National Age Research Articles

Insights on Universal Pension Scheme in Bangladesh: Trajectory or Deviation

The Universal Pension Scheme (UPS) is a fairly new policy by the Bangladesh government, inaugurated on 17th August 2023, aiming at giving the nation's aging population a monthly stipend and placing them under a well-organized social safety net program. This study aimed to find out the perception of the people regarding the UPS and the challenges that beset with this perception. The study uses a quantitative method to collect data from 404 participants through a close ended questionnaire following simple random sampling. The SPSS software was used to analyze the data for chi-square testing, cross tabulation, and descriptive statistics. By conducting the Chi-square test (p0.05), the overall results of the study revealed that the general people are not much willing to participate in the Universal Pension Scheme despite knowing about it. Though many still do not properly understand the different schemes of the UPS and prefer the traditional and familiar banking procedure for saving money, many mainly refrain from agreeing to participate on it because of the risk of inflation and regime change. Thus, most people prefer investing in a business to make profit and be free from these risks that are associated with UPS.

Chinese young adults' perception of fertility: Emotional contagion in fertility policy discussions on Sina Weibo

We investigated the reactions and preferences of the Chinese populace, particularly young adults, toward China's three-child policy, a recent strategy aimed at addressing the nation's aging population that allows couples to have up to three children. By monitoring Sina Weibo discussions related to fertility policies, we gauged public sentiment and potential emotional contagion. We collected 711 main posts and 26,515 responses and used the sentiment analysis method to identify the emotional tendencies of each post, thus determining if emotional contagion occurred. Results showed there were 631 posts with negative emotional contagion effects and 554 posts with positive emotional contagion effects. Further textual analysis indicated that the Chinese public maintains a pessimistic outlook on the three-child policy and expresses concern about the detrimental impact of social circumstances and the difficulties women encounter concerning fertility.

Evolving knowledge of the unmet needs in dry eye disease.

Dry eye disease is a common but underdiagnosed disorder in the United States, and its prevalence is likely to increase as the nation's population ages. Although still regarded as little more than a nuisance by many clinicians and payers alike, dry eye disease is known to have both clinical consequences for ocular health and effects on vision-related quality of life in many people, impairing their ability to function well in vocational and social settings. Pharmaceutical treatments consist mainly of over-the-counter ocular lubricants ("artificial tears") and a few prescription drugs that address the inflammatory component of dry eye disease through immunomodulation and/or inhibition of T-cell activity. In September 2020, Oyster Point Pharma, Inc (Oyster Point Pharma), convened a panel-consisting of 7 managed care executives with experience in management of dry eye disease treatments and 2 eye care practitioners with expertise in dry eye disease-to discuss how the growth of knowledge about dry eye disease in the past 2 decades has altered their thinking about and approach to dry eye disease, as well as how they would like to see the field advance. They pointed to an existing unmet need in knowledge and therapeutics that can address the underlying causes of dry eye disease. Oyster Point Pharma supported the authorship of this article; the authors were members of the panel, and all panelists were compensated by Oyster Point Pharma. This article provides an overview of dry eye disease and summarizes the panel discussion.

Perioperative considerations in nonagenarians

ObjectiveThe nation's aging population presents novel perioperative challenges. Potential benefits of operative interventions must be scrutinized in relation to recoverable quality of life. The purpose of this study is to evaluate common risk calculators used for medical decision making in a nonagenarian patient population. MethodsRetrospective medical record review was performed on patients 90 years or older who underwent operative interventions requiring anesthesia at a large academic medical center between January 1, 2013, and December 31, 2017. GraphPad 8.2.1 was used for statistical analysis. ResultsSignificant differences were found when data were stratified by age for elective versus emergent cases (P value < .0001), ability to return to baseline function (P value = .0062), and mortality (P value < .0001). Significant differences were found in emergent and elective cases, ability to return to baseline function, readmissions, and mortality (all P values < .0001) when stratified by American Society of Anesthesiologists score. Ability of patients to return to baseline functionality after intervention was influenced by their preintervention level of functionality (P value = .0008). American College of Surgeons and Portsmouth Physiologic and Operative Severity Score for Enumeration of Mortality and Morbidity risk calculators underestimated the need for rehabilitation and overestimated mortality for this population (all P values < .0001). ConclusionPerioperative cares of the extreme geriatric population are complex and should be approached collaboratively. Rehabilitation and postoperative assistance resources should be assessed and used fully. Input from palliative care teams should be sought appropriately. End-of-life and escalation-of-care discussions should ideally be organized prior to emergent interventions. Frailty and risk calculators should be used and considered for formal implementation into the preoperative workflow.

