scholarly journals The politics of frailty

2020 ◽  
Vol 49 (4) ◽  
pp. 544-548
Author(s):  
Martin J Vernon
Keyword(s):  
Poor Quality ◽  
Health Condition ◽  
Population Ageing ◽  
World Population ◽  
Policy Makers ◽  
Age Related ◽  
Underlying Causes ◽  
Sustainable Health

Abstract The world population is ageing because of falling fertility and improved life expectancy. Knowing this has not helped governments develop sustainable health and care policies because the underlying causes and impacts of population ageing remain poorly understood. Planning using only population age structure does not account for uneven geographical distribution of older people, their health characteristics, functional needs or lived experiences. English National Health Service (NHS) policy has previously focused on arbitrary age segmentation, failing to capture the origins of cumulative disease and functional burden and missing the opportunity to incorporate wider determinants of health into prevention of poor-quality ageing. This is despite growing international evidence that adults living in places with low per capita income and educational attainment experience a higher burden of age-related disease. Lack of a credible ageing narrative and good quality population health data have contributed to a focus on single disease prevention, rather than life course disease aggregation and its personal impacts. However, a fully explicated health and care narrative incorporating frailty does now give some cause for optimism. In 2017, England became the first country to characterise and systematically identify frailty as a long-term treatable health condition. This was coincident with a UK Government’s Industrial Strategy targeting societal ageing. In 2019, the English NHS published a funded long-term plan including a major programme focused on ageing well. Policy makers, health leaders and clinicians must not squander these opportunities but instead pursue frailty prevention and intervention to improve the quality of population ageing.

Aging of Competitive Athletes

Gerontology ◽  
2017 ◽  
Vol 63 (5) ◽  
pp. 488-494 ◽  
Author(s):  
Hirofumi Tanaka
Keyword(s):  
Older Adults ◽  
Poor Quality ◽  
Negative Stereotypes ◽  
Age Related ◽  
Masters Athletes ◽  
Competitive Athletes ◽  
Vascular Stiffening ◽  
High Motivation ◽  
Clinical Conditions

Demographics of human aging are rapidly changing. As illustrated in the biomedicalization of aging, an ever increasing number of older adults is affected by a variety of clinical conditions and diseases, including vascular stiffening, sarcopenia, physical disability, and poor quality of life. One population that is situated in the opposite end of the health and functional spectrum to the sedentary frail elderly is Masters athletes. These older competitive athletes are endowed with substantial functional capacity, overall long-term health, high motivation, and psychosocial outlook. Masters athletes are combating the dogma and negative stereotypes of older adults and aging. From the scientific standpoint, examining Masters athletes can provide insight into preventive gerontology, primary prevention of age-related diseases and dysfunctions, and exercise-based medical practices. Moreover, the study on Masters athletes is simply joyous and entertaining as they often remind us what can be possible in aging.

scholarly journals Ivor–Lewis oesophagogastrectomy with Roux-en-Y duodenal bypass

2016 ◽  
Vol 98 (2) ◽  
pp. 116-120
Author(s):  
J Cartwright ◽  
E Forbat ◽  
A Botha
Keyword(s):  
Gastric Tube ◽  
Case Series ◽  
Poor Quality ◽  
Benign Disease ◽  
Ivor Lewis ◽  
Biliary Diversion ◽  
Complex Reconstruction ◽  
Long Term Result

Oesophagectomies and gastrectomies are performed predominantly for the treatment of malignant disease. However, in this case series, we describe three patients with benign disease who had a laparoscopic oesophagogastrectomy with gastroduodenal detachment and Roux-en-Y biliary diversion, and discuss the operative feasibility and consequent patient outcomes. Our aim was to modify the procedure using an established reconstruction already practised in gastric and bariatric surgery, thereby preventing operative sequelae that lead to a poor quality of life (eg reflux oesophagitis and vomiting). During the first postoperative year, our first two patients experienced weight loss, indigestion and lower bowel symptoms with no apparent improvement in gastric function compared with a standard gastric tube pull-up reconstruction. In the longer term, in both patients, the gastric tube interpositions appeared to function well and there was no evidence of gastro-oesophageal reflux disease, delayed gastric emptying or troublesome indigestion. Our third patient, who had lifelong severe reflux symptoms, was eating normally three months after the operation with no need for antacid medication. We therefore conclude that laparoscopic Ivor–Lewis oesophagogastrectomy with Roux-en-Y bypass is a more complex reconstruction with added risks but may in the long term result in better overall outcomes and satisfaction for patients, particularly those with benign disease.

