967 resultados para Older adult


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This study investigated the effectiveness of comprehension level preadjunct questions as a learning strategy for older adults in a classroom setting. Fifty-five adults from 55 to 70 years of age were randomly assigned to two groups, the preadjunct question group and a no-question control group. They viewed a video on high blood pressure and completed a recall posttest immediately after viewing the video and again seven days tater. Results demonstrated that there was no significant difference between groups. However, the no-question control group obtained a higher mean score on both the immediate and delayed recall tests than did the preadjunct question group. Nevertheless, significant differences in posttest scores were found related to educational levels and prior knowledge about high blood pressure. Results obtained were explained in terms of resource theory of cognitive aging.

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Adult human neural crest-derived stem cells (NCSCs) are of extraordinary high plasticity and promising candidates for the use in regenerative medicine. Here we describe for the first time a novel neural crest-derived stem cell population within the respiratory epithelium of human adult inferior turbinate. In contrast to superior and middle turbinates, high amounts of source material could be isolated from human inferior turbinates. Using minimally-invasive surgery methods isolation is efficient even in older patients. Within their endogenous niche, inferior turbinate stem cells (ITSCs) expressed high levels of nestin, p75(NTR), and S100. Immunoelectron microscopy using anti-p75 antibodies displayed that ITSCs are of glial origin and closely related to nonmyelinating Schwann cells. Cultivated ITSCs were positive for nestin and S100 and the neural crest markers Slug and SOX10. Whole genome microarray analysis showed pronounced differences to human ES cells in respect to pluripotency markers OCT4, SOX2, LIN28, and NANOG, whereas expression of WDR5, KLF4, and c-MYC was nearly similar. ITSCs were able to differentiate into cells with neuro-ectodermal and mesodermal phenotype. Additionally ITSCs are able to survive and perform neural crest typical chain migration in vivo when transplanted into chicken embryos. However ITSCs do not form teratomas in severe combined immunodeficient mice. Finally, we developed a separation strategy based on magnetic cell sorting of p75(NTR) positive ITSCs that formed larger neurospheres and proliferated faster than p75(NTR) negative ITSCs. Taken together our study describes a novel, readily accessible source of multipotent human NCSCs for potential cell-replacement therapy.

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Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

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The ability to regulate emotion is crucial to promote well-being. Evidence suggests that the medial prefrontal cortex (mPFC) and adjacent anterior cingulate (ACC) modulate amygdala activity during emotion regulation. Yet less is known about whether the amygdala-mPFC circuit is linked with regulation of the autonomic nervous system and whether the relationship differs across the adult lifespan. The current study tested the hypothesis that heart rate variability (HRV) reflects the strength of mPFC-amygdala interaction across younger and older adults. We recorded participants’ heart rates at baseline and examined whether baseline HRV was associated with amygdala-mPFC functional connectivity during rest. We found that higher HRV was associated with stronger functional connectivity between the amygdala and the mPFC during rest across younger and older adults. In addition to this age-invariant pattern, there was an age-related change, such that greater HRV was linked with stronger functional connectivity between amygdala and ventrolateral PFC (vlPFC) in younger than in older adults. These results are in line with past evidence that vlPFC is involved in emotion regulation especially in younger adults. Taken together, our results support the neurovisceral integration model and suggest that higher heart rate variability is associated with neural mechanisms that support successful emotional regulation across the adult lifespan.

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This paper reviewed studies on staff training programs to address the behavioral problems associated with dementia among older people in residential care. The papers were classified according to whether or not the studies included a control group in the research design. The results of the review demonstrate that there has been a wide range of psychosocial and educational interventions to reduce behavioral problems among older people with dementia, with inconsistent results being obtained. However, many of these studies suffer from problems in their research design that make it difficult to evaluate their effectiveness. Problems in conducting research in the nursing home setting are highlighted, and suggestions for future research in this area are discussed.