Lead in Drinking Water and Birth Outcomes: A Tale of Two Water Treatment Plants

The recent drinking water crisis in Newark, New Jersey's largest city, has renewed concerns about the lead-in-water crisis becoming a persistent and widespread problem owing to the nation's aging infrastructure. We exploit a unique natural experiment in Newark, which exogenously exposed some women in the city to higher levels of lead in tap water but not others, to identify a causal effect of prenatal lead exposure on fetal health. Using birth data that contain information on mothers' exact residential addresses, we find robust and consistent evidence that prenatal exposure to lead significantly raises the probability of low birth weight or preterm births by approximately 1.4 to 1.9 percentage points (14-22 percent), and the adverse effects are largely concentrated among mothers of lower socioeconomic status. Our findings have important policy implications in light of the long-term impact of compromised health at birth and the substantial number of lead water pipes that remain in use as part of our aging infrastructure. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study.

BackgroundAs our nation's population ages, operating on older and sicker patients occurs more frequently. Robotic operations have been thought to bridge the gap between a laparoscopic and an open approach, especially in more complex cases like proctectomy.MethodsOur objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. A retrospective cross-sectional cohort study utilizing the Nationwide Inpatient Sample (NIS; 2006–2013) was performed. All cases were restricted to age 70 years old or greater.ResultsWe identified 6740 admissions for rectal cancer including: 5879 open, 666 laparoscopic, and 195 robotic procedures. The median age was 77 years old. The incidence of a robotic proctectomy increased by 39%, while the open approach declined by 6% over the time period studied. Median (interquartile range) length of stay was shorter for robotic procedures at 4.3 (3–7) days, compared to laparoscopic 5.8 (4–8) and open at 6.7 (5–10) days (p < 0.01), while median total hospital charges were greater in the robotic group compared to laparoscopic and open cases ($64,743 vs. $55,813 vs. $50,355, respectively, p < 0.01). There was no significant difference in the risk of total complications between the different approaches following multivariate analysis.ConclusionRobotic proctectomy was associated with a shorter LOS, and this may act as a surrogate marker for an overall improvement in adverse events. These results demonstrate that a robotic approach is a safe and feasible option, and should not be discounted solely based on age or comorbidities.

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACTBy 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.

Temporal discounting rates and their relation to exercise behavior in older adults

As our nation's population ages, the rates of chronic illness and disability are expected to increase significantly. Despite the knowledge that exercise may prevent chronic disease and promote health among older adults, many still are inactive. Factors related to exercise behaviors have been explored in recent years. However, temporal discounting is a motivational concept that has not been explored in regard to exercise in older adults. Temporal discounting is a decision making process by which an individual chooses a smaller more immediate reward over a larger delayed reward. The aim of this study was to determine if temporal discounting rates vary between exercising and non-exercising older adults. DesignThis study used cross-sectional survey of 137 older adults living in the community. Older adults were recruited from 11 rural Arkansas churches. The Kirby delay-discounting Monetary Choice Questionnaire was used to collect discounting rates and then bivariate analysis was performed to compare temporal discounting rate between the exercisers and non-exercisers. Finally, multivariate analysis was used to compare discounting rate controlling for other covariates. ResultsThe results indicated that exercising older adults display lower temporal discounting rates than non-exercising older adults. After controlling for education, exercisers still have lower temporal discounting rates than non-exercisers (p<0.001). Conclusions and implicationsThese findings are important as several chronic health conditions relate to lack of exercise especially in older adults. This research suggests that if we can find appropriate incentives for discounting individuals, some type of immediate reward, then potentially we can design programs to engage and retain older adults in exercise.

