The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

Alleviation of Papain-Induced Osteoarthritis by Recombinant Human Endostatin via Downregulation of Matrix Metalloproteinase-13, Interleukin-1 and Interleukin-6 in Rats

Osteoarthritis (OA) is a degenerative disease of joints commonly occurring in the elderly and middleaged people. This study aimed to investigate the effect of recombinant human endostatin (rhEndo) on OA and the levels of MMP-13, IL-1 and IL-6 in the synovial fluid in osteoarthritis rats. OA models were made by injecting 4% papain into the knee joint cavity of rats once every three days for three times. The models were then injected subcutaneously with rhEndo and examined six weeks later for the Mankin scores and levels of MMP-13, IL-1 and IL-6 using ELISA. Compared with control, the Mankin score as well as the levels of IL-1, IL-6 and MMP-13 were significantly increased in the models (0.30 vs. 5.80, 1.12 vs. 12.84 pg/ mL, 12.22 vs. 43.82 pg/ mL and 0.23 vs. 26.31 ng/ mL). Following treatment with 4 mg/kg rhEndo, the Mankin score in model decreased to 0.90, meanwhile, the levels of IL-1, IL-6 and MMP-13 decreased significantly to 0.79 pg/ mL, 2.89 pg/mL and 1.17 ng/mL, respectively, in a dose dependent manner. Therefore, rhEndo can alleviate osteoarthritis by reducing MMP-13, IL-1 and IL-6 expression in rats.

Factors Affecting Customer Intention to Adopt a Mobile Chronic Disease Management Service

The Mobile Chronic Disease Management Service (MCDMS) is an emerging medical service for chronic disease prevention and treatment, but limited attention has been paid to the factors that affect users’ intention to adopt the service. Based on the unified theory of acceptance and use of technology 2 and the protection motivation theory, the authors built an MCDMS adoption model. The authors also verified the differentiating age effect on the service adoption intention from experiential distance perspective of the construal level theory. Empirical results showed that the young group focused more on the impact of effort expectancy, whereas the elderly group focused more on performance expectancy, imitating others, and perceived severity. Furthermore, the young group, however, focused more on the impact of perceived vulnerability, and offline medical habits showed no significant influence on either group’s intention to adopt, which were not consistent with the original hypotheses. The findings can aid MCDMS providers in selecting marketing strategies targeted toward different age groups.

Factors Affecting the Sense of Coherence (SOC) for Long-term Evacuees after a Large-Scale Disaster in Japan

Disasters has been occurring frequently all over the world, and an increasing number of people have been forced to continue their evacuation life for a long time. In the aftermath of the 2011 Great East Japan Earthquake and the Fukushima nuclear power plant accident in Japan, some people are still unable to return to their homes due to radioactive contamination and are forced to live as evacuees for long periods of time. It is considered a serious public health issue to keep mentality healthy under the stress of living after the disaster. Therefore, the purpose of this study was to examine the factors that affect the sense of coherence (SOC), which is considered as the ability to cope with stress and maintain health, in residents who continue to live as evacuees after a large-scale disaster. The method was a self-administered questionnaire survey of 1,602 long-term evacuees in Japan. Multiple logistic regression analysis was conducted with the high and low SOC score groups as dependent variables in order to identify factors that predicted high and low SOC. The results showed that the SOC tended to decrease in the elderly and those with deteriorating mental health. On the other hand, those who were active in education and hobbies, and those who socialized with their neighbors and friends tended to have the higher SOC. In order to support residents who have been forced to continue living as evacuees for a long period of time, it is important to provide them with psychological and emotional support to prevent them from being emotionally overwhelmed, as well as living environment improvement and economic support. It was suggested that the promotion of resident-led activities that lead to mental relaxation and the introduction of stress reduction methods that can be easily adopted by residents are effective in maintaining mental health.

The Moderation of Perceived Comfort and Relations with Patients in the Relationship between Secure Workplace Attachment and Organizational Citizenship Behaviors in Elderly Facilities Staff

This study focuses on caregivers who work in residential facilities (RFs) for the elderly, and specifically on their organizational citizenship behaviors (OCBs) in relation to their interaction respectively with the overall context (workplace attachment dimension), the spatial-physical environment (perceived environmental comfort), and the social environment (relationship with patients). A sample of health care workers (medical or health care specialists, nurses, and office employees, n = 129) compiled a self-report paper-pencil questionnaire, which included scales measuring the study variables. The research hypotheses included secure workplace attachment style as independent variable, OCBs as the dependent variable, and perceived comfort and relations with patients as moderators. Results showed that both secure workplace attachment and perceived comfort promote OCBs, but the latter counts especially as a compensation of an insecure workplace attachment. As expected, difficult relationships with patients hinder the relationship between secure workplace attachment style and OCBs. In sum, our study highlights the importance of the joint consideration of the psychological, social, and environmental dimensions for fostering positive behaviors in caregivers employed in elderly care settings.