Age Care Facilities Research Articles

Resource recovery potential of Kumasi landfill waste

Landfill mining is an innovative way to minimize environmental pollution, secure land and airspace, and recover secondary raw materials from landfills. The study examined the characteristics of landfilled waste at the Kumasi landfill and its potential for resource recovery. Samples were collected based on the deposition age and characterized in the laboratory. Characteristics determined were composition, volatile solids, moisture content, and heavy metal concentrations. The results indicated that the most significant recoverable resources were Decomposed Organic Materials (organic waste mixed with sand and papers) and combustibles (plastics, wood, and textile), constituting 44 % and 36 % by weight, respectively. The composition of the landfill waste was found to be influenced by the components of waste initially disposed at the landfill and its subsequent age of deposition. The metal content concentration was, however, independent of the age of deposition. The results indicate that a landfill mining project at the Kumasi landfill will make available about 89 % of the landfill volume and airspace for reuse. However, the DOMs recovered may not be suitable for application as compost on agricultural soils due to the high zinc concentrations unless applied to zinc-deficient soils. It may, however, be used as construction material in earthworks and as cover materials at landfill sites. The combustible component can be combusted to generate heat for producing hot water for hospitals, hotels, and old age care facilities.

Atmospheric particulate matter effects on Sars-Cov-2 infection and its dynamics spreading: a spatio-temporal point process model

Background and Aim: Particulate matter (PM) may play a role in differential distribution and transmission rates of SARS-CoV-2. Identification of factors affecting the transmission dynamics concerning the endemic (persistent sporadic) and epidemic (rapidly clustered) component of infection can helps to implement intervention strategies to reduce the disease burden. Aim of this study is to assess the effect of long-term residential exposure to PM on Sars-Cov-2 incidence and on the dynamics of infectious disease spreading in Marche Region (Central Italy). Methods: All individuals with first positive SARS-CoV-2 molecular test from February to May 2020, residing in the Marche region were analysed along with gender, age, employment, Nursing Homes and Long-Term Care Facilities (NH-LTCF) residence and socio-economic deprivation index (DI); long-term exposure to outdoor PM ≤ 10 μm (PM10) concentrations, Temperature and Relative Humidity were estimated at 10 km2 grid cells. The endemic-epidemic spatio-temporal regression model for individual-level data was used to identify factors influencing SARS-CoV-2 spreading and its infectious rate. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Results: 10-years average exposure to PM10 was associated with an increased risk of new endemic (RR 1.14, 95%CI 1.04-1.24) and epidemic (RR 1.15, 95%CI 1.08-1.22) infectious. Male gender, older age, living in NH-LTCF and the worsening of DI increased RR in epidemic component. Lockdown increase the risk of becoming positive to Sars-Cov2 as concerning endemic while it reduces virus spreading in epidemic component. Increased temperature was associated with a reduction of endemic and epidemic infectious. Conclusions: Results show an increment of RR for exposure to increased levels of PM10 both in endemic and epidemic components. Targeted interventions are necessary to improve air quality in most polluted areas to minimize the burden of endemic and epidemic COVID-19 disease and to reduce unequal distribution of health risk. Keywords: air polltuion, Sars-Cov2, infectious disease

English language proficiency and hospital admissions via the emergency department by aged care residents in Australia: A mixed-methods investigation.