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The field of adult literacy and basic education (ALBE) has undergone dramatic changes in recent years with the advent of labour market programs, accreditation, competency-based assessment and competitive tendering for program funds. Teachers' working conditions have deteriorated and their professional autonomy has been eroded. ALBE has been increasingly instrumentalised to fulfil the requirements of a marketised economy and conform to its norms. The beliefs and value systems which traditionally underpinned the work of ALBE teachers have been reframed according to the principle of 'performativity' and the demands of the 'performative State' (Lyotard, 1984: 46, Yeatman 1994: 110). The destabilisation of teachers' working lives can be understood as a manifestation of the 'postmodern condition' (Lyotard 1984; Harvey 1989): the collapse of the certainties and purposes of the past; the proliferation of technologies; the impermanence and intensification of work; the commodification of knowledge and curricula; and the dissolving of boundaries between disciplines and fields of knowledge. The critiques of the modernist grand narratives which underpin progressivist and critical approaches to adult literacy pedagogy have further undermined the traditional points of reference of ALBE teachers. In this thesis I examine how teachers are teaching, surviving, resisting, and 'living the contradictions' (Seddon 1994) in the context of struggles to comply with and resist the requirements of performativity. Following Foucault and a number of feminist poststructuralist authors, I have applied the notions of 'discursive engagement' and 'the politics of discourse' (Yeatman 1990a) as a way of theorising the interplay between imposed change and teachers' practice. I explore the discursive practices which take place at the interface between the 'new' policy discourses and older, naturalised discourses; how teachers are engaged by and are engaging with discourses of performativity; how teachers are discursively constructing adult literacy pedagogy; what new, hybrid discourses of 'good practice' are emerging; and the micropractices of resistance which teachers are enacting in their speech and in their practice. My purpose was to develop knowledge which would support the reflexivity of teachers; to enrich the theoretical languages that teachers could draw upon in trying to make sense of their situation; and to use those languages in speaking about the dilemmas of practice. I used participatory action research as a means of producing knowledge about teachers' practices, structured around their agency, and reflecting their standpoint (Harding 1993). I describe two separate action research projects in which teachers of ALBE participated. I reflect on both projects in the light of poststructuralist theory and consider them as instances of what Lather calls 'within/against research' (Lather 1989: 27). I analyse written and spoken texts produced in both projects which reflect teachers' responses to competency-based assessment and other features of the changing context. I use a method of discourse mapping to describe the discursive field and the teachers' discursive practices. Three main configurations of discourse are delineated: 'progressivism', 'professional teacher' and 'performativity'. The teachers mainly position themselves within a hybridising 'progressivist /professional teacher' discourse, as a discourse of resistance to 'performative' discourse. In adapting their pedagogies, the teachers are in some degree taking the language and world view of performativity into their own vocabularies and practices. The discursive picture I have mapped is complex and contradictory. On one hand, the 'progressivist /professional teacher' discourse appears to endure and to take strength from the articulation into it of elements of performative discourse, creating new possibilities for discursive transformation. On the other hand, there are signs that performative discourse is colonising and subsuming progressivist /professional teacher discourse. At times, both of these tendencies are apparent in the one text. Six micropractices of resistance are identified within the texts: 'rational critique', 'objectification', 'subversion', 'refusal', 'humour' and 'the affirmation of desire'. These reflect the teachers' agency in making discursive choices on the micro level of their every day practices. Through those micropractices, the teachers are engaging with and resisting the micropractices and meanings of performativity. I apply the same multi-layered method of analysis to an examination of discursive engagement in pedagogy by analysing a transcript of the teachers' discussion of critical incidents in their classrooms. Their classroom pedagogies are revealed as complex, situated and eclectic. They are combining and integrating their 'embodied' and their 'institutional' powers, both 'seducing' (McWilliam 1995) and 'regulating' (Gore 1993) as they teach. A strong ethical project is apparent in the teachers' sense of social responsibility, in their determination to adhere to valued traditions of previous times, and in their critical self-awareness of the ways in which they use their institutional and embodied powers in the classroom. Finally, l look back on the findings, and reflect on the possibilities of discursive engagement and the politics of discourse as a framework for more strategic practice in the current context. This research provides grounds for hope that, by becoming more self-conscious about how we engage discursively, we might become more strategic in our everyday professional practice. Not withstanding the constraints (evident in this study) which limit the strategic potential of the politics of discourse, there is space for teachers to become more reflexive in their professional, pedagogical and political praxis. Development of more deliberate, self-reflexive praxis might lead to a 'postmodern democratic polities' (Yeatman 1994: 112) which would challenge the performative state and the system of globalised capital which it serves. Short abstract Adult literacy and basic education (ALBE) teachers have experienced a period of dramatic policy change in recent years; in particular, the introduction of competency-based assessment and competitive tendering for program funds. 'Discourse politics' provides a way of theorising the interplay between policy-mediated institutional change and teachers' practice. The focus of this study is 'discursive engagement'; how teachers are engaged by and are engaging with discourses of performativity. Through two action research projects, texts were generated of teachers talking and writing about how they were responding to the challenges, and developing their pedagogies in the new policy environment. These texts have been analysed and several patterns of discursive engagement delineated, named and illustrated. The strategic potential of 'discourse polities' is explored in the light of the findings.

