Transition from community dwelling to retirement village in older adults:cognitive functioning and psychological health outcomes

Supported living and retirement villages are becoming a significant option for older adults with impairments, with independence concerns or for forward planning in older age, but evidence as to psychological benefits for residents is sparse. This study examined the hypothesis that the multi-component advantages of moving into a supported and physically and socially accessible “extra care” independent living environment will impact on psychological and functioning measures. Using an observational longitudinal design, 161 new residents were assessed initially and three months later, in comparison to 33 older adults staying in their original homes. Initial group differences were apparent but some reduced after three months. Residents showed improvement in depression, perceived health, aspects of cognitive function, and reduced functional limitations, while controls showed increased functional limitations (worsening). Ability to recall specific autobiographical memories, known to be related to social-problem solving, depression and functioning in social relationships, predicted change in communication limitations, and cognitive change predicted changes in recreational limitations. Change in anxiety and memory predicted change in depression. Findings suggest that older adults with independent living concerns who move to an independent but supported environment can show significant benefits in psychological outcomes and reduction in perceived impact of health on functional limitations in a short period. Targets for focussed rehabilitation are indicated, but findings also validate development of untargeted general supportive environments.

Journey to work:exploring difficulties, solutions and the impact of aging

A study was conducted in the UK, as part of the New Dynamics of Ageing Working Late project, of the journey to work among 1215 older workers (age groups 45-49, 50-55, 56-60 and 60 + ). The aim was to identify problems or concerns that they might have with their commute, strategies that have been adopted to address them, and the role that employers can play to assist them. Follow-up interviews with 36 employees identified many strategies for assisting with the problems of journeys to work, ranging from car share and using public transport to flexible working and working some days from home. Further interviews with a sample of 12 mainly larger companies showed that employers feel a responsibility for their workers’ commute, with some offering schemes to assist them, such as adjusting work shift timings to facilitate easier parking. The research suggests that the journey to work presents difficulties for a significant minority of those aged over 45, including issues with cost, stress, health, fatigue and journey time. It may be possible to reduce the impact of these difficulties on employee decisions to change jobs or retire by assisting them to adopt mitigating strategies. It does not appear that the likelihood of experiencing a problem with the journey to work increases as the employee approaches retirement; therefore, any mitigating strategy is likely to help employees of all ages. These strategies have been disseminated to a wider audience through an online resource at www.workinglate.org.

Individual's recollections of their experiences in eye clinics and understanding of their eye condition:results from a survey of visually impaired people in Britain

Background/aims: Network 1000 is a UK-based panel survey of a representative sample of adults with registered visual impairment, with the aim of gathering information about people’s opinions and circumstances. Method: Participants were interviewed (Survey 1, n = 1007: 2005; Survey 2, n = 922: 2006/07) on a range of topics including the nature of their eye condition, details of other health issues, use of low vision aids (LVAs) and their experiences in eye clinics. Results: Eleven percent of individuals did not know the name of their eye condition. Seventy percent of participants reported having long-term health problems or disabilities in addition to visual impairment and 43% reported having hearing difficulties. Seventy one percent reported using LVAs for reading tasks. Participants who had become registered as visually impaired in the previous 8 years (n = 395) were asked questions about non-medical information received in the eye clinic around that time. Reported information received included advice about ‘registration’ (48%), low vision aids (45%) and social care routes (43%); 17% reported receiving no information. While 70% of people were satisfied with the information received, this was lower for those of working age (56%) compared with retirement age (72%). Those who recalled receiving additional non-medical information and advice at the time of registration also recalled their experiences more positively. Conclusions: Whilst caution should be applied to the accuracy of recall of past events, the data provide a valuable insight into the types of information and support that visually impaired people feel they would benefit from in the eye clinic.

