scholarly journals Innovative solutions to enhance safe and green environments for ageing well using stakeholder co-design.

2020 ◽  
Author(s):  
Anna L Hatton ◽  
Catherine Haslam ◽  
Sarah Bell ◽  
Joe Langley ◽  
Ryan Woolrych ◽  
...  
Keyword(s):  
Older Adults ◽  
Small Group ◽  
Social Connectedness ◽  
Interdisciplinary Approach ◽  
Human Movement ◽  
Evidence Base ◽  
Ageing Population ◽  
Physical Environments ◽  
Innovative Solutions ◽  
The Uk

Abstract Background There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. In order to develop solutions that meet the needs of a diverse ageing population, an interdisciplinary approach is needed. Our aim was to identify the needs of older people in relation to ageing well in the environment by bringing together knowledge from different stakeholder and interdisciplinary perspectives. Methods An international consortium (Retrofit living For ageing well through Understanding and Redesign of Built environments consortium: ReFURB) was established in April 2018, including ten core members, to (i) explore cutting-edge solutions to safe living for ageing populations and (ii) develop innovative approaches to everyday physical environments, which bring about health benefits. We used a co-design, interdisciplinary framework involving older adults, carers, physiotherapists, geriatricians, engineers, human movement experts, geographers and psychologists from the UK and Australia. This engaged people in a one day workshop that comprised a series of presentations from international speakers on urban design, social connectedness, hazards and injury prevention, and the physical environment. Small group discussions (facilitated by consortium members) followed presentations to consider the opportunities, challenges and barriers encountered with ageing, which included the use of creative engagement activities (LEGO® Serious Play, mind maps, poster gallery walk), to help participants share personal stories and reflect on the issues raised. Thematic coding was used to synthesise the outputs of the small group work. Results Five themes emerged across the workshops, comprising: access and transport; involvement of the whole community; restoration rather than redesign; assistive and digital technology; and intergenerational approaches. These dimensions related to the physical, social and nature-based qualities of everyday environments, as they pertain to ageing well. Conclusions Co-design was a valuable tool that helped understand the perceptions of stakeholders and essential to develop effective interventions and solutions. Participants highlighted several issues affecting people as they age and key environmental considerations to promote wellbeing, activity, and participation. The consortium identified gaps in the existing evidence base and are now planning activities to further develop research ideas in collaboration with our co-design participants.

scholarly journals Defining the older patient population that require, but do not undergo emergency laparotomy: an observational cohort study protocol

2021 ◽  
Author(s):  
Nicola Reeves ◽  
Susan Chandler ◽  
Elizabeth McLennan ◽  
Angeline Price ◽  
Jemma Boyle ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Cohort Study ◽  
Emergency Laparotomy ◽  
Ageing Population ◽  
Older Patient ◽  
Vulnerable Patient ◽  
The Uk ◽  
National Emergency ◽  
Vulnerable Patient Group

<p><strong>Background: </strong>Despite older adults (65 years and above) accounting for almost half of emergency laparotomies and an ageing population, there remains a paucity of research in the older adult emergency surgery population. One key clinical area that requires urgent assessment is the older patient who presents with acute abdominal pathology treatable by laparotomy, but who does not undergo surgery (NoLAP). <strong></strong></p><p><strong>Methods: </strong>This multicentre prospective cohort study [defining the denominator: emergency laparotomy and frailty study 2 (ELF2)] will recruit consecutive older adults that require but do not undergo emergency laparotomy (NoLAP). We will recruit from 47 national health service hospitals over a 3-month timeframe. The same criteria as NELA for inclusion and exclusion will be applied. The primary aim is 90-day mortality. Secondary aims include characterisation of the NoLAP group, frailty and sarcopenia with comparison to those older adults that have undergone emergency laparotomy (ELAP). Decision-making will also be explored. Assuming a NoLAP rate of 32% and 10% dropout, a minimum of 700 patients are required for 95% power (alpha=0.05).</p><p><strong>Conclusions: </strong>The UK national emergency laparotomy audit has provided vital information on those patients undergoing emergency laparotomy and driven standards in operative and perioperative care. However, little is known of outcomes in those patients who do not undergo emergency laparotomy.  Improved understanding of this NoLAP population would aid shared decision-making and improve standards for this otherwise poorly understood vulnerable patient group.</p><p><strong>Trial registration:</strong> This study is registered online at www.clinicaltrial.gov (Reg number: ISRCTN14556210).</p><p><strong> </strong></p>

scholarly journals General practitioners’ attitudes and decision making regarding admission for older adults with infection: a UK qualitative interview study

