High Proportion Of Elderly People Research Articles

RETROSPECTIVE ANALYSIS OF ESOPHAGEAL CANCER MORTALITY IN BRAZIL (1998-2022): Gender disparities, ethnic contrasts, temporal dynamics, and regional variations

Introduction: The esophageal cancer is derived from numerous dysplastic mutations usually located in the most distal portion of the esophagus, and is an aggressive neoplasm with a low survival rate. Environmental factors and gastroesophageal reflux disease (GERD) are the main precursors of this pathology, and its risk factors include males aged over 50, obesity, smoking and alcohol consumption. Its diagnosis can be made through upper digestive endoscopy (UDE). Methodology: Data was collected from the Mortality Information System (SIM) from 1998 to 2022 in order to analyse the evolution of esophageal cancer mortality and compare demographic, temporal and regional trends in esophageal malignant neoplasm mortality in Brazil. Results and discussion: There has been an increase in mortality over time, with a predominance of Caucasians and males in all races. The southeast and south regions have the highest incidence and mortality rates. The disparity between the sexes is attributed to men's greater exposure to smoking and alcohol. In the South, the consumption of mate is highlighted as a significant risk factor, and its higher incidence in white people is explained by the high proportion of elderly people in this region, as esophageal cancer is more common in the elderly due to prolonged exposure to carcinogens. Conclusion: The scientific analysis carried out provides mortality trends in Brazil with regard to esophageal cancer and allows these data to be correlated with the ethnic groups, sexes and regions most affected. Finally, the study highlights the importance of environmental factors in causing this pathology, indicating public health interventions mainly in the South and Southeast regions in order to reduce mortality figures.

Актуальні проблеми стану та розвитку економічної системи України в умовах воєнного стану

A structural and system analysis of the state and development of the economic system of Ukraine in wartime conditions is carried out and a set of economic measures to counter the negative manifestations of the full-scale invasion of the territory of Ukraine by russia is proposed. The authors systematize the most significant and growing threats in the economic sphere under conditions of uncertainty: demographic crisis, deformed age structure of the population with a high proportion of elderly people; high number of migrants; extremely high dependence on external financial assistance; irregular flow of foreign aid and a decrease in its volume with a simultaneous increase in defense spending; structural imbalances in GDP. The authors note that forecasts for GDP growth will not lead to an increase in the quality of life of Ukrainians and their purchasing power. The authors emphasize that, given the unpredictability of the duration of hostilities, unpredictable financial and material losses, a colossal deficit of the State Budget of Ukraine, a decrease in the stability of the economic system, and further inflow of external financial assistance are the main sources of funding for the military and social spheres. The main directions of reconstruction of the economic system of Ukraine to achieve the highest possible level of economic and financial self-sufficiency of the national economy are proposed; increasing the level of resilience and development of domestic enterprises in the conditions of military conflicts; prioritizing military spending; return of migrants to their homeland; sustainable growth of labor productivity of specialists in all sectors of the economy. This is especially important for the agro-industrial complex – through the development of industrial parks, technology parks, innovation parks, ecological agroparks, clusters, etc. Also, in order to generate additional sustainable income for socially vulnerable segments of the population, it is important to develop social entrepreneurship and the «silver economy» in territorial communities.

Electric vehicle adoption in a mature market: A case study of Norway

The transportation sector, led by the automobile, is the major contributor to greenhouse gas emissions and increasing global warming. Transport electrification is one of the effective solutions to reduce oil dependency and mitigate environmental and climatic impacts from road transportation. Norway aims to be a major force in the electric vehicle market and has the ambition to have all newly sold light-weight vehicles be zero-emission by 2025. The share of battery electric vehicles (BEVs) in the auto market in Norway had reached up to 64.5% in 2021, indicating that Norway has recently become a well-matured BEV market. Some previous studies have investigated the drivers of BEV adoption in different countries but primarily in areas with low BEV market share. The drivers of a well-mature market with high BEV adoption remain poorly understood. Additionally, some existing works ignored the impacts of climatic conditions on BEV adoption, although climate conditions have been considered as one of the most important factors that impact BEV performance. In this study, we estimated how socioeconomic drivers and climatic conditions affect the spatial patterns of Norwegian BEV adoption in 2019 using the conditional autoregressive models. We found that the BEV adoption in Norway have a significant clustering pattern. Norwegians in urban areas with more available charging stations and having higher income levels and demand for travel are more likely to adopt BEVs. Municipalities with lower minimum temperatures and a higher proportion of elderly people often have a lower BEV adoption rate. Our findings emphasized the impacts of climatic conditions on BEV adoption and could provide important insights into the late-stage BEV adoption market for many countries in which the current BEV market is still in development.

