Recovery after ischemic stroke:Effects of FuekFone home-based program on upper limb and cognitive function

Objectives:This study aimed to explore the effects of the“FuekFone(F.F.)home-based program”on the upper limb and cognitive function of ischemic stroke patients after discharge.Methods:A single group pre-and post-test design was conducted.A total of 40 patients with recovery after ischemic stroke were recruited from two university hospitals in Thailand.The study was conducted between June 2022 and January 2023.Participants underwent a six-week“F.F.home-based program,”which combined an upper limb and cognitive function rehabilitation device with Android games,including stationary barrel,adventure walk,adventure stroll,sliding barrel,sauce squeeze,and cut objects.Each game has different difficulty levels.Patients can perform corresponding exercises through the games according to their conditions under the guidance of medical staff.The patients played for 24 min per time,4 min each game,three days a week.The second week,let the patients play games for 30 min per time,5 min each game,3 days a week.Then,in the 3e6 weeks,let the patients play games for 1 h per time,10 min each game,5 days a week.At the pre-and post-intervention,the Thai version of the National Institutes of Health Stroke Scale(NIHSS),the Motor Assessment Scale,and the Montreal Cognitive Assessment(MoCA score)were administered to patients at discharge and at 2,4,and 6 weeksafter discharge,and the results were compared.Results:All participants completed this program.Participants had statistically improved upper limb function(upper arm function score,hand movements score,advanced hand activities score,total Motor Assessment Scale score)and MoCA score at 2,4,and 6 weeks after discharge(P<0.001).In the comparison of upper limb function and cognitive function at each of the study times,we found statistically improved upper limb function(upper arm function score,hand movements score,advanced hand activities score,total Motor Assessment Scale score)and MoCA score at 4,and 6 weeks after discharge when compared to after discharge and 2 weeks after discharge,respectively(P<0.05).Conclusions:Continuing care of patients post-stroke after discharge from hospital,such as F.F.homebased program should be applied at home to enhance upper limb and cognitive function.

Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.

Analysis of Distribution of Public Toilets within Walking Range around Communities of the Elderly under the Model of Community Home-based Care for the Elderly: A Case Study of Changxindian, Fengtai District, Beijing

In recent years,under the influence of multiple factors such as traditional ideas and living economic conditions,the aging population in China continues to increase.Most of the elderly are more inclined to aged at home,and the first places for elderly activities are communities and the surrounding environment,which greatly affects the convenience of life and happiness of the elderly.In this paper,Changxindian area in Fengtai District of Beijing was as the research object,and detailed calculation and analysis were carried out by using POI data and arcGIS software.The relative location of residential areas and surrounding public toilets was explored,and the best location of public toilets in the daily walking area under the model of community home-based care for the elderly was further studied.

A Review of Device-Free Indoor Positioning for Home-Based Care of the Aged:Techniques and Technologies

With the development of urbanization,the problem of neurological diseases brought about by population aging has gradually become a social problem of worldwide concern.Aging leads to gradual degeneration of the central nervous system,shrinkage of brain tissue,and decline in physical function in many elderlies,making them susceptible to neurological diseases such as Alzheimer’s disease(AD),stroke,Parkinson’s and major depressive disorder(MDD).Due to the influence of these neurological diseases,the elderly have troubles such as memory loss,inability to move,falling,and getting lost,which seriously affect their quality of life.Tracking and positioning of elderly with neurological diseases and keeping track of their location in real-time are necessary and crucial in order to detect and treat dangerous and unexpected situations in time.Considering that the elderly with neurological diseases forget to wear a positioning device or have mobility problems due to carrying a positioning device,device-free positioning as a passive positioning technology that detects device-free individuals is more suitable than traditional active positioning for the home-based care of the elderly with neurological diseases.This paper provides an extensive and in-depth survey of device-free indoor positioning technology for home-based care and an in-depth analysis of the main features of current positioning systems,as well as the techniques,technologies andmethods they employ,fromthe perspective of the needs of the elderly with neurological conditions.Moreover,evaluation criteria and possible solutions of positioning techniques for the home-based care of the elderly with neurological conditions are proposed.Finally,the opportunities and challenges for the development of indoor positioning technology in 6G mobile networks for home-based care of the elderly with neurological diseases are discussed.This review has provided comprehensive and effective tracking and positioning techniques,technologies and methods for the elderly,by which we can obtain the location information of the elderly in real-time and make home-based care more comfortable and safer for the elderly with neurological diseases.