A robust nanoscale experimental quantification of fracture energy in a bilayer material system.

Accurate measurement of interfacial properties is critical any time two materials are bonded--in composites, tooth crowns, or when biomaterials are attached to the human body. Yet, in spite of this importance, reliable methods to measure interfacial properties between dissimilar materials remain elusive. Here we present an experimental approach to quantify the interfacial fracture energy Γi that also provides unique mechanistic insight into the interfacial debonding mechanism at the nanoscale. This approach involves deposition of an additional chromium layer (superlayer) onto a bonded system, where interface debonding is initiated by the residual tensile stress in the superlayer, and where the interface can be separated in a controlled manner and captured in situ. Contrary to earlier methods, our approach allows the entire bonded system to remain in an elastic range during the debonding process, such that Γi can be measured accurately. We validate the method by showing that moisture has a degrading effect on the bonding between epoxy and silica, a technologically important interface. Combining in situ through scanning electron microscope images with molecular simulation, we find that the interfacial debonding mechanism is hierarchical in nature, which is initiated by the detachment of polymer chains, and that the three-dimensional covalent network of the epoxy-based polymer may directly influence water accumulation, leading to the reduction of Γi under presence of moisture. The results may enable us to design more durable concrete composites that could be used to innovate transportation systems, create more durable buildings and bridges, and build resilient infrastructure.

Achieving Prescriptive Authority for Clinical Nurse Specialists

Achieving Prescriptive Authority for Clinical Nurse Specialists

Nitric oxide and geriatrics: Implications in diagnostics and treatment of the elderly

The nation's aging population is growing rapidly. By 2030, the number of adults age 65 and older will nearly double to 70 million. Americans are living longer and older adults can now live for many years with multiple chronic illnesses but with a substantial cost to health care. Twenty percent of the Medicare population has at least five chronic conditions i.e., hypertension, diabetes, arthritis, etc. Studies in experimental models and even humans reveal that constitutive production of nitric oxide (NO) is reduced with aging and this circumstance may be relevant to a number of diseases that plague the aging population. NO is a multifunctional signaling molecule, intricately involved with maintaining a host of physiological processes including, but not limited to, host defense, neuronal communication and the regulation of vascular tone. NO is one of the most important signaling molecules in our body, and loss of NO function is one of the earliest indicators or markers of disease. Clinical studies provide evidence that insufficient NO production is associated with all major cardiovascular risk factors, such as hyperlipidemia, diabetes, hypertension, smoking and severity of atherosclerosis, and also has a profound predictive value for disease progression including cardiovascular and Alzheimers disease. Thirty plus years after its discovery and over 13 years since a Nobel Prize was awarded for its discovery, there have been no hallmark therapeutic breakthroughs or even NO based diagnostics. We will review the current state of the science surrounding NO in the etiology of a number of different diseases in the geriatric patient. From these observations, it can be concluded that enzymatic production of NO declines steadily with increasing age in healthy human subjects. Implementing strategies to diagnose and treat NO insufficiency may provide enormous benefit to the geriatric patient.

Professional and Personal Factors Associated with Gerontological Practice: Implications for Training and Education

Professional practice with older adults is performed in a variety of settings and across a broad range of areas. Planning for care throughout the end of life represents an increasingly important aspect of work with older adults as a result of the nation's aging demographic and concomitant health care needs. Community-based geriatric case managers represent a growing cadre of professionals encountering frail older adults with future care needs that can be anticipated in advance; however, little is known regarding specific professional and personal factors associated with greater practice in this area. This article presents the findings from a study of 148 community-based case managers' advance care planning practices, conducted in the Southeastern United States. Correlational analyses revealed specific gerontological skills, educational activities, and personal experiences in advance care planning that was highly correlated with practice. Implications for training are discussed.