Mortality Rate Differentiation in Russia in 2019-2020: COVID-19 Pandemic and Other Factors

The aim of the work is to find the factors that caused the differences in the change in the mortality rate in the regions caused by the pandemic. Using the data of official statistics and the results of regionally representative data of sample socio-demographic surveys of Rosstat, the authors attempt to achieve the goal by methods of both demographic and statistical analysis. The analysis showed that a significant part of the variation of regions in terms of mortality growth is explained by the characteristics of the demographic structure of the region (a high proportion of elderly people in the region, a large household size, the proportion of people with cancer in the region), as well as high population density and frequency of social contacts (especially in large cities). It was noteworthy that there was no significant impact on the regional differentiation of mortality from the availability of medical services and the scale of health infrastructure, which apparently indicates that in 2020 the probability of dying from COVID-19 or concomitant complications did not depend much on the actions of doctors and the equipment of hospitals. The paper also highlights the problem of imperfection of the research information base in terms of the selection of objective indicators and methods for analyzing the contribution of the COVID-19 epidemic to the level and dynamics of mortality.

Spatial temporal distribution of COVID-19 risk during the early phase of the pandemic in Malawi.

BackgroundCOVID-19 has been one of the greatest challenges the world has faced since the second world war. This study aimed at investigating the distribution of COVID-19 in both space and time in Malawi.MethodsThe study used publicly available data of COVID-19 cases for the period from 2 April 2020 to 28 October 2020. Semiparametric spatial temporal models were fitted to the number of monthly confirmed cases as an outcome data, with time and district as independent variables, where district was the spatial unit, while accounting for sociodemographic factors.ResultsThe study found significant effects of location and time, with the two interacting. The spatial distribution of COVID-19 risk showed major cities being at greater risk than rural areas. Over time, the COVID-19 risk was increasing then decreasing in most districts with the rural districts being consistently at lower risk. High proportion of elderly people was positively associated with COVID-19 risk (β = 1.272, 95% CI [0.171, 2.370]) than low proportion of elderly people. There was negative association between poverty incidence and COVID-19 risk (β = −0.100, 95% CI [−0.136, −0.065]).ConclusionFuture or present strategies to limit the spread of COVID-19 should target major cities and the focus should be on time periods that had shown high risk. Furthermore, the focus should be on elderly and rich people.

Safety of co-administration of herbal and conventional medicines on liver and kidney function in stroke patients: A single-center retrospective study

BackgroundAlthough herbal medicines (HMs) are widely used worldwide, information concerning their interactions with conventional medicines (CMs) is sparse. In particular, stroke affects a high proportion of elderly people with impaired hepatic and renal function. Stroke is often accompanied by various complications and is commonly treated via the co-administration of HMs and CMs in Asia. PurposeWe aimed to investigate the effects of co-administration of HMs and CMs on liver and kidney function in patients with stroke. We estimated the prevalence of drug-induced liver injury (DILI) or herb-induced liver injury (HILI) and drug-induced acute kidney injury (DIAKI) or herb-induced acute kidney injury (HIAKI) in patients co-administered HMs and CMs. Study designThis was a retrospective study that reviewed the electronic medical records of 401 patients with stroke in a single hospital. MethodsThe prevalence of DILI or HILI and types of liver injury was examined according to abnormal increases in liver tests. The probable causality between drug or herb administration and liver injury was assessed using the Roussel Uclaf Causality Assessment Method. In addition, the prevalence of DIAKI or HIAKI was estimated using the Kidney Disease Improving Global Outcomes acute kidney injury stage criteria and related medical records. ResultsOut of a total of 401 patients, only four (1.0%) developed liver injury. Two cases of DILI (0.5%) and two cases of HILI (0.5%) were reported. Moxifloxacin and ebastine were the CMs that caused hepatotoxicity. Chungpyesagan-tang and Yeoldahanso-tang were the HMs that caused liver toxicity. Even in cases showing severe liver damage, alkaline phosphatase levels remained less than five times the normal value, and liver function test values recovered within 14 days. There were no cases of DIAKI or HIAKI in this cohort. ConclusionThese results suggest that if appropriately prescribed by experts, the co-administration of CMs and HMs is safe and does not adversely affect liver and kidney function in patients with stroke. To support these results, further large-scale multicenter prospective studies and toxicological studies based on the interaction between HMs and CMs are warranted.

