scholarly journals Association between syphilis seroprevalence and age among blood donors in Southern China: an observational study from 2014 to 2017

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e024393
Author(s):  
Xiaobing Wu ◽  
Yang Guan ◽  
Jianbin Ye ◽  
Hanlin Fu ◽  
Chunlai Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Blood Donors ◽  
Southern China ◽  
Healthcare Providers ◽  
Treponema Pallidum ◽  
Targeted Prevention ◽  
Active Infection ◽  
Effective Interventions ◽  
Prevention Interventions ◽  
And Control

ObjectiveThis study investigated the association between syphilis seroprevalence and age among blood donors, and described the distribution of serological titres among syphilis-infected donors, aiming to confirm the syphilis epidemic characteristics and to promote effective interventions for older adults.MethodsData were obtained from the Shenzhen Programme for Syphilis Prevention and Control in 2014–2017. Blood samples were screened using the ELISAs, and confirmed using the Treponema pallidum particle agglutination assay (TPPA) and toluidine red unheated serum test (TRUST).ResultsAmong 394 792 blood donors, 733 tested TPPA and TRUST positive (active infection), and 728 tested only TPPA positive (historical infection). The overall prevalence of syphilis seropositivity was 370.1 per 100 000 (95% CI 351.1 to 389.0 per 100 000); the prevalence of active infection was 185.7 per 100 000 (95% CI 172.2 to 199.1 per 100 000). People aged ≥45 years displayed a prevalence of 621.8 per 100 000 in syphilis seropositivity and 280.5 per 100 000 in active infection, which were 3.8 times and 2.4 times higher than that for people aged <25 years, respectively. The prevalence of syphilis seropositivity (χ2trend=311.9, p trend<0.001) and active infection (χ2trend=72.1, p trend<0.001) increased significantly with age. After stratification by gender and year of donation, the increasing trend of prevalence with age remained (p trend<0.05), except for the prevalence of active infection in males and females in 2014. About 16.3% of donors with active infection and aged ≥45 years had a TRUST titre of ≥1∶8, lower than that of patients aged <25 years (51.3%) and 25–34 years (34.1%).ConclusionsThe findings confirm the high prevalence of syphilis among older adults, and suggest the need to increase awareness among healthcare providers and deliver more targeted prevention interventions for older adults to promote early testing.

Tuberculosis Prevention and Control in Long-Term–Care Facilities for Older Adults

2004 ◽  
Vol 25 (12) ◽  
pp. 1097-1108 ◽  
Author(s):  
Lauri Thrupp ◽  
Suzanne Bradley ◽  
Philip Smith ◽  
Andrew Simor ◽  
Nelson Gantz ◽  
...  
Keyword(s):  
Older Adults ◽  
Prevention And Control ◽  
Long Term Care ◽  
Healthcare Providers ◽  
The United States ◽  
Disease Diagnosis ◽  
Term Care ◽  
Care Facilities ◽  
And Control

AbstractIn the United States, older adults comprise 22% of cases of tuberculous disease but only 12% of the population. Most cases of tuberculosis (TB) occur in community dwellers, but attack rates are highest among frail residents of long-term–care facilities. The detection and treatment of latent TB infection and TB disease can pose special challenges in older adults. Rapid recognition of possible disease, diagnosis, and implementation of airborne precautions are essential to prevent spread. It is the intent of this evidence-based guideline to assist healthcare providers in the prevention and control of TB, specifically in skilled nursing facilities for the elderly.

scholarly journals Increasing Adoption and Utility of Smartwatches in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 411-412
Author(s):  
Mitchell Roberts ◽  
Erica Sappington ◽  
Ali Yalcin ◽  
Jeffrey Lowenkron ◽  
David Amzallag ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthcare Providers ◽  
Fall Detection ◽  
Wearable Devices ◽  
South Florida ◽  
High Tech ◽  
Policy And Practice ◽  
Step Counting ◽  
Fitness Tracking ◽  
And Control