Home-based nursing for improvement of quality of life and depression in patients with postpartum depression

BACKGROUND Postpartum depression is a common mental illness in puerpera,with an incidence of approximately 3.5%-33.0%abroad,and the incidence of postpartum depression in China is higher than the international level,reaching 10.0%-38.0%.Providing effective nursing care in clinical nursing activities is one of the key points of obstetrical care.However,little research has been designed to investigate the positive role of home-based nursing in the prevention of postpartum depression.AIM To study the effect of home-based nursing for postpartum depression patients on their quality of life and depression.METHODS The clinical data of 92 patients with postpartum depression treated at our hospital were retrospectively analyzed.The patients were grouped according to the nursing methods used;40 patients receiving basic nursing were included in a basic nursing group,and 52 receiving home-based nursing were included in a home-based nursing group.Depression and anxiety were evaluated and compared between the two groups.The estradiol(E2),serotonin(5-hydroxytryptamine,5-HT),and progesterone(PRGE)levels were measured.RESULTS The SAS and SDS scores of the home-based nursing group were significantly lower than those of the basic nursing group(P<0.05).The E2 and 5-HT levels of the home-based nursing group were significantly higher than those of the basic nursing group,but the PRGE level was significantly lower than that of the basic nursing group.The GQOLI-74 scores(material,social,somatic,and psychological)and nursing satisfaction were significantly higher in the home-based nursing group(P<0.05).CONCLUSION Postpartum depression through home-based nursing can effectively alleviate depression and improve the quality of life of patients,help modulate their serum E2,5-HT,and PRGE levels,and improve their satisfaction with nursing care.

Evaluation of the intervention of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Objective:Chronic obstructive pulmonary disease(COPD)can be prevented and treated,although presenting with persistent airflow restriction;the airflow restriction caused by COPD is mostly progressive.In recent years,more attention has been paid to the home-based pulmonary rehabilitation(PR)and its influence on COPD.Exercise training is the basic constituent of PR.However,it is not clear which exercise trainings are the ideal ways to deliver home-based PR.Methods:In this review,we focus on the effect of home-based exercise training on patients with COPD.We searched literature,which was necessarily required to be randomized controlled trails(RCTs)from the establishment of the four respective databases(Medline,PubMed,Web of Science,and China National Knowledge Infrastructure)from January 2008 to January 2018.We used the Cochrane collaborative“risk of bias”tool to assess the quality of evidence.A total of 21 trials(1694 participants)were included.Through the analysis of the literature,we find that a simple,low-cost,and low-intensity family-based lung-rehabilitation plan to adapt to the real life may lead to the improvement of the ability to exercise,the reduction of the difficulty in breathing,and the improvement of carrying out daily activities.Results:In the exercise training of home-based PR,lower limb exercise(LLE)training demonstrated a more perceptible effect in improving the quality of life of patients with COPD.At the same time,the combination of LLE training,breathing training,and upper limb exercise training is more obvious than the simple LLE training.In addition,home-based low-intensity aerobic training may sometimes be no less than the outpatient or center intervention to improve dyspnea,health status,and exercise tolerance.In conclusion,the simple and easy home-based PR exercise program is useful.Long-term home-based PR may require an enhanced need for maintenance.Conclusions:A simple,low-cost,and low-intensity high blood pressure response(HBPR)plan to adapt to the real life may lead to an augmentation in the ability to exercise,a reduction of the difficulty in breathing,and an improvement in carrying out day-to-day activities.HBPR strategies can benefit patients(elderly patients with COPD at home)in the long term.