The association between the incidence of COVID-19 and the distance from the virus epicenter in Iran.

Since the first official report of the spread of SARS-CoV-2 infections in the city of Qom in mid-February, Iran has become the country most affected by the COVID-19 epidemic in the Middle East. All Iranian provinces are now affected, although to a different extent. The aim of the present study was to evaluate whether the distance from the epicenter of the infection (Qom) or demographic factors such as population density and the ratio of the elderly population are associated with the incidence of COVID-19 in different Iranian provinces. For the purpose of determining whether the distance from the virus epicenter could be associated with the spread of infection, linear regression analysis was performed using STATA 12.0 software. The association of the incidence of COVID-19 with the population density and the ratio of the population over 65 years old in 31 Iranian provinces was also evaluated. According to our results, a strong association was found between the incidence of COVID-19 in Iranian provinces and their respective distance from Qom (p < 0.001; C = -0.68). The incidence of COVID-19 in Iranian provinces was also positively associated with the ratio of the population over 65 years old (p = 0.002; C = 0.53), while no significant association with population density was found (p = 0.39; C = 0.16). These results suggest that the implementation of travel restrictions from highly affected areas to other provinces could considerably reduce the rate of transmission of the disease throughout the country. Also, provinces with a higher proportion of elderly people (over 65) were identified as particularly at risk for the spread of SARS-CoV-2 infections. These results will contribute to better management of the COVID-19 outbreak in Iran, taking into account demographic and geographic characteristics of different provinces.

Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

Socioeconomic inequalities in suicide mortality in Barcelona during the economic crisis (2006–2016): a time trend study

ObjectivesThis study aimed to analyse trends in socioeconomic inequalities in suicide mortality in Barcelona before and after the start of the economic crisis that started at the end of 2008,...

CANDIDA SPECIES AND STRAINS IN THE ORAL CAVITIES OF THE ELDERLY: A COMPARISON BETWEEN PEOPLE IN HOME-BASED CARE AND IN AGED-CARE FACILITIES

Oral candidiasis is prevalent in the elderly population due to medical conditions, use of systemic medications and the presence of oral appliances such as dentures. It is uncertain whether residing in an aged-care facility contribute to Candidacarriage and has an impact on the Candida species or strains colonizing elderly patients. Objective The aim of this study was to investigate the presence and abundance of Candida species and strains in saliva and from the oral mucosal swabs and smears of people living in institutional rest homes and those living at home. Findings A higher proportion of elderly people living in rest homes had PAS+Candida hyphae present in smears (9/25, 36%) compared to those living in their own home (5/21, 24%). CFU were present in 17/25 (68%) palatal swabs, 20/25 (80%) tongue swabs and in saliva from 21/25 (84%) of elders living in rest homes compared with 4/21 (19%) palatal swabs, 6/21 (28%) tongue swabs and from saliva in 12/21 (57%) of elderly living in their own home. Conclusion The results indicate that elderly people living in aged-care facilities are more likely to have Candidahyphae detected on PAS stained smears and have a higher Candida carriage rate compared to elderly living at home. This may be due to the presence of co-morbidities which led to the need for residential care and/or may be related to the rest home environment.

Bayesian zero-inflated spatio-temporal modelling of scrub typhus data in Korea, 2010-2014.