Abstract Older adults (55+) represent one of the fastest growing groups adopting wearable devices (e.g. smartwatches). However, questions remain as to how older adults, healthcare providers and researchers can maximize the ability of these devices to maintain and improve health. The objective of this study was to understand the needs and preferences of older adults in wearable devices, as part of a Florida High Tech Corridor Matching Grant between The Villages Health, Aviv/Xtend Scientific, and The University of South Florida. Six focus groups were conducted with older adults (n=36) living in The Villages, Florida, and were stratified by gender. Topics such as adoption, benefits/concerns, usability, and potential gender differences were explored. Heart rate monitoring, calories burned, and step counting features were most often utilized by current wearable users (43%). Participants reported that the most important benefits of wearables were atrial fibrillation identification, fitness tracking and fall detection. Concerns included privacy, the “learning curve” and too frequent of notifications by the device. Across both genders, choice resonated strongly as a theme. Male and female participants desired personalized, easy to understand outcomes and control over data sharing preferences. Men were interested in continual access to wearable health data, whereas females were interested in daily or weekly summaries. Further, men reported higher on-going use and comfort with smartwatches as compared to females. Participants suggested “low, medium, and high-tech savvy” user profiles and supporting resources (e.g. 1-1 training, paper manuals) to enhance adoption. Recommendations for policy and practice are shared, in light of the findings.

scholarly journals Molecular characteristics of HBV infection among blood donors tested HBsAg reactive in a single ELISA test in southern China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xianlin Ye ◽  
Tong Li ◽  
Ran Li ◽  
Heng Liu ◽  
Junpeng Zhao ◽  
...  
Keyword(s):  
Viral Load ◽  
Hepatitis B ◽  
Nested Pcr ◽  
Blood Donors ◽  
Southern China ◽  
Core Promoter ◽  
Elisa Test ◽  
Hbv Infection ◽  
Molecular Characteristics ◽  
Blood Samples

Abstract Background Hepatitis B virus (HBV) infection is a major concern for blood safety in high-prevalence HBV countries such as China. In Shenzhen, dual hepatitis B surface antigen (HBsAg) enzyme-linked immunosorbent assays (ELISAs) have been adopted in parallel with nucleic acid testing (NAT) for donors for over a decade. A small proportion of blood donors test reactive (R) for HBsAg but negative through routine NAT, which can lead to HBV infection with an extremely low viral load. Objectives We aimed to investigate and analyze the molecular characteristics of HBV among blood donors that tested HBsAg R in a single ELISA test. Methods Blood donations were evaluated in this study if confirmed HBsAg R through one of two ELISA kits. Samples with non-reactive (NR) results by NAT were collected and tested for HBsAg by chemiluminescent microparticle immunoassay (CLIA) with a neutralization test. The level of HBsAg was further assessed by electrochemiluminescence immunoassay (ECLIA). The viral basic core promoter (BCP) and pre-core (PC) and S regions were amplified by nested PCR. Quantitative real-time PCR (qPCR) for viral load determination and individual donation (ID)-NAT were adopted simultaneously. HBsAg was confirmed with CLIA, ECLIA, nested PCR, qPCR, and ID-NAT. Results Of the 100,252 donations, 38 and 41 were identified as HBsAg R with Wantai and DiaSorin ELISA kits, respectively. Seventy-nine (0.077%, 79/100,252) blood samples with ELISA R-NR and NAT NR results were enrolled in the study. Of these, 17 (21.5%,17/79) were confirmed as HBsAg-positive. Of the 14 genotyped cases, 78.6% (11/14) were genotype B, and C and D were observed in two and one sample, respectively. Mutations were found in the S gene, including Y100C, Y103I, G145R, and L175S, which can affect the detection of HBsAg. A high-frequency mutation, T1719G (93.3%), was detected in the BCP/PC region, which reduced the viral replication. Conclusion A small number of blood samples with HBsAg ELISA R-NR and NAT NR results were confirmed as HBV infection, viral nucleic acids were found in most of the samples through routine NAT methods. It is necessary to employ more sensitive and specific assays for the detection of HBV infection among blood donors.

scholarly journals “PrEP”ing for a PrEP demonstration project: understanding PrEP knowledge and attitudes among cisgender women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth C. Pasipanodya ◽  
Jamila Stockman ◽  
Thupten Phuntsog ◽  
Sheldon Morris ◽  
Christina Psaros ◽  
...  
Keyword(s):  
Los Angeles ◽  
Focus Groups ◽  
Knowledge And Attitudes ◽  
Women Living With Hiv ◽  
Effective Interventions ◽  
Hiv Serostatus ◽  
Prep Awareness ◽  
Exposure Prophylaxis ◽  
Competing Priorities ◽  
And Control

