The global challenge of ageing population – Part II: the impact on health services, and the optimum healthcare strategy for older patients

Objectives: Analysis of data from the World Health Organization over the past 50 years, has demonstrated a transition towards population ageing globally. This has a significant impact on acute care services as well as on the approach to patient care in the acute setting. Methods: A narrative review of the literature was undertaken using Medline, CINAHL and the Cochrane Database, supplemented by manual searches of the literature, and further guided by the reference lists of relevant papers identified in the electronic search. No restriction was placed on the type of paper to be included in the study. Results: The initial electronic search of the three databases included 239 papers, of which 87 were found to be relevant and included in this review. Among the papers included were those which described the unique challenges posed by the ageing population, proposed modifications to the delivery of health services and recommended adaptations in the approach to older patients in the acute care setting. Conclusion: Population ageing is a significant global phenomenon, affecting both developed and developing regions of the world. More work is needed, particularly in the developing world, to better understand the impact of ageing on our population.

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The global challenge of ageing population – Part I: Definitions, epidemiology and physiological changes

Caribbean Medical Journal ◽

10.48107/cmj.2018.11.004 ◽

2018 ◽

Author(s):

Ian Sammy ◽

Joanne Paul

Keyword(s):

Developing World ◽

Population Ageing ◽

World Health ◽

Ageing Population ◽

Physiological Changes ◽

Electronic Search ◽

Study Results ◽

The World ◽

Epidemiological Characteristics ◽

The Impact

Background & Objectives Over the past 50 years, epidemiological data from the World Health Organisation has demonstrated a trend towards population ageing throughout the world. While this is widely recognised in the developed world, the phenomenon has been largely overlooked in the developing world, despite the fact that the rate of ageing in developing countries far outstrips that of developed countries. This global trend towards an increasingly older society has significant implications for healthcare. This article aims to review the definitions of ageing, its epidemiological characteristics and physiological changes associated with ageing. Methods A narrative review of the literature was undertaken using Medline, CINAHL and the Cochrane Database, supplemented by manual searches of the literature, and guided by the reference lists of relevant papers identified in the electronic search. No restriction was placed on the type of paper to be included in the study. Results The initial electronic search of the three databases included 239 papers, of which 60 were found to be relevant and included in this review. These articles discussed the epidemiology and definition of ageing, the physiology of ageing and its impact on health and illness, and the implications for health services. The overall findings of the studies implicate the clear differences in the physiology of older people, which do create specific challenges for health service provision. Conclusion Population ageing is a significant global phenomenon, affecting both developed and developing regions of the world. More work is needed, particularly in the developing world, to better understand the impact of ageing on our population.

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Monitoring the Control of Sexually Transmissible Infections and Blood-Borne Viruses: Protocol for the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) (Preprint)

10.2196/preprints.11028 ◽

2018 ◽

Author(s):

Denton Callander ◽

Clarissa Moreira ◽

Carol El-Hayek ◽

Jason Asselin ◽

Caroline van Gemert ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Surveillance System ◽

Sentinel Surveillance ◽

World Health ◽

People Living With Hiv ◽

Surveillance Network ◽

Sexually Transmissible Infections ◽

The World ◽

The Impact

BACKGROUND New biomedical prevention interventions make the control or elimination of some blood-borne viruses (BBVs) and sexually transmissible infections (STIs) increasingly feasible. In response, the World Health Organization and governments around the world have established elimination targets and associated timelines. To monitor progress toward such targets, enhanced systems of data collection are required. This paper describes the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS). OBJECTIVE This study aims to establish a national surveillance network designed to monitor public health outcomes and evaluate the impact of strategies aimed at controlling BBVs and STIs. METHODS ACCESS is a sentinel surveillance system comprising health services (sexual health clinics, general practice clinics, drug and alcohol services, community-led testing services, and hospital outpatient clinics) and pathology laboratories in each of Australia’s 8 states and territories. Scoping was undertaken in each jurisdiction to identify sites that provide a significant volume of testing or management of BBVs or STIs or to see populations with particular risks for these infections (“priority populations”). Nationally, we identified 115 health services and 24 pathology laboratories as relevant to BBVs or STIs; purposive sampling was undertaken. As of March 2018, we had recruited 92.0% (104/113) of health services and 71% (17/24) of laboratories among those identified as relevant to ACCESS. ACCESS is based on the regular and automated extraction of deidentified patient data using specialized software called GRHANITE, which creates an anonymous unique identifier from patient details. This identifier allows anonymous linkage between and within participating sites, creating a national cohort to facilitate epidemiological monitoring and the evaluation of clinical and public health interventions. RESULTS Between 2009 and 2017, 1,171,658 individual patients attended a health service participating in ACCESS network comprising 7,992,241 consultations. Regarding those with unique BBV and STI-related health needs, ACCESS captured data on 366,441 young heterosexuals, 96,985 gay and bisexual men, and 21,598 people living with HIV. CONCLUSIONS ACCESS is a unique system with the ability to track efforts to control STIs and BBVs—including through the calculation of powerful epidemiological indicators—by identifying response gaps and facilitating the evaluation of programs and interventions. By anonymously linking patients between and within services and over time, ACCESS has exciting potential as a research and evaluation platform. Establishing a national health surveillance system requires close partnerships across the research, government, community, health, and technology sectors. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11028