Scrub typhus, a bacterial, febrile disease commonly occurring in the autumn, can easily be cured if diagnosed early. However, it can develop serious complications and even lead to death. For this reason, it is an important issue to find the risk factors and thus be able to prevent outbreaks. We analyzed the monthly scrub typhus data over the entire areas of South Korea from 2010 through 2014. A 2-stage hierarchical framework was considered since weather data are covariates and the scrub typhus data have different spatial resolutions. At the first stage, we obtained the administrative-level estimates for weather data using a spatial model; in the second, we applied a Bayesian zero-inflated spatio-temporal model since the scrub typhus data include excess zero counts. We found that the zero-inflated model considering the spatio-temporal interaction terms improves fitting and prediction performance. This study found that low humidity and a high proportion of elderly people are significantly associated with scrub typhus incidence.

Korean traditional beliefs and renewable energy transitions: Pungsu, shamanism, and the local perception of wind turbines

Wind farms are constructed in mountainous rural villages where indigenous elderly people believe in Korean traditional beliefs such as pungsu (fengshui or geomancy) thought and shamanism. Built upon mixed qualitative methods, this research examines the relationship between traditional beliefs and local opposition to wind farms. First, the interpretation of mountains and wind based on pungsu clashes with favorable discourses on wind turbines. From the pungsu viewpoint, the wind turbine is considered similar to the iron stakes driven into renowned Korean mountains by Japanese imperialists to block the national spirit of Korea during the Japanese colonial era. A straight, strong wind with high-energy efficiency for wind power generation is considered inauspicious in terms of pungsu. Second, pungsu in local opposition to wind farms is prominent in clan communities in mountainous inland areas with a high proportion of elderly people. Third, senses are associated with shamanism in shaping the elderly’s perception of wind turbines. The noise and lights of wind turbines is a reminder of past memories related to ghosts or dokkaebi (a Korean goblin). Thus, pungsu and Korean shamanism present a unique story that is absent in Western debates on wind farms.

Assessing the social context of wildfire-affected areas. The case of mainland Portugal

Wildfires cause different impacts, depending on the conditions and resilience level of the exposed communities. Wildfire occurrence in mainland Portugal was assessed with regard to socioeconomic and demographic parameters, to identify the most distinctive conditions of fire-affected areas, without implying the existence of causal relationships. The latest population and agriculture census data were used to retrieve conditions at the civil parish level, regarding demographic patterns, social and labor conditions, physical structures and agricultural activities. To identify differences between parishes, two groups were created with the communities that showed the highest and lowest 20% of wildfire incidence between 2007 and 2014, separately for density of fire events and for burned area. A stepwise approach based on classification trees and random Forest methods was applied to identify the best discriminant variables between the groups. First, irrelevant variables were removed by an interactive process based on misclassification rates. The second step used random Forest analysis to the remaining variables to evaluate their importance in distinguishing the groups. In the final step, cluster analysis was applied to test the correspondence between the clusters created with the selected variables and the initial groups. Results showed that parishes with higher fire density have higher population density, higher proportion of young and educated people, larger families and more overcrowded buildings. On the contrary, parishes with larger burned area are less populated, less attractive to foreigners, have a higher proportion of elderly people, more degraded housing conditions and agricultural activities, visible in the density of sheep and goat and pastures, are still relevant. The cluster analysis demonstrated a better performance of the model for wildfire density, revealing a strong association with socioeconomic dynamics with an agreement above 0.85, much higher than for burned areas which is 0.29. Overall, the spatial distribution of wildfire impacts is framed by societal settings and particular conditions must be further understood to improve the coping capacity of affected communities.