Residents of Residential Age Care Facilities (RACFs) have particularly high rates of Emergency Department (ED) visits, with up to 55% being potentially avoidable (e.g. not resulting in a hospital admission). This is concerning as ED visits by RACF residents are associated with negative outcomes including longer hospital stays, iatrogenic illness, complications and mortality. Limited English proficiency (LEP) has significant negative impacts on the healthcare quality and outcomes for older people but has not been studied as a factor in ED visits from RACFs. This study aimed to examine if RACF residents with LEP have a lower rate of hospital admission via the ED compared to non-LEP controls and identify any associated factors. We hypothesised that LEP-related communication difficulties would reduce the ability to manage minor health issues in the RACF, leading to a lower proportion of LEP ED transfers being admitted. We used a parallel mixed-methods design, comprising a quantitative matched cohort study of ED visit data from two Local Hospital Networks (LHNs) in South-East Melbourne, Australia and secondary thematic analysis of 25 interviews with LEP residents, family carers and staff from two RACFs in the same region. We found no differences in the proportion of hospital ED transfers that led to admission (LHN1, 87.1% LEP, 85.6% non-LEP controls, p=0.57; LHN2, 76.0% LEP, 76.9% non-LEP controls, p=0.41) and no direct qualitative evidence suggesting that resident LEP affected decisions to transfer residents to ED, despite communication difficulties being reported during the transfer process. These results may be due to the high level of family carer involvement in residents' care identified in the qualitative study. However, additional research using different measures of LEP is recommended to further explore a broader range of cultural and linguistic factors in both rates of ED presentations and the decision-making processes underpinning resident transfers to ED.

The impact of temperature, population size and median age on COVID-19 (SARS-CoV-2) outbreak

ObjectivesThis study aims to explore the association between the spread of COVID-19 and external parameters. In this regard, temperature, population size, median age, and health care facilities of 58 different countries are considered as external factors. MethodsA negative binomial regression model was fitted to identify the associations between the factors and cases of COVID-19 during the study periods. ResultsThe temperature, population size, and median age are positively associated with the spreading rate of COVID-19. There is no evidence supporting that case counts of COVID-19 could decline in countries with better health care facilities. Also, an empirical model was presented to estimate the number of cases within a country using the external parameters. ConclusionsIt is impossible to express the change in the number of cases for a unit increase in each of the variables because a change in a single variable depends on different values of other variables. However, the findings of this study provide useful implications for the authorities and decision-makers to take specific precautionary measures.

Nutritional Status of Adolescent Girls in Bangladesh: A Review Paper Focusing on Regional and Institutional Variations

Adolescence is the most important period of life for overall growth and development. Nutritional deficiency in this period leads to poor nutritional status such as stunting, wasting, underweight and anemia. As for girls, they are the most vulnerable group for malnutrition and having major consequences since they will be mothers in future. The objective of this paper is to review the nutritional status of adolescent girls at different regional and institutional level. From the study we found that about 66% of the adolescent girls were suffering from underweight all over the country along with 51.2% stunting and 20.3% wasting. A comparison between urban and rural girl’s nutrition with same economic condition was conducted. The prevalence of underweight was found 61.7% in urban area and 42.3% in rural area. But severe thinness was 22.4% among urban girls where it was 10.3% among rural girls. There has been evidence that girls with frequent occurrence of illness have shown poor nutritional status and vice versa. The prevalence of fever and jaundice were twice as high in underweight girls (66.7%) as girls with normal weight (33.3%). Periodic food shortage, economic status, age, geographical location, poor knowledge and health care facilities were some of the factors identified that contribute to the poor nutritional status. Improved nutritional services and policies concerning adolescent nutrition as their major focus may play an important role in improving the nutritional status of adolescent girls in Bangladesh.

An evaluation of health workforce models addressing oral health in residential aged care facilities: A systematic review of the literature.

In Australia and globally, there is an increasing problem of unmet oral health needs of older people above 65 residing in aged care facilities. Various workforce models have been trialled to implement oral health care programmes in aged care facilities, but the evidence behind these programmes and their underlying workforce models is not known. To systematically review the literature on the effectiveness, and economic feasibility of the current workforce models addressing oral care in aged care facilities. CINAHL, Cochrane CENTRAL, MEDLINE, EMBASE, EMB Reviews, NHS Economic Evaluation Database and grey literature were searched. Studies were included if they described an oral health workforce model with a clinical intervention and defined oral health outcome measures. Analysis was conducted using the NHMRC guidelines for scientific and economic evaluations. Twenty-eight studies were included. Four distinct workforce models of care were identified. 60% of the studies demonstrated short-term effectiveness in clinical measures. Workforce models were similar in their effectiveness, with varying levels of quality within each model. Although three studies considered individual components of economic feasibility, only one provided a comprehensive economic analysis of both the costs and health outcomes. All workforce models of care had some positive impact on oral health for residents of aged care. Oral health should be included as a health focus in age care facilities. Future studies should include longer-term health outcomes with rigorous economic analysis to ensure sustainably delivered workforce models of care for oral health management within aged care.