Abstract Background Prior to implementing a pre-exposure prophylaxis (PrEP) demonstration study, we sought to explore cisgender women’s experiences with HIV prevention, PrEP knowledge and attitudes, and anticipated barriers and facilitators for PrEP uptake and adherence in Southern California. Methods Three focus groups were held with cisgender women of mixed HIV serostatus in San Diego and Los Angeles between November 2015 and January 2016. Women were recruited through local testing sites, community-based organizations, and social media. Focus groups were audio-recorded and transcripts were analyzed using thematic analysis. Results Twenty-two women participated in focus groups, with median age 44 (IQR 30–53) and 6 identifying as non-Hispanic Black, 7 non-Hispanic White, 8 Latina and 1 mixed race. Despite limited prior PrEP knowledge and no PrEP experience, participants expressed interest in taking PrEP. Anticipated benefits were freedom from worry about HIV and control over sexual health; however, these were tempered by concerns including the possibility of increased HIV risk behaviors and potential side effects. Cisgender women reported potential barriers to PrEP uptake and adherence barriers, like competing priorities and poor PrEP access. Conversely, PrEP facilitators included utilizing practical tools such as phone apps and pill boxes as well as receiving encouragement from loved ones and support from other cisgender women on PrEP, women living with HIV and their medical providers. Conclusions Although PrEP awareness was low, participants recognized the importance of PrEP and ways to facilitate adherence. Exploring perspectives of cisgender women is integral to developing effective interventions to support PrEP uptake and adherence for women at elevated risk for HIV.

scholarly journals Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932110291
Author(s):  
Atsuko Satoh ◽  
Yukoh Kudoh ◽  
Sangun Lee ◽  
Masumi Saitoh ◽  
Miwa Miura ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Controlled Trial ◽  
Intervention Group ◽  
Berg Balance Scale ◽  
Control Group ◽  
Mobility Assessment ◽  
Before And After ◽  
Day Services ◽  
And Control

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

scholarly journals Perceptions of Treatment Burden Among Elders With Diabetes and Comorbid Alzheimer’s Disease and Related Dementias

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 276-276
Author(s):  
Victoria Vaughan Dickson ◽  
Halia Melnyk ◽  
Rosie Ferris ◽  
Joshua Chodosh ◽  
Caroline Blaum
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Qualitative Study ◽  
Financial Burden ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Patient Treatment ◽  
Treatment Burden ◽  
Treatment Plans

Abstract Background: An estimated 25% of older adults with diabetes (DM) may have co-occurring Alzheimer’s Disease and Related Dementias (ADRD), complicated by multiple treatment plans and providers. Assessing treatment burden has been limited to patients’ perspectives; little is known about caregiver perceptions of treatment burden despite their important role in personal care and treatment adherence. The purpose of this qualitative study was to describe caregiver perceptions of treatment burden for older adults with DM-ADRD. Methods: This qualitative study was conducted in the formative phase of “Enhanced Quality in Primary care for Elders with DM-ADRD (EQUIPED-ADRD) a pragmatic randomized controlled trial in a large, diverse healthcare system. A diverse sample of caregivers (n=15) of patients enrolled in the RCT participated in interviews about their caregiver role and perceptions of treatment burden of DM-ADRD clinical management. Qualitative data were analyzed using content analysis and themes about treatment burden were compared to domains on the Treatment Burden Questionnaire (TBQ). Results: Caregivers reported high levels of burden related to treatment plans for patients with DM-ADRD. Themes related to complexity and burden of medication management, monitoring (e.g., blood pressure, glucose monitoring), dietary and physical activity regimens, navigating healthcare providers and financial burden were reported. Caregivers also described high levels of emotional burden that was associated with patient’s cognitive decline and family functioning stress. Conclusions: Interventions to reduce treatment burden for patients and caregiver should include activating social/nursing services, respite care and care coordination that may support caregivers especially as patient treatment increases in complexity over time.

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

Biostability in distribution systems in one city in southern China: Characteristics, modeling and control strategy

2014 ◽  
Vol 26 (2) ◽  
pp. 323-331 ◽  
Author(s):  
Pinpin Lu ◽  
Xiaojian Zhang ◽  
Chiqian Zhang ◽  
Zhangbin Niu ◽  
Shuguang Xie ◽  
...  
Keyword(s):  
Control Strategy ◽  
Distribution Systems ◽  
Southern China ◽  
Modeling And Control ◽  
And Control

scholarly journals Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 477
Author(s):  
Catherine B. Chan ◽  
Naomi Popeski ◽  
Leah Gramlich ◽  
Marlis Atkins ◽  
Carlota Basualdo-Hammond ◽  
...  
Keyword(s):  
Older Adults ◽  
Design Thinking ◽  
Healthcare Providers ◽  
Community Organizations ◽  
Community Dwelling ◽  
Nutrition Risk ◽  
Intersectoral Cooperation ◽  
Stakeholder Perspectives ◽  
Patient Representatives ◽  
Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

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