Epidemiology of uveal melanomas in Moscow

Rationale: Melanoma of the uveal tract of the eye is among the most prevalent malignant intraocular tumors. Aim: To identify epidemiological characteristics of uveal melanoma in Moscow. Materials and methods : We performed a retrospective analysis of out-patient files and follow-up charts of patients with uveal melanoma in the Ophthalmological Clinical Hospital of the Department of Healthcare, Moscow, from 1977 to 2012. Results: Within 36 years, 2547 patients with uveal melanoma have been registered, at the age of 16 to 92 years. The male to female ratio was 1:1.5. The rate of patient referrals with subsequent diagnosis of uveal melanoma has not changed from 1977 to 2000 and was on average 1.07 persons per 100,000 of the adult population. From 2001 to 2012, there was some decline in the number of referrals with uveal melanoma to the average of 0.9 persons per 100,000 of the adult population. We analyzed survival among 359 patients with uveal melanoma after enucleation surgery of the eye; 37% of them were men (63.2 ± 1.8 years) and 63% women (69.5 ± 2.7 years). Their 5-year metastasis-free survival was 65 ± 3%, whereas the 7-year survival was 60 ± 4%. The mean time to death was 5.5 years. There were no association between the life longevity and patients gender, but their survival was associated with the age of patients. The risk of death from metastatic uveal melanoma among patients above 60 years of age was on average 10% higher. After the enucleation surgery, patients with Т4 melanoma lived significantly less than those with Т1-3 tumor (5 and 6.5 years, respectively; р = 0.05). Conclusion: The rates of diagnosis of uveal melanoma at referrals within 36 years did not increased. Epidemiology of uveal melanoma in Moscow is characterized by a high proportion of elderly women. Shorter overall and metastasis-free survival of patients with uveal melanoma after the enucleation surgery depends from a higher proportion of elderly people in the regional population and late diagnosis of the disease.

Feasibility of Using a Game-Based Cognitive Assessment for Older Adults in Emergency Care

Background: Developed nations are currently facing a demographic shift towards a higher proportion of elderly people and increasing age-related health concerns. Elderly adults often enter into the health care system through emergency services. As a result, emergency departments (EDs) are an opportune environment for cognitive screening to improve patient outcomes. Existing methods are not designed for use in EDs and require administration by a trained test administrator. As an alternative, we suggest serious games as screening tools that can be self-administered or used with minimal assistance in emergency care. The use of validated and reliable serious games can encourage more efficient and engaging cognitive screening. Objective: Our objective was to investigate the feasibility and usability issues identified in the process of evaluating the validity and reliability of a game-based cognitive screening tool administered on an interactive tablet, for use by elderly adults in emergency care. Methods: We carried out a study in a hospital ED to evaluate the validity of the serious game with elderly adults over the age of 70 years (N=146). Validity was assessed in terms of the correlation of game performance with outcomes of current assessment methods. Comparative assessments included the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Confusion Assessment Method (CAM). We also assessed the reliability of our game-based assessment tool in a hospital ED for a large subset of the patients who underwent a revised protocol involving follow-up sessions at a minimum of every 8 hours (n=127). In both studies, research personnel (RP) administered the standard cognitive assessments and then asked the patients to play the serious game. Recruitment for the reliability study overlapped with our validation study, with 56 potential overlap cases. Results: In our validation group, 141 of 146 patients consented to play the serious game. Performance on the serious game correlated significantly with the MoCA (r=–0.339, P<.001), MMSE (r=–0.558, P<.001), CAM (r=0.565, P<.001), and other cognitive assessments. In our reliability study of 127 adults, we obtained data from 126 people. We observed good test-retest reliability with Pearson correlation r values between 0.5 and 0.7. These results supplement findings from our validation study that the assessment was correlated with MMSE, MoCA, and CAM scores. Usability feedback suggested that the game was too easy and the need to use a stylus for users with dry skin. All patients were able to play the serious game administered on a tablet either independently or with minimal assistance from RP. In the latter case, RP would assist by holding the tablet as some patients found it heavy. Conclusions: This research demonstrates the feasibility, validity, and reliability of using a game-based cognitive assessment in a clinical setting. Elderly users in an ED can use our screening tool by improving on the usability of the system by incorporating their feedback in our design process. This research shows that appropriately designed serious games can be self-administered or used with minimal assistance in a clinical setting repeatedly for each person. [iproc 2016;2(1):e35]