Feasibility and acceptability of wrist actigraph in assessing sleep quality and sleep quantity: A home-based pilot study in healthy volunteers

Purpose: This study aimed to determine the feasibility and acceptability of actigraphy to monitor sleep quality and quantity in healthy self-rated good sleeper adults at home-based settings. Method: Sixteen healthy volunteers (age > 18) were invited to participate. Each participant was provided with a wrist actigraph device to be worn for 24-hour/day for seven consecutive days to monitor their sleep-wake patterns. Actigraphy data were downloaded using-proprietary software to generate an individual-sleep report. Participants also completed a set of self-reported Health Related Quality of Life (HRQOL) using WHO (five) Well Being Index (WBI) questionnaires. Results: Actigraphy was well accepted by all participants. Only 43.8% of the participants achieved normal total sleep time (TST) and 62.5% had a mean sleep efficiency value below the normal range. Despite a reduced quality of sleep among the participants, the self-reported HRQOL scores produced by the WHO-5 WBI showed a “fair” to “good” among the participants. Conclusions: To maintain healthy well-being, it is vital to have efficient and quality sleep. Insufficient and poor sleep may contribute to various health problems and hazardous outcomes. People often believe they have normal and efficient sleep, not realising they may be developing poor sleep habits. This study found that actigraphy can be easily utilized to monitor sleep-wake patterns at home-based settings. We proposed that actigraphy could be adapted for use in the primary care settings (e.g. community pharmacy) to improve the sleep health management in the community.

Self-management A concept analysis of self-management for cancer patients’ home-based rehabilitation

Objective： To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method： Walker and Avant’s framework （2011） was used to analyse the concept of self-management.Results： Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion： According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Functional outcomes after home-based rehabilitation for heroin-induced spongiform leukoencephalopathy

A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments. Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge. His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge. These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.

Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison

Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based participants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p < 0.001) and WHR (p 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.

Reported National Level Stock-Outs of Home-Based Records—A Quiet Problem for Immunization Programmes That Needs Attention

Home-based records (HBRs) are an important tool for recording and communicating within primary healthcare service delivery. Unfortunately, HBRs are currently unable to fulfil their intended purpose in many communities either because the HBR is not functionally well-designed to serve its objectives, not made available, not fully adopted and/or not appropriately utilized by caregivers and/or health workers. This brief report describes the occurrence of nationally reported HBR stock-outs and HBR financing patterns during 2014 and 2015 across 195 countries reporting immunization system performance data to the World Health Organization and United Nations Children’s Fund. National level HBR stock-outs were reported by 19 and 22 countries during 2014 and 2015, respectively, with eleven countries reporting stock-outs during both 2014 and 2015. During 2015, 12 of the 22 countries reporting HBR stock-outs were from the African Region and two-thirds of the countries were Gavi-eligible. Information on HBR stock-outs was either not available or not reported by 66 countries (19 were Gavi-eligible) for 2014 and 53 (11 were Gavi-eligible) countries for 2015. Among the 22 countries reporting HBR stock-outs in 2015, 12 (54%) countries reported a single HBR financing source, and nine (41%) countries reported more than one source for HBR financing. The occurrence of HBR stock-outs remains a concern, particularly in Gavi-eligible countries introducing new vaccines where dedicated funding is received for revising and printing new recording tools, including HBRs. Additional attention is needed to understand the root causes for stock-outs and identify solutions to ensure a well-designed, durable HBR is readily available in the right quantity, in the right place at the right time in all countries.

Research Progress on the Home-based Healthcare Plan for the Elderly with Chronic Diseases

Objective:To develop a home-based care plan for the elderly person with chronic diseases based on the status of their home-based care needs and relevant literature.Methods:The clinical data consisted of 132 patients who were 60-year-old or older with chronic diseases from June 2019 to May 2020 were selected and categorized into control and treatment groups of 66 patients each.For the experimental group,a care team for chronically ill elderly receiving regular post-treatment bome-based care.Meanwhile,a general clinical care team for chronically ill elderly receiving regular treatment for the control group.The effectiveness of these two healthcare models was evaluated and analyzed.Results:Results showed that satisfaction and effectiveness of home-based care among the elderly with chronic diseases were statistically better(P<0.05)than those in the usual care group.Conclusion:Providing home-based care services to elderly patients with chronic illnesses helps them to improve their chronic disease condition,patients are more receptive to home care,and patients have higher rates of recovery and treatment satisfaction.