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“With Friends Like These”: Unpacking Panicked Metaphors for Population Ageing

Societies ◽

10.3390/soc11030069 ◽

2021 ◽

Vol 11 (3) ◽

pp. 69

Author(s):

Sally Chivers

Keyword(s):

Life Experience ◽

Population Ageing ◽

World Health ◽

Active Ageing ◽

Close Reading ◽

Ageing Population ◽

Global Age ◽

The World ◽

Individual Actions ◽

Age Studies

Age studies scholars have long noted problems with using a tsunami metaphor to describe population ageing. Age-friendly offers a new way to respond to an increase in older adults. Though critical gerontologists identify the related movement’s limits, “age-friendly” itself is rarely recognized as a metaphor. This paper proposes that, while the metaphor of age-friendly is more benign than that of the tsunami, it still portrays an ageing population as a homogenous problem to be solved through morally obligatory individual actions, thereby participating in a form of age panic. The analysis draws on a humanities-based close reading of the World Health Organization’s 2007 “Global Age-Friendly Cities: A Guide.” The method uncovers attitudes that anchor the metaphor and hamper the movement’s effectiveness, particularly when trying to reach people who have not already been well served all their lives. The emphasis on a narrow version of active ageing feeds a neoliberal imagination that affects how value is assigned to an ageing population. That underlying emphasis needs to shift before new metaphors, policies and practices for population ageing—that allow for the variability and uniqueness of late-life experience—can take hold. How might we reconceptualize the ageing population if we focus on contributions and meaning instead?

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Nurses in Australian acute care settings: experiences with and outcomes of e-health. An integrative review.

INTERNATIONAL JOURNAL OF MANAGEMENT & INFORMATION TECHNOLOGY ◽

10.24297/ijmit.v3i1.1384 ◽

2013 ◽

Vol 3 (1) ◽

pp. 01-08 ◽

Cited By ~ 5

Author(s):

Jane Mills ◽

Jennifer Chamberlain-Salaun ◽

Renee Henry ◽

Jenny Sando ◽

Glynda Summers

Keyword(s):

Acute Care ◽

Discharge Planning ◽

Integrative Review ◽

World Health ◽

Computer Usage ◽

Future Research ◽

Successful Implementation ◽

The World ◽

Acute Care Settings ◽

The Impact

The World Health Organization (WHO) defines e-health as the use of information and communication technology for health [1]. The use of e-health, including electronic medical records (EMR), is a growing trend. This integrative review of the literature examines nurses experiences of e-health in Australian acute care settings. A search of the literature identified 21 papers for inclusion in this review. Two discernable themes in the literature are apparent. Research to date largely focuses on nurses experiences of e-health, including its usefulness in their work. Findings indicate that nurses attitudes to e-health and computer usage are positive, however there are indications that nurses currently using e-health in practice are often dissatisfied with the implementation of new e-health systems in their workplace and that there are a number of barriers to its successful implementation. Secondly, a discernable gap in the literature regarding the impact of e-health, and in particular EMRs, on nursing outcomes is identified with research to date limited to findings related to nursing documentation and multi-disciplinary discharge planning. Future research that considers nurse experiences in implementing e-health and applies focused strategies across a range of health settings, both in Australia and around the world, can influence successful adoption and implementation of e-health.