scholarly journals Quality of models supplied to dental laboratories for the fabrication of partial removable denture framework

2020 ◽  
Vol 68 ◽  
Author(s):  
Luma de Vasconcelos MENEZES ◽  
Thais Carine SILVA ◽  
Catia Maria Fonseca GUERRA ◽  
Renata CIMÕES ◽  
Bruna de Carvalho Farias VAJGEL
Keyword(s):  
Poor Quality ◽  
Metallic Structure ◽  
Removable Denture ◽  
The City ◽  
Plaster Models

ABSTRACT Objective The aim of this study was to evaluate the models and plannings of metallic framework of removable partial prosthesis sent to dental laboratories in the city of Recife. Methods: The physical and technical conditions of plaster models were sent by the dentists to 4 dental laboratories. All models were examined, photographed and recorded on a form according to the research objective. Results: A total number of 235 models sent by dental surgeons were used to prepare the metallic structure, in which none of the models presented surveying nor the path of insertion. Out of the 235 models, 41 (17.44%) presented serious failures, such as positive and negative bubbles, broken dental elements, direct retainers and damaged edentulous areas. With respect to the planning, only 22 (9.35%) models were presented with the metallic framework planning, but in an unsatisfactory way. Regarding mouth preparation, no model presented a guide plane, and only 6.8% of models had rests seats, but incorrectly prepared. Conclusion: The models evaluated presented poor quality, lack of planning and no mouth preparation. This shows the need for dental surgeons to be aware of the appropriate prosthesis models and plannings in order to ensure a satisfactory and long-term rehabilitation of the patient, as well as preserving the remaining mouth structures.

scholarly journals Sarcopenia, obesity, osteoporosis and old age

2021 ◽  
Vol 11 (4) ◽  
pp. 23-35
Author(s):  
S. V. Topolyanskaya
Keyword(s):  
Body Composition ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Mineral Density ◽  
Term Care ◽  
Visceral Fat Accumulation ◽  
Age Related ◽  
Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

Teamwork

2018 ◽  
pp. 587-594
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Health Professionals ◽  
Healthcare Setting ◽  
Healthcare Services ◽  
Health Condition ◽  
Illness Episode ◽  
Wide Range ◽  
Working Together ◽  
Effective Organization

The importance of teamworking has been long established in healthcare, with nurses working both as part of a nursing team and as members of the wider multidisciplinary team. The effective organization and delivery of healthcare services depends upon a wide range of health professionals, patients, families, and carers working together to achieve the best health outcomes and quality of life. Whether healthcare is necessary for an acute illness episode, helping someone with a long-term health condition achieve an acceptable level of function, or supporting a person who is dying, placing people at the centre of care decisions demands effective teamworking. Understanding the nature and characteristics of teams can help nurses to work effectively and uphold professional caring values when working with people in any healthcare setting. This chapter outlines the key definitions and characteristics of teamworking.

scholarly journals Interventions to improve the quality of cataract services: protocol for a global scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036413
Author(s):  
Miho Yoshizaki ◽  
Jacqueline Ramke ◽  
João M Furtado ◽  
Helen Burn ◽  
Stephen Gichuhi ◽  
...  
Keyword(s):  
Global Health ◽  
Scoping Review ◽  
Vision Loss ◽  
Open Science ◽  
Poor Quality ◽  
Surgical Interventions ◽  
Accessible Information ◽  
Age Related ◽  
Full Text Review