Stress-related cognitive and non-cognitive impairments in elderly patients

Aging is a physiological process that may develop long without manifestations of comorbidities. In the meantime a high proportion of elderly people very often experience limitations in daily life due to impairments in memory and other cognitive functions. Non-cognitive neuropsychiatric disorders, most commonly stress-related anxiety disorders, are a major contribution to maladaptation in these patients. The present studies of the neurobiology of aging enable one to decipher not only the mechanisms that underlie the physiology of brain aging, but also the factors that influence cognitive aging and aggravate the manifestations of cognitive dysfunction and neurodegenerative disease. The process of brain aging is known to presume the long-term preservation of functional neuroplasticity that is greatly influenced by different lifestyle factors, such as daily social and physical activities, the pattern and amount of food taken, cognitive activity, and stressful life events. These lifestyle factors are supposedly a potent tool to maintain physiological brain aging and a delayed cognitive diminution in elderly people. At the same time, studies of the possibility of pharmacologically correcting age-related (both cognitive and non-cognitive) impairments are promising to improve everyday function in elderly people.

영구임대아파트 리모델링을 통한 노인공동생활가정의 계획 방안

Because most of permanent rental housings in Korea were constructed more than 20 years ago, they are actually in need of renovation. Also high proportion of elderly people are living in permanent rental housing who are fragile in the social, financial, and physical aspect. It is inconvenient and dangerous for them to continuously live in such a deteriorated environment. But they want to live as long as possible in their old residences until they are severely ill or they die. Introducing communal living home for the aged into these existing permanent rental housings will be a way to provide Aging in Place to these seniors. This study has surveyed related laws, previous studies and advanced cases in foreign countries to propose a type of communal living homes for the aged in permanent rental housings. This study has suggested the communal living home for the aged with a concrete plan on roof top and the first floor of a representative permanent rental housing block. From this study, we tries to relieve 3 major problems of seniors such as alienation, poverty, and disease. This can be an option for realizing Aging in Place by residing seniors within the existing complex and forming sustainable community.

Pulmonary Resection for Lung Cancer in Nonagenarians: A Report of Five Cases

Lung cancer surgery in octogenarians has already become common in Japan due to the high proportion of elderly people and the progress in perioperative management, including anesthesia and video-assisted thoracic surgery. However, there have been few reports about the surgical treatment of lung cancer in nonagenarians. Five cases (mean age: 91.2 years; 3 men, 2 women) of non-small cell lung cancer in nonagenarians in whom pulmonary resection was performed are reported. All were adenocarcinomas; three were clinical stage IA, and two were IB. Three patients underwent lobectomy, and two underwent wedge resection. Mediastinal lymph node dissection was omitted in all patients. There were no fatal postoperative complications. During follow-up, one patient died due to fatal arrhythmia, and one patient who underwent wedge resection had local recurrence, but the others are alive in good condition. Pulmonary resection of lung cancer is possible for highly selected, nonagenarian patients without lymph node metastasis.

Fastlegetilhørighet og sykefravær – en registerbasert studie

Undertaking research on the role of regular GPs with regard to rates of sickness absence is methodologically challenging, and existing results show a wide divergence. We investigated how long-term sickness absence is affected by the characteristics of doctors and their patient lists. The study encompassed all those vocationally active residents of Oslo and Bergen in 2005-2006 who had the same regular GP throughout 2006 (N = 298,039). Encrypted data on sickness absence for each individual in 2006, as well their age, gender and level of education were merged with data on the regular GPs (N = 568) and their patient lists, and subsequently analysed with the aid of logistic regression. The outcome variable was at least one period of sickness absence which had been paid for by the Norwegian Labour and Welfare Administration (NLWA). The explanatory variables included the age, gender, list length and list status (open/closed) of the regular GPs, as well as variables that characterised the composition of the patient lists. The analyses were stratified by gender and controlled for individual age and education. The age, gender and list length of the regular GPs were not associated with sickness absence paid for by the NLWA. The odds ratio for sickness absence > 16 days was reduced for both women and men when the list contained many highly educated patients, a high proportion of elderly people and few disability pensioners. Men on lists with a high proportion of men and lists with a high proportion of vocationally active patients also had lower odds rates for sickness absence > 16 days. Among women, the rate of sickness absence was lower for those on open lists than for those on closed lists. In addition to well-known individual factors, the study shows that the likelihood of sickness absence is affected by the socio-demographic composition of the patient list to which one belongs.