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Characterizing the effectiveness of COVID-19 mitigation measures: A data-centric approach (Preprint)

10.2196/preprints.21321 ◽

2020 ◽

Author(s):

Lukman Olagoke ◽

Ahmet E. Topcu

Keyword(s):

Control Measure ◽

Control Measures ◽

World Health ◽

Mitigation Measures ◽

Effective Control ◽

The World ◽

Decision Making Processes ◽

And Performance ◽

Health Organization ◽

The Impact

BACKGROUND COVID-19 represents a serious threat to both national health and economic systems. To curb this pandemic, the World Health Organization (WHO) issued a series of COVID-19 public safety guidelines. Different countries around the world initiated different measures in line with the WHO guidelines to mitigate and investigate the spread of COVID-19 in their territories. OBJECTIVE The aim of this paper is to quantitatively evaluate the effectiveness of these control measures using a data-centric approach. METHODS We begin with a simple text analysis of coronavirus-related articles and show that reports on similar outbreaks in the past strongly proposed similar control measures. This reaffirms the fact that these control measures are in order. Subsequently, we propose a simple performance statistic that quantifies general performance and performance under the different measures that were initiated. A density based clustering of based on performance statistic was carried out to group countries based on performance. RESULTS The performance statistic helps evaluate quantitatively the impact of COVID-19 control measures. Countries tend show variability in performance under different control measures. The performance statistic has negative correlation with cases of death which is a useful characteristics for COVID-19 control measure performance analysis. A web-based time-line visualization that enables comparison of performances and cases across continents and subregions is presented. CONCLUSIONS The performance metric is relevant for the analysis of the impact of COVID-19 control measures. This can help caregivers and policymakers identify effective control measures and reduce cases of death due to COVID-19. The interactive web visualizer provides easily digested and quick feedback to augment decision-making processes in the COVID-19 response measures evaluation. CLINICALTRIAL Not Applicable

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Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

10.2196/preprints.20886 ◽

2020 ◽

Author(s):

Ahmed Youssef Kada

Keyword(s):

Case Fatality Rate ◽

Doubling Time ◽

Case Fatality ◽

World Health ◽

Fatality Rate ◽

Therapeutic Protocol ◽

First Case ◽

The World ◽

The Impact ◽

At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

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Evaluation of the first pharmacy-led weight management programme in Greece

International Journal of Pharmacy Practice ◽

10.1093/ijpp/riab015.056 ◽

2021 ◽

Vol 29 (Supplement_1) ◽

pp. i45-i46

Author(s):

A Peletidi ◽

R Kayyali

Keyword(s):

Public Health ◽

Health Services ◽

Potential Role ◽

Annual Report ◽

World Health ◽

Public Health Services ◽

Cvd Risk ◽

The World ◽

Health Organization

Abstract Introduction Obesity is one of the main cardiovascular disease (CVD) risk factors.(1) In primary care, pharmacists are in a unique position to offer weight management (WM) interventions. Greece is the European country with the highest number of pharmacies (84.06 pharmacies per 100,000 citizens).(2) The UK was chosen as a reference country, because of the structured public health services offered, the local knowledge and because it was considered to be the closest country to Greece geographically, unlike Australia and Canada, where there is also evidence confirming the potential role of pharmacists in WM. Aim To design and evaluate a 10-week WM programme offered by trained pharmacists in Patras. Methods This WM programme was a step ahead of other interventions worldwide as apart from the usual measuring parameters (weight, body mass index, waist circumference, blood pressure (BP)) it also offered an AUDIT-C and Mediterranean diet score tests. Results In total,117 individuals participated. Of those, 97.4% (n=114), achieved the programme’s aim, losing at least 5% of their initial weight. The mean % of total weight loss (10th week) was 8.97% (SD2.65), and the t-test showed statistically significant results (P<0.001; 95% CI [8.48, 9.45]). The programme also helped participants to reduce their waist-to-height ratio, an early indicator of the CVD risk in both male (P=0.004) and female (P<0.001) participants. Additionally, it improved participants’ BP, AUDIT-C score and physical activity levels significantly (P<0.001). Conclusion The research is the first systematic effort in Greece to initiate and explore the potential role of pharmacists in public health. The successful results of this WM programme constitute a first step towards the structured incorporation of pharmacists in public’s health promotion. It proposed a model for effectively delivering public health services in Greece. This study adds to the evidence in relation to pharmacists’ CVD role in public health with outcomes that superseded other pharmacy-led WM programmes. It also provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement. This primary evidence should support the Panhellenic Pharmaceutical Association, to “fight” for their rights for an active role in primary care. In terms of limitations, it must be noted that the participants’ collected data were recorded by pharmacists, and the analysis therefore depended on the accuracy of the recorded data, in particular on the measurements or calculations obtained. Although the sample size was achieved, it can be argued that it is small for the generalisation of findings across Greece. Therefore, the WM programme should be offered in other Greek cities to identify if similar results can be replicated, so as to consolidate the contribution of pharmacists in promoting public health. Additionally, the study was limited as it did not include a control group. Despite the limitations, our findings provide a model for a pharmacy-led public health programme revolving around WM that can be used as a model for services in the future. References 1. Mendis S, Puska P, Norrving B, World Health Organization., World Heart Federation., World Stroke Organization. Global atlas on cardiovascular disease prevention and control [Internet]. Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization; 2011 [cited 2018 Jun 26]. 155 p. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/ 2. Pharmaceutical Group of the European Union. Pharmacy with you throughout life:PGEU Annual Report [Internet]. 2015. Available from: https://www.pgeu.eu/en/library/530:annual-report-2015.html