2018 ◽  
Vol 36 (4) ◽  
pp. 493-500 ◽  
Author(s):  
Abigail Moore ◽  
Caroline Croxson ◽  
Sara McKelvie ◽  
Dan Lasserson ◽  
Gail Hayward
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
General Practitioners ◽  
Older Patients ◽  
Ageing Population ◽  
Structured Interviews ◽  
Suspected Infection ◽  
Qualitative Interview Study ◽  
System Factors ◽  
The Uk

Abstract Background The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home. Objectives To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective. Methods. Qualitative study using semi-structured interviews. GPs were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interview transcripts were coded and analysed using a modified framework approach. Results GPs’ key influences on decision making were grouped into patient, GP and system factors. Patient factors included clinical factors, social factors and shared decision making. GP factors included gut instinct, risk management and acknowledging an associated personal emotional burden. System factors involved weighing up the pressure on secondary care beds against increasing GP workload. GPs described that finding an alternative to admission could be more time consuming, complex to arrange or were restricted by lack of capacity. Conclusion GPs need to be empowered to make safe decisions about place of care for older adults with suspected infection. This may mean developing strategies to support decision making as well as improving the ease of access to, and capacity of, any alternatives to admission.

scholarly journals Improving indoor thermal comfort, air quality and the health of older adults through environmental policies in London

2021 ◽  
Vol 2069 (1) ◽  
pp. 012240
Author(s):  
I Tsoulou ◽  
J Taylor ◽  
P Symonds ◽  
N Mohajeri ◽  
M Davies
Keyword(s):  
Older Adults ◽  
Air Quality ◽  
Thermal Comfort ◽  
Rapid Assessment ◽  
Environmental Policies ◽  
Vulnerable Groups ◽  
Ageing Population ◽  
Quality Improvements ◽  
Indoor Thermal Comfort ◽  
The Uk

Abstract In this work we evaluate the potential of selected environmental strategies in reducing air pollution and summertime indoor overheating. Associated changes in mortality rates are also calculated for older adults in London. Reducing these risks for vulnerable groups is an immediate priority and given that seniors spend most of their time indoors, our focus is on strategies that prioritize the transformation of residential environments for indoor thermal comfort and air quality improvements. For each strategy, we develop specific scenarios related to building adaptations and test potential reductions on indoor overheating and pollutant exposures from outdoor sources (PM2.5), as well as on senior mortality through the CRAFT tool (Cities Rapid Assessment Framework for Transformation). We then pick the scenarios with highest impacts on mortality, aiming to formulate effective policy recommendations for Greater London. Preliminary results suggest that environmental policies related to the installation of shading could have the highest reduction in heat and pollution-related senior mortality, followed by moderate effects due to building insulation retrofits and the greening of roofs. With an increasing ageing population in the UK and beyond, our work highlights the need for city-level policies to address building modifications, considering the importance of indoor spaces for older adults.

scholarly journals Promoting a musical lifecourse towards sustainable ageing: A call for policy congruence

2021 ◽  
Vol 14 (1) ◽  
pp. 103-119 ◽  
Author(s):  
Tuulikki Laes ◽  
Patrick Schmidt
Keyword(s):  
Older Adults ◽  
Music Education ◽  
Lifelong Learning ◽  
Social Connectedness ◽  
Well Being ◽  
Active Ageing ◽  
Ageing Population ◽  
Perceived Quality Of Life ◽  
Multiple Constituencies

Today, individually perceived quality of life for a growing ageing population could be said to be significantly dependent on meaningful life experiences, social connectedness and a sense of purpose. In this article, we argue for a wider theorization of policy and the politics of ageing. The central aim is to reflect on understandings of ageing within music education and musical participation, and, in particular, shift the focus from active ageing ‐ and the ways it might support the narrow agenda of music for older adults ‐ to the potentials of holistic and sustainable learning and participation in music. To do so, we draw from the concept of policy congruence, presenting a vision of policy as a critical catalyst that may amplify parameters for concerted initiatives among multiple constituencies within music education. We argue these amplified parameters may afford renewed efforts towards transdisciplinary action that can support the actions of community musicians and strengthen their role as networked actors labouring in consonance with others in the growingly significant areas of lifelong learning and ageing populations. Our stance is that, if we can assume that music education and musical participation have a serious contribution to make in the lives and well being of individuals across the lifespan, including older adults, then we ought to consider how systematic policy engagement may actively contribute to appropriate allocation of resources and renewed pedagogical and organizational framings, which more directly use lifelong learning to support sustainable ageing.

