An Exploratory Study to Identify the Factors Affecting the Management of Covid-19 Patients among Nursing Officers at Selected Hospital, Puducherry

The pandemic outbreak of covid -19 especially caused by the pathogen called corona virus2 (SARS-CoV-2) which causes severe acute respiratory distress syndrome (SARS) .This virus especially affects the more elderly individual than youth and more men than women and killed over 80,000 in china. It was established by WHO.

Analysis of Impact Factors Affecting Sleep Quality among Community-Dwelling Elderly Individuals in The Chinese Community in Shanghai

Context: Insomnia is prevalent among elderly individuals and has become a public health problem receiving increasing concern. Low sleep quality is related to a number of negative health outcomes. Objective: This research aims to investigate the sleep status of community-dwelling elderly individuals (aged 60 years or older) in Shanghai, China, to explore the impact factors affecting sleep quality. Methods: One street in Shanghai city was randomly selected, and 50% of the elderly residents were randomly selected as participants for a total number of 9,616 people. Investigations were conducted by indoor surveys through home doctors and paper questionnaires. For statistical analysis, univariate and multivariate regression analysis and the Spearman correlation model were performed using SAS 9.4 to analyze the effects of the impact factors on the sleep quality of elderly individuals. Results: Sleep quality is greatly affected by physical pain in both the elderly individual and the individual’s spouse. Healthy elderly people tend to have better sleep quality, and the more chronic diseases an elderly individual suffers, the worse their sleep quality is. In addition, the physical pain of a cohabiting spouse is one of the most significant impact factors influencing sleep quality. Conclusion: We suggest that community-dwelling elderly people maintain moderate outdoor activities and a healthy mental state, which will improve their sleep quality.

Dyshidrosiform Bullous Pemphigoid

Dyshidrosiform bullous pemphigoid is a variant of bullous pemphigoid. At least 84 patients with dyshidrosiform bullous pemphigoid have been described. Dyshidrosiform bullous pemphigoid usually presents with pruritic blisters in elderly individuals; the hemorrhagic or purpuric lesions on the palms and soles can be the only manifestation of the disease. However, bullae may concurrently or subsequently appear on other areas of the patient’s body. Patients typically improve after the diagnosis is established and treatment is initiated. The mainstay of therapy is systemic corticosteroids, with or without topical corticosteroids, and systemic dapsone or immunosuppressants. Drug-related or nickel-induced dyshidrosiform bullous pemphigoid improves after stopping the associated agent; however, systemic therapy has also been required to achieve resolution of the blisters. Similar to classic bullous pemphigoid, neurologic conditions and psychiatric disorders have been observed in dyshidrosiform bullous pemphigoid patients. The new onset of recurrent or persistent blisters on the palms, soles, or both of an elderly individual should prompt the clinician to consider the diagnosis of dyshidrosiform bullous pemphigoid.

Complicated versus complexity: when an old woman and her daughter meet the health care system

Background Detecting infection in frail elderly is a challenge due to lack of specific signs and symptoms. We highlight the complex situation when an elderly woman with urinary tract infection (UTI) and her daughter meet the highly qualified health care system. The aim was to describe and analyze the process when an elderly individual with an acute infection encounters the healthcare system. Methods A descriptive, retrospective Single Case Study design with a qualitative approach was used. Data from interviews with the old women and her daughter, medical record data and different regulatory documents were gathered and analysed with a qualitative content analysis. In a second step, the results were interpreted with concepts from the complexity theory. Complexity theory has been used as a conceptual framework for analysis or a framework for interpretation. In this study we are using the theory for interpretation by comparing the results with the complexity theory, which is explored in the discussion. Results The latent content analysis of the daughter’s story is interpreted as though she perceives the situation as causing a life crisis and a threat to her mother’s entire existence. The old women herself does not take part in what is happening, though after returning to home she is trying to understand her behaviour and what has happened. The health care tries different diagnoses and treatment according to standardized care plans without success. When urinary tract infection is finally diagnosed and treated successfully, the old women recovers quickly. Conclusion The healthcare system should embrace the complexity in the encounter with an elderly individual. However, we found that the immediate reaction from the healthcare system is to handle the patients’ problem as complicated by complexity reduction. Shortcomings are that elderly patients with multiple disorders are difficult to evaluate and triage “correctly” for later placement in the appropriate continuum of care, although the findings of this case study also imply that with time the system instead took on an approach of absorption of complexity.

Mass evacuation and increases in long-term care benefits: lessons from the Fukushima nuclear disaster

BackgroundThough mass evacuation may increase the need for long-term care (LTC) services, how the need for LTC services increases and how the public LTC system affects it is not well understood. We evaluated changes in public LTC benefits for the people living in the mandatory evacuation areas established after the 2011 Fukushima nuclear disaster and examined the roles of the universal LTC insurance system in Japan.MethodsIn order to evaluate the effect of the mandatory evacuation on LTC benefits, we examined the trends of LTC benefits in the Fukushima evacuation group and the nationwide non-evacuation group. We first decomposed per-elderly-individual benefits at the municipality level into the LTC certification rate and per-certified-individual benefits, and then implemented difference-in-differences analysis using these variables as outcomes.ResultsPer-elderly-individual benefits significantly increased from 2012 onward in the evacuation group, and this was explained by an increase in the certification rate rather than in per-certified-individual benefits. Increases in per-elderly-individual benefits and the certification rate in the post-disaster period were observed in all but the highest care level, and the corresponding outcomes for the highest care level decreased immediately after the disaster. We also found that the increase in the certification rate had been mostly realized by an increase in the number of certified individuals.ConclusionsThe increase in LTC benefits can be associated with the impact of the increase in the number of people newly certified to receive LTC benefits after the mandatory evacuation. In order to cope with the increase in utilization of long-term care and associated costs after disasters in aging societies, both formal long-term care services and social support for informal care for evacuees should be considered important.