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Financial abuse of older people too often lives ‘in the shadows, hidden by fear and shame’. This and the protective love between family members can screen changes that are critical to an older person’s financial and living arrangements. Rather than a single event, it is usually a series of well-intentioned but ill-considered financial acts, which at some point tips over into abuse interwoven with an intricate web of family relationships. Was a transfer of title or a loan to an adult child really misappropriation? Has thoughtlessness become undue influence or even theft? 

Seniors’ support agencies find that older people call for help after they have transferred money or property in the expectation of future housing and care from a younger family member. By then the money has usually gone, relationships have been destroyed and serious issues of health and homelessness have arisen. These situations are preventable and this is core to Seniors Rights Victoria’s legal education project – the prevention of financial abuse of older people in situations where assets have been transferred in exchange for care.
This paper is the third of three publications produced for this project. The previous two were: ‘Assets for Care: A Guide for Lawyers to Assist Clients at Risk of Financial Abuse’, and a guide for older people: ‘Care for Your Assets: Money, Ageing and Family. Each of these publications reflects the experience and knowledge of Seniors Rights Victoria and the service’s rights-based, preventive approach. Prevention of financial abuse helps avoid deep personal anguish and can lessen the burden on services that respond to elder abuse.
An examination of current law and its effectiveness together with discussion of and recommendations for law and policy reform, relevant to ‘assets for care’ scenarios, are this paper’s focus. Although some reform approaches are worthwhile, many shortcomings are systemic and cannot be dealt with through law reform alone, particularly given people’s reluctance to seek legal recourse for these complex and intensely personal family issues.

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Background
Cost-effectiveness analyses of interventions for older adults have traditionally focused on health status. There is increasing recognition of the need to develop new instruments to capture quality of life in a broader sense in the face of age-associated increasing frailty and declining health status, particularly in the economic evaluation of aged and social care interventions which may have positive benefits beyond health. 


Objective
To explore the relative importance of health and broader quality of life domains for defining quality of life from the perspective of older South Australians.

Methods
Older adults (n=21) from a day rehabilitation facility in Southern Adelaide, South Australia attended one of two audiorecorded focus groups. A mixed methods (qualitative and quantitative) approach was adopted. The study included three main components. Firstly, a general group discussion on quality of life and the factors of importance in defining quality of life. Secondly, a structured ranking exercise in which individuals were asked to rank domains from the brief Older People’s Quality of Life questionnaire (OPQOL-brief) and Adult Social Care Outcomes Toolkit (ASCOT) in order of importance. Thirdly, participants were asked to self-complete the Euroqol (EQ-5D) a measure of health status, and two broader quality of life measures: the OPQOL-brief and ASCOT.

Results
Mean scores on the EQ-5D, OPQOL-brief and ASCOT were 0.71 (SD 0.20, range 0.06-1.00), 54.6 (SD 5.5, range 38-61) and 0.87 (SD 0.13, range 0.59-1.00) respectively, with higher scores reflecting better ratings of QOL. EQ-5D scores were positively associated with OPQOL-brief (rho: .730, p<.01), but not ASCOT. Approximately half (52.4%) of the respondents ranked either “health” or “psychological and emotional well- being” as the domain most important to their quality of life. However, one-third (33.3%) of the total sample ranked a non-health domain from the ASCOT or OPQOL-brief (safety, dignity, independence) as the most important contributing factor to their overall quality of life. Qualitative analysis of focus group transcripts supported the high value of both health-related (health, psychological well-being) and social (independence, safety) domains to quality of life.

Conclusions
Older adults value both health and social domains as important to their overall quality of life. Future economic evaluations of health, community and aged-care services for older adults should include assessment of both healthrelated and broader aspects quality of life.