Care facilities for Germans in Thailand and Poland: making old age care abroad legitimate

This article looks at old age care facilities abroad that target people who live in Germany. Such facilities have been established in Southeast Asia (mainly Thailand) and in Eastern Europe (mainly Poland). Given that they challenge central guiding orientations for old age care in Germany, considerable criticisms are levelled at them, and their use is viewed with distinct scepticism. Nevertheless, some of these facilities succeed in sustaining considerable demand from Germany over quite a few years. In this article, we therefore ask what strategies and arguments they use to make them a legitimate option for people in Germany and to be established on the German market. Based on two case studies of an old age facility in Thailandand Poland, we will show how they skilfully position themselves as “better” options for residential care even though their strategies considerably vary and result in very different models of old age care. Drawing on neo-institutional organisation theories, we will show how these strategies are essential for the facilities’ emergence as new players in the care market for older people from Germany.

Two Years of Retrospective Study on the Incidence of Tuberculosis in Dir Lower Valley, Khyber Pakhtunkhwa, Pakistan.

Background: Pakistan has high tuberculosis (TB) burden with alarming mortality and morbidity, and its rate increases day by day, especially in remote areas where access of quality health is not available. Objective: The objective of the study was to determine the incidence rate of pulmonary TB in the Dir valley among the suspected patients according to age-, gender-, and location-wise prevalence of the disease. Methods: A retrospective descriptive study was designed from January 2015 to December 2016. All the 556 people registered are suspected patients of pulmonary tuberculosis sputum smear (PTB-SS) positive, whereas the remaining cases were diagnosed with extra-pulmonary TB and hence excluded from the study. Results: The ratio of PTB-SS-positive cases was higher in females (50.5%, n = 281) compared with males (49.5%, n = 275). Furthermore, in the age group 1 to 20 years, the percentage of PTB-SS-positive cases was 28.1% (n = 156), in 21 to 40 years 40.3% (n = 224), in 41 to 60 years 18.7% (n = 104), in 61 to 80 years 11.2% (n = 62), and at age group >81 years, it was 1.8% (n = 10). No difference was found in the years 2015 and 2016 regarding PTB-SS-positive cases registration. Age and health care facilities (P < .000) and treatment outcome (P < .000) have a strong relationship. No significant relation was found with other demographics variables (P > 0.05). Conclusion: It was concluded from our finding that TB was considerably increased in the general population of District Dir (Lower), and proper supervision, diagnosis, treatment, and awareness of rapid prophylactic measures are needed to eradicate the issue.

VOCs in cleaning products used in age care and social facilities: Identification of hazardous substances

Prior to the nationwide survey on indoor air quality in 100 age care and social facilities across France, which is planned for 2019, a questionnaire was sent by email to the directors of all 18,432 institutions of these types to determine the potential emission sources of indoor pollutants. Among these, cleaning practices and cleaning products were targeted. The questionnaire included items regarding cleaning frequency and periods, cleaning techniques, storage areas, the use of air fresheners and the commercial names of the products used. A total of 2140 questionnaires were collected and processed, and 1109 cleaning products, along with their commercial names, were listed. From them, 341 different products were identified, for which 299 safety data sheets (SDSs) were available and analyzed. A total of 216 different chemical substances were identified in the SDSs. The boiling points were retrieved to classify the substances according to their volatility. Finally, information regarding their hazard classification was collected, and six categories of human health effects were considered. A total of 41 chemical substances were classified, among which 10 are carcinogenic, 6 are mutagenic, 1 has reproductive toxicity, 3 have specific target organ toxicity - repeat exposure, 19 are possible endocrine disruptors, 14 are skin sensitizers, and 2 are respiratory sensitizers. Of these 41 chemicals, 51% (n = 21) are volatile organic compounds (VOCs). Despite the limitations of using SDSs, which do not report the exact compositions of the products, this study shows that a large spectrum of volatile substances may be emitted from cleaning products used in age care and social facilities, which may have a potential impact on the indoor air quality.