IntroductionCataract is the leading cause of blindness globally and a major cause of vision impairment. Cataract surgery is an efficacious intervention that usually restores vision. Although it is one of the most commonly conducted surgical interventions worldwide, good quality services (from being detected with operable cataract to undergoing surgery and receiving postoperative care) are not universally accessible. Poor quality understandably reduces the willingness of people with operable cataract to undergo surgery. Therefore, it is critical to improve the quality of care to subsequently reduce vision loss from cataract. This scoping review aims to summarise the nature and extent of the published literature on interventions to improve the quality of services for primary age-related cataract globally.Methods and analysisWe will search MEDLINE, Embase and Global Health for peer-reviewed manuscripts published since 1990, with no language, geographic or study design restrictions. To define quality, we have used the elements adopted by the WHO—effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency—to which we have added the element of planetary health. We will exclude studies focused on the technical aspects of the surgical procedure and studies that only involve children (<18 years). Two reviewers will screen all titles/abstracts independently, followed by a full-text review of potentially relevant articles. For included articles, data regarding publication characteristics, study details and quality-related outcomes will be extracted by two reviewers independently. Results will be synthesised narratively and presented visually using a spider chart.Ethics and disseminationEthical approval was not sought, as our review will only include published and publicly accessible information. We will publish our findings in an open-access peer-reviewed journal and develop an accessible summary of the results for website posting. A summary of the results will be included in the ongoing Lancet Global Health Commission on Global Eye Health.Registration detailsOpen Science Framework (https://osf.io/8gktz).

scholarly journals Long-Term Effects of Kasai Portoenterostomy for Biliary Atresia Treatment in Russia

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 686
Author(s):  
Anna Degtyareva ◽  
Alexander Razumovskiy ◽  
Nadezhda Kulikova ◽  
Sergey Ratnikov ◽  
Elena Filippova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Critical Importance ◽  
Long Term Effects ◽  
Age Related

This prospective study enrolled 144 patients after surgical treatment of biliary atresia in early infancy. We analyzed the immediate effectiveness of the surgery and the age-related structure of complications in the up to 16-year follow-up. The immediate 2-year survival rate after the surgery constituted 49.5%. At the time of this writing, 17 of the patients had celebrated their 10th birthdays with good quality of life and no indications for transplantation of the liver. The obtained results underscore the critical importance of surgical correction of biliary atresia by Kasai surgery in the first 60 days of life and subsequent dynamic follow-up of patients for the purpose of the early detection and timely correction of possible complications.

scholarly journals Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarieh Poortaghi ◽  
Abbas Ebadi ◽  
Mahvash Salsali ◽  
Afsaneh Raiesifar ◽  
Nayyereh Davoudi ◽  
...  
Keyword(s):  
Delphi Study ◽  
Poor Quality ◽  
Clinical Services ◽  
Policy Makers ◽  
Factors Affecting ◽  
Nursing Managers ◽  
Clinical Nursing ◽  
Communication Program ◽  
Nursing Services

Abstract Background Clinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services. Methods The present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire. Results In the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance. Conclusion Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.

Impact of age-related socio-economic and clinical determinants of quality of life among long-term breast cancer survivors

Maturitas ◽  
2015 ◽  
Vol 81 (3) ◽  
pp. 362-370 ◽  
Author(s):  
Pegdwende Olivia Dialla ◽  
Wai-On Chu ◽  
Patrick Roignot ◽  
Marie-Christine Bone-Lepinoy ◽  
Marie-Laure Poillot ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Age Related

scholarly journals Ageing and vulnerable elderly people: European perspectives

2006 ◽  
Vol 26 (1) ◽  
pp. 105-134 ◽  
Author(s):  
EMILY GRUNDY
Keyword(s):  
Older People ◽  
Evaluation Studies ◽  
Later Life ◽  
Poor Quality ◽  
Psychological Help ◽  
Rigorous Evaluation ◽  
Support Policy ◽  
Vulnerable Elderly

This paper considers the processes and circumstances that create vulnerability among older people, specifically to a very poor quality of life or an untimely or degrading death. Models of ageing processes are used to define vulnerable older people as those whose reserve capacity falls below the threshold needed to cope successfully with the challenges they face. Compensatory supports may intervene to mitigate the effects of challenges and to rebuild reserve. The dimensions of reserve, challenges and compensation are discussed, with emphasis on demographic and other influences on the availability of family and social support. Policy initiatives to reduce vulnerability can focus on each part of the dynamic process that creates vulnerability, namely, ensuring that people reach later life with ‘reserve’, reducing the challenges they face in later life, and providing adequate compensatory supports. The promotion through the lifecourse of healthy lifestyles and the acquisition of coping skills, strong family and social ties, active interests, and savings and assets, will develop reserves and ensure that they are strong in later life. Some of the physical and psychological challenges that people may face as they age cannot be modified, but others can. Interventions to develop compensatory supports include access to good acute care and rehabilitation when needed, substitute professional social and psychological help in times of crisis, long-term help and income support. Our knowledge of which interventions are most effective is however limited by the paucity of rigorous evaluation studies.

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