Editorial

This second issue of Knowledge Management Research & Practice (KMRP) continues the international nature of the first issue, with papers from authors based on four different continents. There are five regular papers, plus the first of what is intended to be an occasional series of 'position papers' from respected figures in the knowledge management field, who have specific issues they wish to raise from a personal standpoint. The first two regular papers are both based on case studies. The first is 'Aggressively pursuing knowledge management over two years: a case study a US government organization' by Jay Liebowitz. Liebowitz is well known to both academics and practictioners as an author on knowledge management and knowledge based systems. Government departments in many Western countries must soon face up to the problems that will occur as the 'baby boomer' generation reaches retirement age over the next decade. This paper describes how one particular US government organization has attempted to address this situation (and others) through the introduction of a knowledge management initiative. The second case study paper is 'Knowledge creation through the synthesizing capability of networked strategic communities: case study on new product development in Japan' by Mitsuru Kodama. This paper looks at the importance of strategic communities - communities that have strategic relevance and support - in knowledge management. Here, the case study organization is Nippon Telegraph and Telephone Corporation (NTT), a Japanese telecommunication firm. The third paper is 'Knowledge management and intellectual capital: an empirical examination of current practice in Australia' by Albert Zhou and Dieter Fink. This paper reports the results of a survey carried out in 2001, exploring the practices relating to knowledge management and intellectual capital in Australia and the relationship between them. The remaining two regular papers are conceptual in nature. The fourth is 'The enterprise knowledge dictionary' by Stuart Galup, Ronald Dattero and Richard Hicks. Galup, Dattero and Hicks propose the concept of an enterprise knowledge dictionary and its associated knowledge management system architecture as offering the appropriate form of information technology to support various different types of knowledge sources, while behaving as a single source from the user's viewpoint. The fifth and final regular paper is 'Community of practice and metacapabilities' by Geri Furlong and Leslie Johnson. This paper looks at the role of communities of practice in learning in organizations. Its emphasis is on metacapabilities - the properties required to learn, develop and apply skills. This discussion takes work on learning and core competences to a higher level. Finally, this issue includes a position paper 'Innovation as an objective of knowledge management. Part I: the landscape of management' by Dave Snowden. Snowden has been highly visible in the knowledge management community thanks to his role as the Director of IBM Global Services' Canolfan Cynefin Centre. He has helped many government and private sector organizations to consider their knowledge management problems and strategies. This, the first of two-part paper, is inspired by the notion of complexity. In it, Snowden calls for what he sees as a 20th century emphasis on designed systems for knowledge management to be consigned to history, and replaced by a 21st century emphasis on emergence. Letters to the editor on this, or any other topic related to knowledge management research and practice, are welcome. We trust that you will find the contributions stimulating, and again invite you to contribute your own paper(s) to future issues of KMRP.

Corpus, collocation, and lexical sets

This paper is a progress report on a research path I first outlined in my contribution to “Words in Context: A Tribute to John Sinclair on his Retirement” (Heffer and Sauntson, 2000). Therefore, I first summarize that paper here, in order to provide the relevant background. The second half of the current paper consists of some further manual analyses, exploring various parameters and procedures that might assist in the design of an automated computational process for the identification of lexical sets. The automation itself is beyond the scope of the current paper.

The antioxidant enzyme peroxiredoxin-2 is depleted in lymphocytes seven days after ultra-endurance exercise

Purpose: Peroxiredoxin-2 (PRDX-2) is an antioxidant and chaperone-like protein critical for cell function. This study examined whether the levels of lymphocyte PRDX-2 are altered over one month following ultra-endurance exercise. Methods: Nine middle-aged men undertook a single-stage, multi-day 233 km (145 mile) ultra-endurance running race. Blood was collected immediately before (PRE), upon completion/retirement (POST), and following the race at DAY 1, DAY 7 and DAY 28. Lymphocyte lysates were examined for PRDX-2 by reducing SDS-PAGE and western blotting. In a sub-group of men who completed the race (n = 4) PRDX-2 oligomeric state (indicative of redox status) was investigated. Results: Ultra-endurance exercise caused significant changes in lymphocyte PRDX-2 (F (4,32) 3.409, p=0.020, ?(2) =0.299): seven-days after the race, PRDX-2 levels in lymphocytes had fallen to 30% of pre-race values (p=0.013) and returned to near-normal levels at DAY 28. Non-reducing gels demonstrated that dimeric PRDX-2 (intracellular reduced PRDX-2 monomers) was increased in 3 of 4 race completers immediately post-race, indicative of an "antioxidant response". Moreover, monomeric PRDX-2 was also increased immediately post-race in 2 of 4 race-completing subjects, indicative of oxidative damage, which was not detectable by DAY 7. Conclusions: Lymphocyte PRDX-2 was decreased below normal levels 7 days after ultra-endurance exercise. Excessive accumulation of reactive oxygen species induced by ultra-endurance exercise may underlie depletion of lymphocyte PRDX-2 by triggering its turnover after oxidation. Low levels of lymphocyte PRDX-2 could influence cell function and might, in part, explain reports of dysregulated immunity following ultra-endurance exercise.