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There has been a growing interest in environmental initiatives to reduce sedentary behaviour. A few existing studies on this topic are mostly cross-sectional, focused on the general adult population, and examining neighbourhood walkability. This study examined associations of perceived environmental attributes with change in TV viewing time over seven years among older Australian adults in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

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Phenotypic variation and individual experience can create behavioural and/or dietary variation within a population. This may reduce intra-specific competition, creating a buffer to environmental change. This study examined how intrinsic variation affects foraging behaviour of Australian fur seals. Foraging movements of 29 female Australian fur seals were recorded using FastLoc GPS and dive behaviour recorders. For each individual, body mass, flipper length and axis length were recorded, a tooth was sampled to determine age, and milk was collected for diet analysis. Clustering of fatty acid dietary analysis revealed 5 distinct groups in the population. Behaviour was described using 19 indices, which were then reduced to 7 principal components (>80% of the behavioural variation). Bayesian mixed effect models were developed to describe the relationship between these components and intrinsic variation. No association was found between diet and age or body shape; however, age had a negative relationship with component 1 (27% of variation). Older females spent less time at-sea and foraged nearer to the colony. Age had an effect on component 5 (7% of variation), which represented haul-outs and dive depth; older females made fewer visits to haul-out sites and dived deeper to the benthos. This suggests that as animals age they are able to utilise prior knowledge to exploit nearby foraging sites that younger animals are either unaware of, or have yet to gain the experience required to efficiently utilise. Mass had a negative effect on components representing the directedness of a foraging trip, suggesting heavier individuals were more likely to travel directly to a foraging site.

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Intuitive eating has been proposed as an eating style that fosters a positive attitude towards food, the body, and physical activity. A systematic review of the literature was undertaken to examine intuitive eating in relation to disordered eating, body image, emotional functioning, and other psychosocial correlates in adult women. Articles were identified through Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source (Nursing and Academic Edition), Medline Complete, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, PubMed and Scopus. Eligible studies were those that examined women aged 18 years and older, measured intuitive eating, and assessed a psychosocial correlate of intuitive eating. Twenty-four cross-sectional studies, published between 2006 and September 2015, met eligibility criteria. Intuitive eating was associated with less disordered eating, a more positive body image, greater emotional functioning, and a number of other psychosocial correlates that have been examined less extensively. However, given that all studies used cross-sectional designs, no conclusions regarding the direction of the relationship between intuitive eating and psychosocial correlates can be drawn. Participants in the majority of studies were university students in the United States so findings cannot be generalised to the wider population of female adults. Prospective studies are now needed to verify these cross-sectional findings, and show if intuitive eating may reduce disordered eating and body image concerns, and promote women's psychological health and well-being.

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The study's purpose was to examine age, gender, and education as potential moderators of the associations of perceived neighborhood environment variables with accelerometer-based moderate-to-vigorous physical activity (MVPA). Data were from 7273 adults from 16 sites (11 countries) that were part of a coordinated multi-country cross-sectional study. Age moderated the associations of perceived crime safety, and perceiving no major physical barriers to walking, with MVPA: positive associations were only found in older adults. Perceived land use mix-access was linearly (positive) associated with MVPA in men, and curvilinearly in women. Perceived crime safety was related to MVPA only in women. No moderating relationships were found for education. Overall the associations of adults' perceptions of environmental attributes with MVPA were largely independent of the socio-demographic factors examined. These findings are encouraging, suggesting that efforts to optimize the perceived built and social environment may act in a socially-equitable manner to facilitate MVPA.

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The effects of age on microbiota composition, gut fermentation end-product formation and peripheral lymphocyte numbers were compared between old and young adult Beagle dogs fed four kibble diets differing in yeast cell wall contents. The experiment had a double 4 x 4 Latin square design, one with four mature dogs (4 years old) and the other with four old dogs (10 years old), with four replicates (diets) per dog. In each period a 15d adaptation period preceded a 5d total collection of faeces for the digestibility trial. on day 21, fresh faecal samples were collected for the determination of bacterial enumeration, pH, biogenic amine and short-chain fatty acid. Flow cytometry was used for immunophenotypic evaluation. Dogs were fed four kibble diets with similar composition with 0, 0.15, 0.30 and 0.45% of yeast cell wall (as-fed), respectively. Data were evaluated using general linear models of Statistical Analysis Systems statistical software (P<0.05). No evidence of a difference in faecal bacteria counts between ages was found (total aerobes, total anaerobes, Bifidobacterium, Lactobacillus, Clostridium and Escherichia coli: P. 0.15). Faecal concentrations of butyrate, histamine, agmatine and spermine were lower (P <= 0.05) and faecal pH was higher (P=0.03) in older dogs than in mature adult dogs, suggesting an alteration in bacterial metabolic activity, or in the rate of intestinal absorption of these compounds. Concentrations of T-lymphocytes, T-cytotoxic lymphocytes and B-lymphocytes were also lower (P <= 0.01) in older dogs than in mature adult dogs. The study confirmed alterations in peripheral lymphocytes and revealed a reduced concentration of some fermentation end products in the colon of old dogs.