Construction of Xi'an ecological old-age care community in the new urbanization

The new urbanization is an important carrier of ecological civilization construction, and ecological old-age care is the concrete manifestation of the perfect combination of the two, the proper meaning of the new urbanization connotation and an inevitable trend of its development. Based on the analysis of the connotation and relationship between the new urbanization and ecological old-age care, together with the current situation and existing problems of the current nursing institutions and ecological old-age care in Xi'an area, this paper discusses the major issues that should be noticed when constructing the ecological old-age care community in Xi'an and three main construction modes.

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.

Community Caregivers’ Experiences and Programmatic Strategies to Improve Active Case Finding in Community Tuberculosis Care in Botswana 2016-2021

Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.

Corroborative Activities and Recognition Between Community Comprehensive Care Unit’s Nurses and Care Managers in Supporting Discharge of Elderly from Hospital - A Secondary Publication

Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.

Acute hospital-community hospital care bundle for elderly orthopedic surgery patients:A propensity score-matched economic analysis

BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.

Aging Characteristics and Layout Planning of Old-age Care Facilities in the Downtown Area of Nanchang City

Compared to the situation of population aging and the elderly aging, the development of oldage undertaking in Nanchang is still undeveloped in that the old-age care industry lags behind the urban renewal speed and the objective needs of aging. Apart from discussions on the composition of elderly population and the status quo of aging, this paper took the institutional old-age care in the downtown area of Nanchang for example, explored problems in the current institutional old-age care facilities through field investigation, and proposed suggestions for the layout planning of old-age care facilities in the study area.

Spatial Optimization and Reconstruction of Old Communities under the Background of Aging

As aging becomes increasingly serious,how to make the life of the elderly more convenient and comfortable has become one of the social problems to be solved urgently.Old residential areas are one of spaces where the elderly gather.In this paper,the prominent problems in the community space of existing old residential areas that are not conducive to the life of the elderly were analyzed,and corresponding countermeasures to transform the community space were put forward.It is hoped that public space can play its due value and make old residential areas glow with new vitality.

Community-Based Oncology Nursing:Current Status and Prospects-A Secondary Publication

Objective:Currently,it is difficult to determine whether a comprehensive and systematic community-based cancer care project is properly implemented.The purpose of this article is to present the current status and prospects of community-based oncology nursing by reviewing related literature.Methods:A new cancer care model was established through the analysis of existing models and a literature review of community-based cancer prevention,cancer screening,cancer survivor care,and cancer patient hospice care.Results:The Comprehensive Cancer Care Model(CCCM)was esrablished.The CCCM organizes the stages of cancer treatment and the cancer journey on the horizontal axis.On the vertical axis,public health centers,oncology hospitals,cancer convalescent hospitals,primary care physicians,and prayer centers were involved.The levels of participation of human resources among institutions and the degree of interconnection between organizations was observed.Conclusion:It is expected that CCCM will be used for holistic,sustainable,and cost-effective cancer management.In community-based oncology nursing,the team of health promotion nurses in public health centers is in charge of population-based cancer prevention and early detection programs,while the visiting health management team of nurses is in charge of individual-based cancer survivor and hospice programs.

Outcomes of Integrated Community Care Interventions for Frail Elderly People: A Literature Review

This study aimed to summarize the outcome measures and the significant outcome of effective integrated community care for frail elderly people through a literature review. A literature search was conducted using the Cochrane Library and PubMed for articles published up to November 2016 with the following search terms: Integrated community care, primary care, community, frail elderly, and effectiveness. A total of 106 articles were identified, of which eight with an interventional research design the inclusion criteria. All outcome measures were classified into the three categories: Functional abilities, quality of life, and health. As the significant effect, the physical function was perceived in four references, the quality of life in one reference, and the mental health in one reference. The evidence of the effectiveness of integrated community care seemed to be lacking. More studies will need to be conducted.