Bridging the Gap between Engineers and Finance

The reality of the nation's aging infrastructure dilemma is that we are only beginning to ramp up our efforts to address the planning and costs. The fact remains that the aging water infrastructure issue will never go away, so our industry must incorporate all of its best practices and available technologies to consistently meet these demands in the most cost‐effective manner considering both long‐ and short‐term needs while balancing sustainability with affordability. To do this, the respected and balanced disciplines of both engineering and finance must continually work together to promote asset management. Building a bridge across the disciplines of engineering and finance is in some ways like building a suspended‐span cantilever bridge. For the purpose of this article, the two cantilevers could be considered as representations for engineering and finance, whereas the gap could represent the aging water infrastructure crisis. The entire bridge structure includes representations for all of the practices and joint efforts between these two disciplines to span the distance between the two symbolic cantilevers.

1A1-D12 簡易型電動車いすの斜面走行・段差踏破支援技術に関する研究

Motorized wheelchairs are mainly utilized by the elderly with disabilities in outdoor environments. Accidents involving motorized wheelchairs in Japan have increased as the nation's population ages. To solve the problem, we constructed a new type of motorized wheelchair with many kinds of safety assistive technologies. One of our measures prevents the wheelchair from moving in unintentional direction and tipping over sideways on a laterally graded sidewalk by controlling the drive of each motor based on internal sensors when the wheelchair is moving across a sloped section of a sidewalk. Another of our measures prevents a large backward tipping angle when the wheelchair is moving up over grade height differences and slopes by controlling an electromagnetic brake on a bar that is attached to the rear underside of the wheelchair. The results of our indoor experiments on not only simulated slopes and grade height differences but also in real outdoor environments have confirmed the effectiveness of our safety assistive technologies.

Experiences of Aging Among Immigrants From India to the United States: Social Work Practice in a Global Context

The aging of immigrants is a critical component in the health dynamics of the nation's aging population. To date, few studies have addressed within-group diversity and linked contemporary contexts of global connectedness with the aging experiences of older immigrants. This study aims to conceptually understand the diversity in aging dynamics within a specific immigrant group: Indian immigrants in New York City. The impact of globalization and transnational connection on aging experiences on 2 within groups—Indians who came to the United States at age of 65 or older (LLIs) and those who came at an early age (ELIs) are analyzed. Implications for social work practice, research and policy are discussed.

The Aging Dilemma: Is Increasing Longevity Among People With Intellectual Disabilities Creating a New Population Challenge in the Asia‐Pacific Region?

AbstractThe Macau Declaration on Ageing for Asia and the Pacific and the Plan of Action on Ageing for Asia and the Pacific provide a framework for defining the needs of the aging population in the Asia‐Pacific region. It also served as a stimulus for planning and public commitment to addressing the needs of the region's elderly population, including the needs of each of the nation's adult and aging populations of persons with intellectual disabilities. Within the Asia‐Pacific region, the diversity of cultural and economic interests often combines to define how services are provided to their aging populations and both how disabilities are perceived and how national policies reflect these interests in serving people with disabilities. Reports issued by the World Health Organization on improving longevity and promoting healthy aging among people with intellectual and developmental disabilities and the Tampa Scientific Conference on Aging and Intellectual Disabilities on defining health factors help provide the structure for both the consideration of the impact of aging on people with intellectual and developmental disabilities and how national social and public welfare policies can be framed to respond to aging and lifelong disability.