Meta-analysis of the willingness rate of community home-based care in China

Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the willingness of the elderly in the community to provide for the aged from 2011 to 2021,extracted the data,and evaluated the quality of the included literature.Then,CMA 2.0 software was used for Meta-analysis.Results:A total of 13 articles were included in this study,and 16,402 people over 60 years old were surveyed,1782 people were willing to provide for the aged at home in the community,with a total willingness rate of 11%(95%CI:9%to 26%).The results of subgroup analysis showed that there was a statistically significant difference in the community home care willingness rate of elderly people with different gender,education levels,marital status,monthly income,living alone,the number of children,and residence(P<0.05).There was not any statistically significant difference in the willingness rate of the elderly with different ages,chronic diseases,self-care ability,and loneliness(P>0.05).Conclusion:The overall willingness rate of the elderly in the community of the elderly is relatively low in China.Gender,education level,marital status,monthly income,living alone,number of children,and residence are factors affecting the prediction of community elderly will.

The Potential of Commercial Pension Insurance to Develop into One of the Pillars of Rural Pension Insurance:A Study from the Demand Perspective

The development of a multi-pillar pension insurance system is an effective solution for an aging society.Commercial pension insurance,as the third pillar of pension insurance,is an integral part of this system in China and can play a critical and complementary role in rural areas where support for the elderly is a more pressing concern and a second pillar of pension insurance remains absent.To this end,we first elaborate on the theoretical logic that commercial pension insurance can develop into one of the pillars of rural pension insurance.We then empirically test rural residents’willingness to participate in a commercial pension insurance plan(CPIP)in a probit model with household research data from rural areas in major labor-exporting provinces,such as Sichuan and Henan so as to explore whether commercial pension insurance has the potential to become one of the pillars of rural pension insurance.Our research findings can be synthesized in three points.First,rural residents out of agricultural production for five consecutive years are more willing to participate in a CPIP than other rural residents,indicating that progress in industrialization and urbanization can significantly boost such willingness.Second,the younger rural residents are more inclined to participate in a CPIP than the older generation.Third,income increases can significantly boost rural residents’willingness to participate in a CPIP.Thus,with progress in industrialization and urbanization and an increase in rural disposable income,commercial pension insurance has a promising potential in rural areas and can hopefully develop into one of the pillars of rural pension insurance.

HOME-BASED MEDICAL SERVICES GET POPULAR IN LHASA

Whenever anybody feels uncomfortable,a doctor,once called,will immediately come to provide his or her services.As part of the new wave of doctors providing their services to smaller communities,"homebased doctors"are gradually being introduced to common civilian homes.At present,Lhasa City has been positively promoted the home-

个人养老金税收优惠政策何以可为?——来自美国、德国和澳大利亚的经验与启示

发展个人养老金是健全养老保险体系和积极应对人口老龄化挑战的重要举措,而灵活高效的税收优惠政策则是推动个人养老金制度高质量发展的关键要素。虽然近年来我国制定了个人养老金税收优惠政策,但是仍存在诸多问题,严重掣肘个人养老金制度的高质量发展。基于文献研究法、比较分析法对美国、德国和澳大利亚等典型国家个人养老金税收优惠政策的主要实践、基本特征、实施效果以及对中国的启示等重要问题进行深入探讨。研究发现,经过数十年的积极探索,美国、德国和澳大利亚逐步建立了灵活高效的个人养老金税收优惠政策,主要体现在激励方式灵活多样、政策制定立法先行、政策调整循序渐进、关注低收入群体的需求以及鼓励以家庭为参保对象等五个方面,有效推动了其个人养老金制度的发展与成熟。不过,这些典型国家个人养老金税收优惠政策在取得瞩目成就的同时,仍然面临对低收入群体的吸引力不足等现实困境。结合典型国家的有益经验和深刻教训,对我国个人养老金税收优惠政策存在的主要问题进行剖析,并提出更具针对性的见解,认为我国个人养老金税收优惠政策应当从四个方面作出改进:一是引入多种税收优惠模式,增强政策的吸引力;二是凸显税收优惠政策的精准性,助推优惠资源向低收入群体倾斜;三是提升税收优惠政策的灵活性,鼓励个人合理配置税收优惠额度;四是税收优惠政策应支持以家庭形式参保。