An Association Pattern of Constituent Factors of the Elder Care Community in China

With the development of the aging society in China,the contradiction between the growing old people and the shortage of the elder care community has been increasingly sharp.How to reasonably and effectively establish the elder care community becomes a problem that demanding prompt solution in China.This paper,starting from the most basic constituent factors of the elder care community,namely the concept,the configuration and the service,analyzes 6 types of the concept,redefines the type of the building configuration of the elder care community,and explains the types and levels of the service,which aims to guide the elder care community to deal with the relationship between the 3 factors with a view to providing a reference for the architectural design and standard preparation in the elder care community.

How to Develop a Realist Evaluation to Evaluate the Effectiveness of Integrated Management of Childhood Illness Strategy in Community Care Sites in the Democratic Republic of Congo

Background: In sub-Saharan Africa, the DRC ranks among countries with high infant mortality. To solve this problem, the Health Ministry has set up a programme: the use of integrated management childhood illness (IMCI) in community care sites (CCSs) managed by non-health professional persons known as community health workers (CHW). This approach has not yet been integrated into the health pyramid. This is why we chose the Realist Evaluation Approach to evaluate the effectiveness of this programme on Universal Access to care for children under 5 years of age in the DRC. Methods/design: To conduct this exploratory study which is essentially a descriptive case study, we applied the principles of a realist evaluation by context—mechanisms—effects explained in the conceptual framework. The preliminary theory of the programme was elaborated by data collection through a literature review coupled with semi-structured interviews with key informants who were managers of the government programme and technical and financial partners of the programme. Results: IMCI has been evaluated and shown its positive contribution in the reduction of global children mortality. In the DRC, summaries of data collection through a literature review coupled with semi-structured interviews showed the same result. However, under criticism, based on the data collected during this exploratory study, it is promisingly apparent that this programme will achieve the objectives assigned to it through the preliminary theory of the programme. Conclusion: The literature review corroborated the effectiveness of the IMCI programme. The application of this programme in CCS with non-health professionals who are Community Health Workers has been shown to be effective in the DRC. Based on this reality, it was possible to define the basis for a realist evaluation of the effectiveness of the programme in CCS.

A Literature Review: Pharmaceutical Care an Evolving Role at Community Pharmacies in Pakistan

The aim of this paper is to highlight the role of pharmaceutical care at community pharmacies in Pakistan. The paper draws on the literature related to current dispensing practices at community pharmacies in developing countries as well as in Pakistan. There are approximately 63,000 community pharmacies in Pakistan, and according to an estimate, 80% of the medicines are being distributed through this channel to majority of the population. They often lack adequate facilities, staffing and equipments. Absence of pharmacists and their roles being performed by the non-qualified personnel working at community pharmacies are a common practice. There are 8102 pharmacists who are categorized as a category, 31,000 pharmacy technicians categorized in B & C category in the country. There is a shortage of pharmacists who could be engaged for ensuring good pharmacy practices. There are only ten percent of the total pharmacists who work at community pharmacies in the country according to the Pharmacy Council of Pakistan. All kind of medicines are freely available irrespective of their status as prescription or over the counter drugs. The paper highlights that the professional role of pharmacist in hospitals and community pharmacies is switching from dispensing and sale of drugs, to patient counselling. But, the concept of pharmaceutical care at community pharmacies has not been acknowledged yet in Pakistan. The process of prescription handling is poor and patients are often treated without a proper prescription. Prescription validation, drug labeling and patient counseling are the missing components in effective patient management at the community pharmacies. The paper concludes that although laws exist, but due to lack of accountability and weak regulatory framework their proper implementation is not witnessed. Moreover, due to lack of research and evidence related to problems in dispensing practices in healthcare system of Pakistan, the counteractive actions for resolving these problems are limited.

Mandibular advancement devices in the treatment of obstructive sleep apnea and snoring in community dental care: A pilot study on self-reported sleep quality

Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.