scholarly journals Assessing fitness to drive in dementia and other psychiatric conditions: a higher training learning opportunity at a driving assessment centre

2012 ◽  
Vol 36 (3) ◽  
pp. 113-116 ◽  
Author(s):  
Matthew P. Sheridan
Keyword(s):  
Older Adults ◽  
Driving Safety ◽  
Ageing Population ◽  
Fitness To Drive ◽  
Learning Opportunity ◽  
Professional Obligation ◽  
Assessment Centre ◽  
Psychiatric Conditions ◽  
Road Performance ◽  
The Uk

SummaryWith an ageing population and expected rise in cases of dementia, driving safety will become increasingly important. Doctors have a professional obligation to identify patients who are unsafe to drive and in cases of dementia this decision is often complex. As a result, many centres in the UK offer driving assessments for people with medical conditions that may affect their on-road performance. I aim to identify a valuable learning opportunity for psychiatrists in training, particularly those working with older adults, to improve their knowledge of driving assessment. I also provide an overview of the Scottish Driving Assessment Service and reflect on my visit there.

scholarly journals Modelling age-friendly environment for social connectedness: a cross-sectional study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 955
Author(s):  
Lein Shi Ying ◽  
Lai Ming Ming ◽  
Lau Siok Hwa
Keyword(s):  
Older Adults ◽  
Health Services ◽  
Built Environment ◽  
Social Connectedness ◽  
Civic Participation ◽  
Community Support ◽  
Well Being ◽  
Ageing Population ◽  
Middle Aged ◽  
Cross Sectional

Background: The increase in aged populations in Malaysia has brought unprecedented challenges to families, policy makers, scholars, and business organisations.  This paper adapted the WHO 2007 framework of features of age-friendly cities to examine age-friendly environment constructs and their linkages with social connectedness from the perspective of Malaysian middle-aged and older adults caring for themselves. Methods: A face-to-face cross-sectional survey was conducted on 402 middle-aged and older adults caring for themselves across selected states in west Malaysia, selected via purposive sampling. Firstly, features of age-friendly cities were explored through exploratory factor analysis involving 82 respondents. Subsequently, structural equation modelling was performed, involving 320 respondents. Results: The results indicated that the constructs of an age-friendly environment were built environment, community support and health services, civic participation, and employment as well as communication and information. The structural model provided evidence that implementing age-friendly initiatives relating to built environment, community support and health services, civic participation and employment as well as communication and information enables the ageing population to improve their connectedness with society. These findings supported the ecological theories, agreeing that age-friendly environments help middle-aged and older adults caring for themselves to increase their adaptability and reduce perceived pressure from the environment. This result was in line with the current literature in which an age-friendly environment is a form of support and an enabling environment to cultivate positive social relationships and connectivity. Conclusions: Creating an age-friendly environment that supports active and healthy living for middle-aged and older adults caring for themselves allows them to continue to share their experiences, knowledge, and wisdom. This is helpful and beneficial for societal well-being and economic development as well as for the future generations.

scholarly journals Mobility and safety issues in drivers with dementia

2015 ◽  
Vol 27 (10) ◽  
pp. 1613-1622 ◽  
Author(s):  
David B. Carr ◽  
Desmond O’Neill
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Health Professionals ◽  
Social Connectedness ◽  
Interdisciplinary Approach ◽  
Fitness To Drive ◽  
Progressive Dementia ◽  
Medical Needs ◽  
Dementia Severity ◽  
Driver Licensing

ABSTRACTAlthough automobiles remain the mobility method of choice for older adults, late-life cognitive impairment and progressive dementia will eventually impair the ability to meet transport needs of many. There is, however, no commonly utilized method of assessing dementia severity in relation to driving, no consensus on the specific types of assessments that should be applied to older drivers with cognitive impairment, and no gold standard for determining driving fitness or approaching loss of mobility and subsequent counseling. Yet, clinicians are often called upon by patients, their families, health professionals, and driver licensing authorities to assess their patients’ fitness-to-drive and to make recommendations about driving privileges. We summarize the literature on dementia and driving, discuss evidenced-based assessments of fitness-to-drive, and outline the important ethical and legal concerns. We address the role of physician assessment, referral to neuropsychology, functional screens, dementia severity tools, driving evaluation clinics, and driver licensing authority referrals that may assist clinicians with an evaluation. Finally, we discuss mobility counseling (e.g. exploration of transportation alternatives) since health professionals need to address this important issue for older adults who lose the ability to drive. The application of a comprehensive, interdisciplinary approach to the older driver with cognitive impairment will have the best opportunity to enhance our patients’ social connectedness and quality of life, while meeting their psychological and medical needs and maintaining personal and public safety.