The emergence of care facilities in Thailand for older German-speaking people: structural backgrounds and facility operators as transnational actors.

This paper presents findings from an ethnographic study of old age care facilities for German-speaking people in Thailand. It analyses the conditions and processes behind the development and specific designs of such facilities. It first looks at the intertwinement, at the socio-structural level, of different transborder developments in which the facilities' emergence is embedded. Second, it analyses the processes that accompany the emergence, development and organisation of these facilities at the local level. In this regard, it points out the central role of the facility operators as transnational actors who mediate between different frames of reference and groups of actors involved in these facilities. It concludes that the processes of mediation and intertwining are an important and distinctive feature of the emergence of these facilities, necessitated by the fact that, although the facilities are located in Thailand, their 'markets' are in the German-speaking countries of their target groups.

Improving the sexual lives of older Australians: Perspectives from a qualitative study.

To examine older Australian's perspectives on how their sexual lives can best be supported and/or improved. Fifty-three, semi-structured interviews were conducted with Australian men (n = 30) and women (n = 23) aged 60 and over. Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including normalising the occurrence of sex and sexual desire in later life; increasing and improving on the quality of, cultural representations of older adults; introducing policy, educational and practice-based changes in age care facilities to support the consensual sexual expression of residents; and ensuring that sexual health campaigns and education are inclusive of older people. Our findings present clear implications for further developing sexuality education and public health campaigns, training and education of health-care professionals, and generating social and cultural change pertaining to the acceptability of the diversity of sexual expression in later life.

Staff perspectives of relationships in aged care: A qualitative approach.

To explore aged care staff perceptions and experience of their relationships with co-workers, older people and families via pragmatic exploratory interviews. Thirty-nine direct care staff from seven residential age care facilities and 12 community organisations were interviewed. Staff felt that their capacity to develop therapeutic relationships with older people and families was impeded by care tasks and concerns regarding professional boundaries. Positive relationships between staff-family and staff-staff are hindered by staff perceptions of undue care demands, high family expectations, and staff-staff conflict within a hierarchical context and between work shifts. A relationship-centred approach to care as well as staff training and education should be encouraged to assist the development of therapeutic relationships and the management of professional boundaries.

Old age care facilities and care-seeking elderly on the move

Older people’s mobility and migration to other countries is not a new phenomenon. Research on retirement migration, for instance, has been looking at the movement of older people to countries with ...

Collective Action of 'Others' in Sydney

Various ethnic communities undertake collective action to satisfy their social needs in a place of settlement. Collectively created social resources are representative of the patterns of fragmented ethnic collective actions that differ in their capability to appropriate human and material resources, orientation, outcome, form and intensity. Through collective creation of social space migrants add a new and dynamic dimension to the social environment. During the dramatic post-1945 changes in Sydney demographic and cultural structures, over 450 “other” (ethnic) collectives mobilised through grass-roots efforts their scarce resources and created needed collective goods, such as places of worship, clubs, schools, age care facilities. In this way, through creation of communal roots ethnic collectives navigate the path between exclusion and the various forms of inclusion in a dynamic culturally diverse society. Ethnic communal places signify collective conscience, participation, and the embeddedness of transplanted cultures in a transforming social environment and transnational social space.