Auto plant closures, policy responses and labour market outcomes:a comparison of MG Rover in the UK and Mitsubishi in Australia

This paper provides a preliminary comparative longitudinal analysis of the impact on workers made redundant due to the closure of the Mitsubishi plant in Adelaide and the MG Rover plant in Birmingham. Longitudinal surveys of ex-workers from both firms were undertaken over a 12-month period in order to assess the process of labour market adjustment. In the Mitsubishi case, given the skills shortage the state of Adelaide was facing, together with the considerable growth in mining and defence industries, it would have been more appropriate if policy intervention had been redirected to further training or re-skilling opportunities for redundant workers. This opportunity was effectively missed and as a result more workers left the workforce, most notably for retirement, than could have otherwise been the case. The MG Rover case was seen as a more successful example of policy intervention, with greater funding assistance available and targeted support available, and with more emphasis on re-training needs to assist adjustment. However, despite the assistance offered and the rhetoric of successful adjustment in both cases, the majority of workers have nevertheless experienced deterioration in their circumstances particularly in the Australian case where casual and part-time work were often the only work that could be obtained. Even in the UK case, where more funding assistance was offered, a majority of workers reported a decline in earnings and a rise in job insecurity. This suggests that a reliance on the flexible labour market is insufficient to promote adjustment, and that more active policy intervention is needed especially in regard to further up-skilling.

Public and private hospital services reform:an investigation in Iranian hospitals

This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani province of Iran by making use of DEA approach in order to recognize and suggest the best practice standards. In other words, its aim was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. It is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial and national levels.

Case Comment : Challenging the validity of leasehold guarantees:undue influence, non-est factum and formality issues

Case: Beardsley Theobalds Retirement Benefit Scheme Trustees v Yardley [2011] EWHC 1380 (QB) (QBD). The recent case of Beardsley Theobalds Retirement Benefit Scheme Trustees v Yardley, nicely illustrates, inter alia, the impact of the contractual defences of undue influence and the plea of non est factum in the context of avoiding liability under leasehold guarantees, within the setting of the landlord and tenant relationship. Additionally, the case also gives us an insight into the possible application of other technical defences relating to the law of formalities for leases. Judgment in this case was handed down on September 30, 2011.

Lymphocyte peroxiredoxin-2 levels are depleted one week after ultra-endurance exercise

Peroxiredoxin-2 (PRDX-2) belongs to a family of thiol containing proteins and is important for antioxidant defense, redox signaling and cell function. This study examined whether lymphocyte PRDX-2 levels are altered over one month following ultra-endurance exercise. Nine middle-aged men participated in a 145 mile ultra-endurance running race event. Blood drawing was undertaken immediately before, upon completion/retirement, and at one, seven and twenty eight-days following the race. PRDX-2 levels were examined at each time-point, for all participants (n=9) by reducing SDS-PAGE and western blotting. Further analysis using non-reducing SDS-PAGE and western blotting was undertaken in a sub-group of men who completed the race (n = 4) to investigate PRDX-2 oligomeric state (indicative of oxidation state). Ultra-endurance exercise caused a significant alteration in lymphocyte PRDX-2 levels (F(4,32) 3.409, p=0.020, η2 =0.299): seven-days after the race PRDX-2 levels fell by 70% (p=0.013) and at twenty eight-days after the race returned to near-normal levels. PRDX-2 dimers (intracellular reduced PRDX-2 monomers) in three of the four participants, who finished the race, were increased upon race completion. Furthermore, PRDX-2 monomers (intracellular over-oxidized PRDX-2 monomers) in two of these four participants were present upon race completion, but absent seven-days after the race. This study found that PRDX-2 levels in lymphocytes were reduced below normal levels seven-days after an ultra-endurance running race. We suggest that excessive reactive oxygen species production, induced by ultra-endurance exercise may, in part, explain the depletion of lymphocyte PRDX-2 by triggering its turnover after oxidation.