Social Welfare Transformation and Community Governance Model for the Aging Generation:Rural Community Care in Chiayi County as a Case Study

Over the past two decades,Taiwan’s welfare policies for the elderly have prepared for the arrival of an aged society with the aim of facilitating aging in place(AIP).The Long-Term Care Services Act passed by the Legislative Yuan in 2015 set regulations for long-term care personnel,thereby improving the welfare system for the elderly.The government’s AIP policies focus on providing welfare institutions or service units and do not sufficiently explore key factors such as the relationship between care services and community governance models.Since the basic focus of elderly welfare policies is AIP,it is important to actively empower grassroots community organizations and consider the elderly as important subjects of community participation.AIP policies emphasize providing long-term care and nurturing the elderly until death;such policies will be more proactive and innovative if coproduction is incorporated.This study briefly discusses theories related to coproduction using the case study of Chiayi County’s Dingcaiyian Community Development Association,which links six communities in remote rural villages and establishes a community care network based on the coproduction concept.Follow-up issues related to community care are considered and potential practices and ideas to guide social welfare transformation and community governance in the future are discussed.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

Study on Community Care Needs and Influencing Factors of the Urban Elderly in Shandong Province, China

Objective: To understand community care needs of the urban elderly in Shandong Province. To analysis the influencing factors and community care needs of the urban elderly in Shandong Province. Methods: Shandong Province was divided into four levels according to the level of economic development, multi-stage stratified cluster random sampling method was used. Each city collected the old aged 60 years or older served by 5 community health service centers. A total of 3390 questionnaires were distributed, the recovery rate was 100%, it had 3363 effective questionnaires, and an effective rate was 99.20%. SPSS17.0 software was used for univariate and multivariate analysis. Results: Analysis results show that, the influencing factors of community care needs of health promotion dimension have medical time (t = 3.239, P = 0.001) and EQ-5D score (t = 9.104, P - 6.239, P - 17.276, P - 3.762, P - 8.341, P Conclusions: Community care needs of the urban elderly in Shandong Province are at a medium level and have many influencing factors, the scores of each dimension from high to low are health promotion, disease care and disease prevention. In community nursing work, we should meet the care needs of the elderly, we need to enhance elderly self-care and safety awareness and promote the physical and mental health of the elderly.

Survey and Analysis of Community Care Service in Cities and Towns from the Perspective of Internet

With the aging of the social population,community care has become another important care model between home care and institutional care.In order to fully understand the social cognition and demand of"Internet+community care",the project team conducted a questionnaire survey in accordance with the research objectives.The survey concluded that the public are still dependent on the traditional care,and do not know much about"Internet+community care",but are willing to try."Internet+community care"can not only enrich and innovate the care model,but also effectively solve the problems of limited pension resources and mismatch between supply and demand.It is conducive to promoting the realization of high-quality and efficient services for the aged.

Evaluation Items for Community-Based Health Care Focusing on Social Aspects: A Literature Review

The progressive aging of society has become a global concern, and is expected to lead to the development of effective, sustainable, person-centered, integrated community-based care systems. However, there is insufficient evidence regarding effective integrated community-based care. In particular, few studies have focused on social aspects of the community environment related to elderly health. This study aimed to consider social aspects as evaluation items, focusing particularly on social determinants from the perspective of community-dwelling people, to explore truly effective integrated community-based care to improve elderly health. The definition of social determinants means social cohesion in social and community contexts. A literature review of English articles published in peer-reviewed journals up to October 2019 was conducted using PubMed, MEDLINE, and CINAHL with the following search terms: “social cohesion,” “elderly health,” “mental health” and “community.” Identified articles were screened based on title and abstract, and selected articles were subjected to full-text assessment and critical review. All references cited in the selected articles were also reviewed. The following inclusion criteria were used: 1) studies targeting community-dwelling elderly people or community-dwelling people including elderly people as participants;2) studies with clear descriptions of social factors in the Methods section;and 3) studies with clear descriptions of health-related items in the Methods section. From the 21 articles analyzed, of which 9 articles defined social determinants as social cohesion in social and community context, 37 items were extracted as social aspects at the community level that reflect the perspective of residents. These items can be developed as evaluation items for community-based health care outcomes through consensus among community health care providers and further investigation.