Depression is one of the most severe mental health illnesses among senior citizens.Aiming at the low accuracy and poor interpretability of traditional prediction models,a novel interpretable depression predictive mode...Depression is one of the most severe mental health illnesses among senior citizens.Aiming at the low accuracy and poor interpretability of traditional prediction models,a novel interpretable depression predictive model for the elderly based on the improved sparrow search algorithm(ISSA)optimized light gradient boosting machine(LightGBM)and Shapley Additive exPlainations(SHAP)is proposed.First of all,to achieve better optimization ability and convergence speed,various strategies are used to improve SSA,including initialization population by Halton sequence,generating elite population by reverse learning and multi-sample learning strategy with linear control of step size.Then,the ISSA is applied to optimize the hyper-parameters of light gradient boosting machine(LightGBM)to improve the prediction accuracy when facing massive high-dimensional data.Finally,SHAP is used to provide global and local interpretation of the prediction model.The effectiveness of the proposed method is validated by a series of comparative experiments based on a real-world dataset.展开更多
This study empirically examines whether child characteristics mitigate the negative impact of widowhood on the elderly’s mental health using follow-up survey data from the China Health and Retirement Longitudinal Stu...This study empirically examines whether child characteristics mitigate the negative impact of widowhood on the elderly’s mental health using follow-up survey data from the China Health and Retirement Longitudinal Study(CHARLS).A total of 5,326 older adults aged 60 years and older are selected from three waves of panel data(2013,2015,and 2018).Thefindings suggest that respondents who experienced widowhood exhibit an increase in depressive symptoms.However,the higher income of children and frequent face-to-face emotional interactions improve the mental health of the widowed elderly.Moreover,heterogeneity analyses show that the buffering effect of higher child income is more significant among men and the Midwestern widowed elderly,and frequent face-to-face emotional interactions are more effective in improving the psychological status of women and the Midwes-tern widowed elderly.In the special social and cultural background of China,family members remain the main support for the elderly,and the current social pension system is still imperfect.Therefore,children should strengthen emotional communication with their parents while increasing their economic income.In that way,widowhood can achieve both material and spiritual prosperity.The government should identify the vulnerable groups among the elderly widows and introduce policies aimed at improving their mental health and reducing the disparity in mental health status.展开更多
The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.B...The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.Based on previous literature,the article aims to introduce the publishing trend of medical books on health cultivation and prolonging life on since modern times,generally describe its significance,and initially analyze the contents related to health cultivation for the elderly.The article finds out that after the scientific concepts were imported into China in large quantities from the beginning of the 20th century,the past superstitions rose again.The sciences of nutrition,bacteriology,and physiology in such books had all verified that the road to immortality was possible.The concept of longevity at the time emphasized a concept that could be controlled by science.With the advancement of scientific research and health concepts,people believed that they could eventually achieve immortality.It was obvious that people were filled with optimism about science at that time,thus gradually subverting the definition of the elderly.展开更多
Background Several liver function tests have been identified as predictors of hospitalization for heart failure(HF) and death in patients with chronic HF. The relationship between serum γ-glutamyltranferase(GGT) and ...Background Several liver function tests have been identified as predictors of hospitalization for heart failure(HF) and death in patients with chronic HF. The relationship between serum γ-glutamyltranferase(GGT) and albumin(SA) levels with the response to cardiac resynchronization therapy(CRT) has not been reliably determined. The aim of the study was to evaluate the impact of liver function tests on the results of CRT in the elderly. Methods Baseline GGT and SA were assessed before CRT device implantation in the elderly(> 70-year-old) patients. The endpoints were:(1) CRT response defined as > 5% left ventricular ejection fraction improvement and no hospitalization for HF or cardiovascular death;(2) hospitalizations;and(3) mortality. Results Eighty of 138(58%) included patients were responders at nine months. Compared to responders, the SA levels were not significantly different(35.1 ± 5.4 vs. 33.6 ± 5.5 g/L, P = 0.103);but the GGT levels, higher(81.6 ± 69.3 vs. 54.7 ± 49.6 U/L, P = 0.013) in non-responders to CRT. GGT level was independently associated with non-response to CRT(P < 0.001, OR = 0.17;95% CI: 0.08–0.38, P < 0.001). GGT cut-off value ≥ 55 U/L was highly predictive of non-response [AUC = 0.65, 64% Sensitivity, 69% Specificity(95% CI: 0.56–0.74)]. GGT ≥ 55 U/L was also associated with higher risk of hospitalization for atrial fibrillation(AF)(95% vs. 83%, P = 0.024). Both SA and GGT had no impact on overall(P = 0.220, P = 0.723) mortality. Conclusions Higher level of GGT is an independent predictor of non-response to CRT in patients over age 70 years and is associated with higher risk of hospitalization for AF. Baseline serum levels of albumin and GGT and have no impact on mortality in elderly patients undergoing CRT.展开更多
1 Introduction Societies are ageing at an accelerated pace.This scenario is a well-known challenge for health care systems,as chronic diseases,multiple comorbidities and dependency are all entities that often converge...1 Introduction Societies are ageing at an accelerated pace.This scenario is a well-known challenge for health care systems,as chronic diseases,multiple comorbidities and dependency are all entities that often converge in the elderly.Besides,there is an issue regarding a reduction in the general incidence of acute coronary syndrome(ACS)together with a delayed in the age of presentation,which,in sum,lead to an increase in both incidence and prevalence of ACS with age,especially non-ST elevation myocardial infarction(NSTEMI).展开更多
Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the ...Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the impact of clan culture on the mental health of elderly people in rural China.The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly.Further,there was no gender difference with respect to the impact of clan culture on the depression score of the elderly.At the same time,the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development.Exploration of the mechanisms involved indicated that in areas with stronger clan culture,older people receive more social support.This study enriches our understanding of the impact of informal institutions on the welfare of rural residents.At the same time,it can also provide a certain decisionmaking reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.展开更多
Background It is unclear whether catheter ablation(CA)for atrial fibrillation(AF)affects the long-term prognosis in the elderly.This study aims to evaluate the relationship between CA and long-term outcomes in elderly...Background It is unclear whether catheter ablation(CA)for atrial fibrillation(AF)affects the long-term prognosis in the elderly.This study aims to evaluate the relationship between CA and long-term outcomes in elderly patients with AF.Methods Patients more than 75 years old with non-valvular AF were prospectively enrolled between August 2011 and December 2017 in the Chinese Atrial Fibrillation Registry Study.Participants who underwent CA at baseline were propensity score matched(1:1)with those who did not receive CA.The outcome events included all-cause mortality,cardiovascular mortality,stroke/transient ischemic attack(TIA),and cardiovascular hospitalization.Results Overall,this cohort included 571 ablated patients and 571 non-ablated patients with similar characteristics on 18 dimensions.During a mean follow-up of 39.75±19.98 months(minimum six months),24 patients died in the ablation group,compared with 60 deaths in the non-ablation group[hazard ratio(HR)=0.49,95%confidence interval(CI):0.30-0.79,P=0.0024].Besides,6 ablated and 29 non-ablated subjects died of cardiovascular disease(HR=0.25,95%CI:0.11-0.61,P=0.0022).A total of 27 ablated and 40 non-ablated patients suffered stroke/TIA(HR=0.79,95%CI:0.48-1.28,P=0.3431).In addition,140 ablated and 194 non-ablated participants suffered cardiovascular hospitalization(HR=0.84,95%CI:0.67-1.04,P=0.1084).Subgroup analyses according to gender,type of AF,time since onset of AF,and anticoagulants exposure in initiation did not show significant heterogeneity.Conclusions In elderly patients with AF,CA may be associated with a lower incidence of all-cause and cardiovascular mortality.展开更多
<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for th...<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.展开更多
BACKGROUND The number of elderly individuals with diabetes is dramatically increasing.Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management.Understanding of self-...BACKGROUND The number of elderly individuals with diabetes is dramatically increasing.Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management.Understanding of self-management from the patients’perspectives is important to nurses,healthcare providers,and researchers and benefits people by improving their self-management skills.AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.METHODS Electronic databases were searched,including MEDLINE,CINAH,PsycINFO,PubMed,CNKI,and WANFADATA.Relevant research was identified by manually searching reference lists and gray literature.Only English and Chinese publications were included.The Critical Appraisal Skills Program was used to assess the quality of the research.The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.RESULTS A total of 10 qualitative studies were included,and content analysis was performed.Five themes were identified:The need for knowledge about diabetes care,support systems,functional decline,attitudes toward diabetes,and healthy lifestyle challenges.CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.展开更多
Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients o...Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients older than 65 years and 50% in patients 75 years and older.1 In the Framingham population, the prevalence of HF increased eightfold among men from the fifth decade of life to the seventh decade.2 However, despite of considerable improvement in the treatment, the mortality of HF patients remained relatively constant between 1948 and 1997.展开更多
More old residential communities have become unsuitable for the elderly because of the aging of outdoor physical environment and functional degradation. This paper investigated behaviors and mental activities of the e...More old residential communities have become unsuitable for the elderly because of the aging of outdoor physical environment and functional degradation. This paper investigated behaviors and mental activities of the elderly, problems of outdoor environment in old residential communities, and proposed strategies for the renovation of old residential communities from the perspectives of outdoor environment, road, greening and public supporting facilities according to demands of the elderly on outdoor environment, so as to provide them a comfortable and reasonable outdoor environment.展开更多