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The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽

10.3390/cancers13071700 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1700

Author(s):

Melissa Chalada ◽

Charmaine A. Ramlogan-Steel ◽

Bijay P. Dhungel ◽

Christopher J. Layton ◽

Jason C. Steel

Keyword(s):

Risk Factors ◽

Ultraviolet Radiation ◽

Uveal Melanoma ◽

World Health Organisation ◽

World Health ◽

Genetic Mutations ◽

High Incidence ◽

The World ◽

The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

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Mental Health Consequences of Intimate Partner Violence Against Women in El Salvador

Violence Against Women ◽

10.1177/1077801220978803 ◽

2021 ◽

pp. 107780122097880

Author(s):

Laura Navarro-Mantas ◽

Soledad de Lemus ◽

Jesús L. Megías

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

El Salvador ◽

Violence Against Women ◽

Partner Violence ◽

Common Mental Disorders ◽

Intimate Partner ◽

World Health ◽

The World ◽

The Impact

Violence against women (VAW) is currently one of the main problems in El Salvador, which leads the ranking of femicides in the world. We conducted the first national survey on VAW in El Salvador following the World Health Organization (WHO) methodology, to determine the impact of violence on women’s mental health ( N = 1,274). Women who had experienced intimate partner violence showed significantly poorer mental health and more suicidal ideations. Common mental disorders were significantly associated with the experience of all forms of violence, after adjusting for sociodemographic variables and stressful life experiences. The results are discussed in connection with the primary care protocols and the design of public policies.

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The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population

Journal of Clinical Medicine ◽

10.3390/jcm10020289 ◽

2021 ◽

Vol 10 (2) ◽

pp. 289 ◽

Cited By ~ 1

Author(s):

Maria Stella Epifanio ◽

Federica Andrei ◽

Giacomo Mancini ◽

Francesca Agostini ◽

Marco Andrea Piombo ◽

...

Keyword(s):

Quality Of Life ◽

Online Survey ◽

Physical Space ◽

Sampling Strategy ◽

World Health ◽

Snowball Sampling ◽

World Health Organization Quality ◽

The World ◽

The Impact

The COVID-19 pandemic that has hit the world in the year 2020 has put a strain on our ability to cope with events and revolutionized our daily habits. On 9 March, Italy was forced to lockdown to prevent the spread of the infection, with measures including the mandatory closure of schools and nonessential activities, travel restrictions, and the obligation to spend entire weeks in the same physical space. The aim of this study was to assess the impact of the COVID-19 pandemic and lockdown measures on quality of life (QoL) in a large Italian sample, in order to investigate possible differences in QoL levels related to both demographic and pandemic-specific variables. A total of 2251 Italian adults (1665 women, mainly young and middle adults) were recruited via a snowball sampling strategy. Participants were requested to answer to an online survey, which included demographic and COVID-related information items, and the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF). The results showed statistically significant differences in QoL depending on a number of variables, including sex, area of residence in Italy, and being diagnosed with a medical/psychiatric condition. To our knowledge, this is the first study to assess QoL during COVID-19 pandemic in Italy, therefore the present findings can offer guidelines regarding which social groups are more vulnerable of a decline in QoL and would benefit of psychological interventions.

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