Current status of the mechanical valve and bioprosthesis in Japan

The American College of Cardiology/American Heart Association guidelines for the management of patients with valvular heart disease were revised in 2006. These guidelines are introduced in this review, and the current status of the mechanical valve, bioprosthesis, and treatment of valvular heart disease are described based on the new guidelines as compared with the guidelines of 1998. The trend in valve selection in aortic valve replacement in the United States has been toward bioprosthesis, away from the mechanical valve. The reasons are: 1) current bioprostheses appear to have lower rates of structural valve deterioration, 2) the risks of reoperation have continued to decrease, 3) patients undergoing AVR today represent an older population than those in studies in randomized trials, 4) young patients undergoing AVR are often reluctant to accept warfarin therapy, 5) some large comparative trials have shown apparent survival benefit for patients receiving bioprostheses. In Japan, the use of tissue valves has been increasing and may continue to increase owing to the nation's aging population and to the reasons mentioned above. However, more patients received mechanical valves than bioprostheses for mitral valve replacement both in the United States and in Japan. The number of mitral valve repair cases has increased more than that of valve replacement. In selection of valve prosthesis for valve surgery, it is important that patients should decide by themselves based on mutual respect and trust between patient and doctor, with thorough discussion of the possibility of redo surgery and its risks, life-long warfarin intake, quality of life, and the patient's lifestyle and outlook on life.

Sustaining the Nation's Aging Infrastructure Systems: Lessons Learned Applying an Asset Management Framework

systems permeate society at both the personal and business levels. These systems are taken for granted, but the implications of system breakdowns are staggering and directly impact our national competitiveness, having both immediate consequences and long lasting effects on the local, regional and national economies. Many of the infrastructure systems found in the United States have been in place far beyond their design lives. How does an organization manage these aging assets given constrained resources? This paper presents an innovative research and problem formulation method created as part of an effort by the United States Army Corps of Engineers' to develop an Asset Management Framework (AMF) to manage its aging civil infrastructure assets. This paper outlines the development of the framework using an intent-driven command and control approach, grounded by the input from dozens of practitioners, gathered through a series of interviews, surveys, and field studies. The paper describes mechanisms used to bring together economists, biologists, civil engineers, and others to create a robust AMF. The AMF will be illustrated showing transparent integration of preservation and risk mitigation initiatives, as well as budget and resource allocation processes supporting a lifecycle investment strategy for sustainability across the entire agency. The Framework's scope includes oversight of much of America's watersheds covering 1,000 coastal structures, 800 dams, 250 navigation locks, 75 hydropower plants and other assorted facilities. Lessons learned in developing this system are provided, along with its current status. The implications of this work to other industries and pubic sector agencies will be examined.

Nano Monitors for Identification of Vulnerable Cardio-Vascular Plaque

AbstractAs our nation's population ages, there will be a substantial demand for surgical services. The best predictor of postoperative outcome is the presence of perioperative ischemia, which is caused by vulnerable coronary plaque rupture. It is not know what makes plaques rupture, but inflammation has been proposed as a unifying etiology. The physiologic perioperative state is one of intense, acute inflammation and thrombosis. This is characterised by the presence of protien- Human Serum C-Reactive Protein( hsCRP) and Myeloperoxidase(MPO). There is a gap in detection capability between gold standard in proteomics detection –Enzyme Linked Immunosorbent Assay (ELISA) assay methods and electrical biosensors.ELISA based protein biomarker detection in too slow to be applicable in early patient bedside treatment. Electrical biosensors on the other hand may overcome this limitation with their improved sensitivity, specificity and rapid detection. In this application we demonstrate the development of nanomembrane based electrical protein “nano monitor”. This technique overcomes the limitations current “state-of- the- art” methods such as:• Specificity in detection of multiple markers that characterizes the disease pathogenesis from a single marker to multiple markers.• Speed of detection from a turnaround time of 12/24 hours to a few minutes.• Sensitivity of detection from milligram/ml to nanogram/ml.

IEEE 1547 Series of Standards: Interconnection Issues

IEEE 1547 2003 standard for interconnecting distributed resources with electric power systems is the first in the 1547 series of planned interconnection standards. Major issues and a wealth of constructive dialogue arose during 1547 development. There was also a perceived increased vitality in updating complementary IEEE standards and developing additional standards to accommodate modern electrical and electronics systems and improved grid communications and operations. Power engineers and other stakeholders looking to the future are poised to incorporate 1547 into their knowledge base to help transform our nation's aging distribution systems while alleviating some of the burden on existing transmission systems.