Investigation of the Associations Between Social Connectedness and Internet Usage for Older Adults

2013 ◽  
Author(s):  
Edd D. Easton-Hogg ◽  
Nicholas K. Lim ◽  
Tomas Bergandi ◽  
Kevin Borders
Keyword(s):  
Older Adults ◽  
Social Connectedness ◽  
Internet Usage

Unlock imagined: arts in criminal justice

2019 ◽  
Vol 1 (2) ◽  
pp. 131-143
Author(s):  
Alison Frater
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Interdisciplinary Approach ◽  
Personal Perspective ◽  
Theoretical Understanding ◽  
The Arts ◽  
Optimistic Picture ◽  
The Uk ◽  
Causes Of Crime

Starting with a personal perspective this piece outlines the place and role of the arts in the criminal justice system in the UK. It paints an optimistic picture, though an unsettling one, because the imagination and reflexiveness of the arts reveals a great deal about the causes of crime and the consequences of incarceration. It raises questions about the transforming impact of the arts: how the benefits could, and should, be optimised and why evaluations of arts interventions are consistent in identifying the need for a non-coercive, more socially focused, paradigm for rehabilitation. It concludes that the deeper the arts are embedded in the criminal justice system the greater the benefits will be, that a more interdisciplinary approach would support better theoretical understanding, and that increased capacity to deliver arts in the criminal justice system is needed to offer more people a creative pathway out of crime.

NESTORE Ontology: a Multi-Domain Semantic Tool for the Characterization of Older Adults Status and Behaviour to Promote Healthy Ageing by IoT Systems (Preprint)

2020 ◽  
Author(s):  
Alfonso Mastropietro ◽  
Filippo Palumbo ◽  
Silvia Orte ◽  
Michele Girolami ◽  
Francesco Furfari ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mental Status ◽  
Scientific Knowledge ◽  
Social Behaviour ◽  
Physical Activity Behaviour ◽  
Healthy Ageing ◽  
Physiological Status ◽  
Ageing Population ◽  
Activity Behaviour

BACKGROUND The constant progression in number and share of the ageing population will likely have deep effects in most of the industrialized countries. The Internet of Things (IoT) paradigm can play a key role in facilitating independent living of the ageing population thus trying to reduce the burden on the society. Considering that ageing is a multi-factorial physiological process, the development of novel IoT systems, tools and devices, specifically targeted to older people, must be based on a holistic framework built on robust scientific knowledge in different scientific domains. OBJECTIVE A novel semantic formalization was developed, based on a multidomain healthy ageing model, to support structuring and standardizing heterogeneous scientific knowledge about ageing. The main aim of the paper is to present the new NESTORE ontology, with the purpose thus extending the available ontologies provided by universAAL-IoT (uAAL-IoT). METHODS Well-assessed scientific knowledge, specifically selected to target older adults aged between 65 and 75, was formalized into a holistic model using a multi-domain approach including three main different dimensions related to well-being: (i) Physiological Status and Physical Activity Behaviour, (ii) Nutrition, and (iii) Cognitive and Mental Status and Social Behaviour. Based on this model, within the NESTORE H2020 project, a new ontology was developed in the uAAL-IoT framework, which provides modelling tools and a set of core ontologies. RESULTS The NESTORE ontologies cover all the needed concepts to represent 5 significant domains of ageing. In total, 12 sub-ontologies were modelled with more than 60 classes and sub-classes referenced among them by using more than 100 relations and around 20 enumerations. NESTORE increases the uAAL ontologies collection by 40% and expand the uAAL domain usage for Physiological Status and Physical Activity Behaviour (8 ontologies), Nutrition (3 ontologies) and Cognitive and Mental Status and Social Behaviour (4 ontologies). CONCLUSIONS NESTORE ontology provides innovation both in terms of semantic content and technological approach. The thoroughly use of this ontology can support the development of a decision support system, to promote healthy ageing, with the capacity to do dynamic multi-scale modelling of user-specific data based on the semantic annotations of users’ profile.

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