. A three-stage stratified random sampling technique was adopted. The results of the study are presented using descriptive statistics. The study established that a total of 55.8% (95/170) of the youth had utilized at least one or more of a sexual and reproductive health service in life time. However, only 45.2% (43/95) of youth used or accessed sexual and reproductive health services from a facility based setting. Facility based sexual and reproductive health service provided specifically for the youth is very limited. This calls for the provision of out-of health facility services located within the communities and at strategic places while ensuring confidentiality to the youth. More rigorous research is recommended on a national scale to examine youth preference for the type of facility based and out-of-facility based sexual and reproductive health services to meet the needs of young people.

Dynamic Hand Gesture-Based Person Identification Using Leap Motion and Machine Learning Approaches

Person identification is one of the most vital tasks for network security. People are more concerned about theirsecurity due to traditional passwords becoming weaker or leaking in various attacks. In recent decades, fingerprintsand faces have been widely used for person identification, which has the risk of information leakage as a resultof reproducing fingers or faces by taking a snapshot. Recently, people have focused on creating an identifiablepattern, which will not be reproducible falsely by capturing psychological and behavioral information of a personusing vision and sensor-based techniques. In existing studies, most of the researchers used very complex patternsin this direction, which need special training and attention to remember the patterns and failed to capturethe psychological and behavioral information of a person properly. To overcome these problems, this researchdevised a novel dynamic hand gesture-based person identification system using a Leap Motion sensor. Thisstudy developed two hand gesture-based pattern datasets for performing the experiments, which contained morethan 500 samples, collected from 25 subjects. Various static and dynamic features were extracted from the handgeometry. Randomforest was used to measure feature importance using the Gini Index. Finally, the support vectormachinewas implemented for person identification and evaluate its performance using identification accuracy. Theexperimental results showed that the proposed system produced an identification accuracy of 99.8% for arbitraryhand gesture-based patterns and 99.6% for the same dynamic hand gesture-based patterns. This result indicatedthat the proposed system can be used for person identification in the field of security.

Effects of Depth of Needle Insertion with Risperidone Long-Acting Injectable in Persons with Schizophrenia: A Randomized Double-Blind Study

In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.

Living Arrangements and Conditions of Older Persons in Namibia

In Africa, ageing is a phenomenon that is just beginning to reveal its shape. Most governments, including the Namibian government, recognize the fact that the number of older persons is on the increase, however, discussing it is still a distant phenomenon and family matter. This paper examines the living arrangements of older adults in Namibia, identifying the existing structure of living arrangements and the nature of family relationships of older people, as well as provides some basic descriptive information on the housing conditions in which older persons live and how they are associated with their socioeconomic and demographic factors. The analysis is based on 1991, 2001 and 2011 Namibia Population and Housing Censuses. The study concluded that living arrangements is constantly changing from extended family pattern to western nuclear family, mainly due to urbanization and decreased fertility rate. Housing conditions had notably improved in rural areas while in urban areas the conditions are affected by the mushrooming of informal settlements. There is need to encourage or conduct focused research on ageing to help coin policies based on evidence and make communities sensitive towards ageing. The study further recommends Government to encourage old people to form organizations that would in turn focus on sensitizing and help championing issues of ageing and aged persons.

Psychosocial and Sociodemographic Predictors of Depression among Older Persons in Jordan

The average annual growth rate for the ageing population is increasing considerably. The purpose of this study is to examine the psychosocial predictors of depression among older persons in Jordan. Methods: A quantitative approach using cross-sectional, descriptive-correlational design was used to carry out on a nationally representative, stratified multistage clustered area probability sample of non-institutionalized adults (aged ≥ 60 years). Data collected using self-report (structured format) of data collection. Data collected in regards to depression, social support, life satisfaction, and psychological distress. Results: About 55.5% of the participants have none to slight depressive symptoms, 22% of them have mild depressive symptoms, 17.3% of them have moderate depressive symptoms, and only 5.2% of them have severed depressive symptoms. Older persons have moderate levels of life satisfaction, perceived social support and psychological distress. Type of diagnosis was not a significant predictor of depressive symptoms as it was in model 1 while working status and marital status remained significant predictors. In addition, perceived social support total (β = -1.98, 0.016), psychological distress (β = 0.465, β = -0.284, <0.001) were significant predictors of depressive symptoms. Conclusion: Effective, community-level primary mental health care for older people is crucial, and its recommended to equally focus on the long-term care of older adults suffering from mental health problems, as well as to provide caregivers with education, training and support.

Four Hurried Persons

2. Hearing this, theshop-owner rushed to himwith a bowl of dry noodlesand threw the noodles onthe table, "Be quiek,"saidthe shop-owner. "I have toclean the bowl and thetable, I don't want to wait."