养老保险省级统筹对养老保险基金平衡的影响研究

提高基本养老保险统筹层次是增强养老金支付能力的重要改革举措,也是实现养老金制度安全规范发展的关键。文章基于养老保险省级统筹改革的准自然实验,利用2008-2019年中国A股上市公司数据,构建双重差分模型实证评估了养老保险统筹改革对企业实际缴费率及基本养老保险基金平衡的影响。研究发现:省级统筹显著降低了企业养老保险实际缴费率,该结果在更改变量度量方式、排除竞争性解释、考虑异质性处理效应等一系列稳健性检验中仍然成立。养老保险省级统筹在不同征管模式、企业类型及地区层面对企业养老保险实际缴费率存在异质性影响,对于社保征收和税务代征模式、劳动密集度高的企业、所在地区老龄化程度低和财政压力小的企业影响更明显。机制分析发现,市县政府由于“相对剥夺效应”和“逐底竞争效应”所产生的征管强度不足是造成省级统筹改革后企业缴费率下降的重要因素。进一步分析表明,省级统筹改革降低了基金收支平衡,并对中西部省份影响更明显。研究对于加强地方政府征管治理、促进养老保险基金平衡发展具有重要启示,为征管主体间利益关系的平衡及养老保险全国统筹的顺利推进提供了经验证据。

Innovative Development Path of the Pension Model Under the Background of the Aging Society: Taking Chongqing as an Example

The aging society has dawned on China,and the pension industry is now considered to be a sunrise industry.In 2020,the number of people over the age of 65 in Chongqing had reached more than 5.47 million.At present,the mainstream home-based care,children support,and institutional care cannot fully meet the needs of the elderly for food,housing,medical care,nursing,and entertainment.The value curve model from“Blue Ocean Strategy”is used to look for innovative,differentiated competitive strategies.Through community-sharing pension institutions,it is believed that a new model that provides lower prices and more professional medical care services for the elderly,enriches the spiritual world of the elderly with rich entertainment activities,and connects social services through an elderly studio to meet the needs of the elderly for self-realization can be introduced.

优化我国养老金制度体系:个人养老金制度的发展定位

我国已初步建成了第三支柱个人养老金制度,但该制度尚未实现规模化发展。分析现行养老金制度体系面临的现实困境后发现诸多问题,如第一支柱可持续性面临挑战,第二支柱发挥的作用有限,养老资产规模不足等。个人养老金制度对于优化我国养老金体系具有关键作用。据此,明确个人养老金制度的发展定位,包括完善三支柱养老保障体系、提高基本养老保险待遇水平、增加养老金资产储备、强化个人养老储备意识。提出政府应该协调发展三支柱养老保险,实施税收激励政策并加强宣传教育以激励个人的有效参与,优化养老资产储备的投资管理的相关建议。

基于共同富裕的养老金体系优化

养老金是最受关注的社会保障项目,有效的养老金体系有益于社会财富增加,有益于社会发展成果共享,也有益于人的全面发展,因而有益于推进共同富裕。经过多年的改革和建设,我国在养老金领域已经取得了伟大成就,然而由于历史和现实的诸多原因,现行养老金体系的反贫困功能不强,对促进就业创业、促进经济增长、改善收入分配的贡献不足,与共同富裕的要求不相适应。在扎实推进共同富裕的进程中,需要进一步明确养老金体系的功能定位、优化养老金体系层次结构、增强其对经济社会发展的适应性,建设更加公平、更可持续、更有效率的养老金体系。据此,现阶段的重点包括:一是控制和缩小群体间的公共养老金待遇差距,二是积极稳妥推进公共养老金制度参量改革,三是加快建设基金收支长期平衡机制。