Telemedicine is the use of information and communication technology to deliver healthcare at a distance.It has been resorted to during the COVID-19 pandemic to lessen the need for in-person patient care decreasing the...Telemedicine is the use of information and communication technology to deliver healthcare at a distance.It has been resorted to during the COVID-19 pandemic to lessen the need for in-person patient care decreasing the risk of transmission,and it can be of benefit afterward in the management of cardiac disease.The elderly population has unique challenges concerning the use of telehealth technologies.We thus review the advances in telemedicine technologies in treating elderly cardiac patients including in our discussion only studies with a mean age of participants above 60.Remote monitoring of blood pressure,weight,and symptoms,along with home ECG recording has been found to be superior to usual in-clinic follow up.Combining remote monitoring with video conferencing with physicians,patient education websites,and applications is also of benefit.Remote monitoring of Implantable Cardioverter Defibrillators(ICD)and Cardiac Resynchronization Therapy Defibrillators(CRT-D)is also beneficial but can be at the cost of an increase in both appropriate and inappropriate interventions.Implantable sensing devices compatible with remote monitoring have been developed and have been shown to improve care and cost-effectiveness.New smartphone software can detect arrhythmias using home ECG recordings and can detect atrial fibrillation using smartphone cameras.Remote monitoring of implanted pacemakers has shown non-inferiority to in clinic follow up.On the other hand,small-scale questionnaire-based studies demonstrated the willingness of the elderly cardiac patients to use such technologies,and their satisfaction with their use and ease of use.Large-scale studies should further investigate useability in samples more representative of the general elderly population with more diverse socioeconomic and educational backgrounds.Accordingly,it seems that studying integrating multiple technologies into telehealth programs is of great value.Further efforts should also be put in validating the technologies for specific diseases along with the legal and reimbursement aspects of the use of telehealth.展开更多
BACKGROUND: The study aims to investigate the occurrence of post-traumatic stress disorder(PTSD) after earthquakes among the elderly. METHODS: Data from cross-sectional studies focusing on the prevalence of PTSD after...BACKGROUND: The study aims to investigate the occurrence of post-traumatic stress disorder(PTSD) after earthquakes among the elderly. METHODS: Data from cross-sectional studies focusing on the prevalence of PTSD after earthquakes among the elderly were collected from Pub Med, EMBASE, Cochrane Library, and China National Knowledge Infrastructure in December 2019. The search terms included post-traumatic stress disorder, earthquake, and elderly. This study used Review Manager 5.0 to evaluate the impact of the results. In addition, forest plots, sensitivity analysis, and bias analysis were carried out on the included articles. The combined estimate of the risk ratio and the standard deviation of the 95% confidence interval(95% CI) were measurements of the size of the effect.RESULTS: There were 4,834 patients included from 10 eligible studies. The sample sizes of PTSD group and non-PTSD group were 1,277 and 3,557, respectively. The meta-analysis showed that the overall occurrence of PTSD after earthquakes among the elderly was 0.25;the occurrence in females was higher than that in males, and the occurrence in the same province indicated little difference(Wenchuan city 0.25 and Ya'an city 0.24).CONCLUSIONS: After earthquakes, the occurrence of PTSD is higher among the elderly than among other age groups, and higher among the females than among the males, while there is little difference among different areas within the same province. This indicated that prioritized specific psychological interventions should be provided to the aged and the females.展开更多
In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, ... In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, renal artery stenosis, carotid stenosis, and even disease of supra-aortic vessels may variously impact the patient's recovery from surgery. Also, the fact that involvement of two or more arterial beds are more common among the elderly makes this article all the more relevant at this time.……展开更多
BACKGROUND: Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE: To ob...BACKGROUND: Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE: To observe the clinical therapeutic effect of modified hemodilution combined therapy applied in elderly patients with acute cerebral thrombosis and analyze the mechanism of this therapeutic method. DESIGN: 1∶1 paired grouping according to gender and controlled observation. SETTING: Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University. PARTICIPANTS: Totally 90 elderly patients with acute ischemic stroke who received the treatment in the Cadre Ward and Mental Ward, Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University from March 1996 to June 2004 were recruited. They all met the diagnosis criteria revised by the Fourth Academic Conference of National Cerebrovascular Diseases in 1995 and were diagnosed as acute ischemic stroke by skull CT. They were informed of therapeutic plan and detected items. According to 1∶1 paired principle in gender, 90 enrolled patients were assigned into treated group (n=45) and control group (n=45). There were 39 male and 6 female in the treatment group, and they were aged (76±6)years, ranging from 71 to 84 years, and hospitalized at the 14th to 76th hours after onset. There were 39 male and 6 female in the control group, and they were aged (76±6)years , ranging from 70 to 82 years, and hospitalized at the 16th to 72th hours after onset. METHODS: Therapeutic method: Patients of treated group received modified hemodilution combined therapy. 200 mL whole blood of patients was exchanged with 500 mL dextran-40 (including 20 mL danshen parenteral solution and 32 mg heparin) at the beginning of therapy; From the 2nd day, compound huangqi tea bag (Huangqi mainly, including danshen, honghua, chuanxiong, shishao and a little acetyl salicylic acid) was made, twice a day, 1 bag once. At the same time, the above-mentioned dextran-40 liquid of 500 mL was intravenously injected, once a day, 14 days in total; On the 6th day after therapy, the above-mentioned aseptic autoblood stored in refrigerator at 4 ℃ was transfused back into the patients following pre-treatment of high-concentration oxygenation and ultraviolet irradiation by light quantum instrument. Patients of control group were intravenously injected of 0.4 g venoruton(Traditional Chinese medicine compound parenteral solution for promoting blood circulation and removing blood stasis ) and 50 g/L glucose of 500 mL, 75 mg acetosal was taken orally, once a day, 14 days in total. ② Measurement and observation of index: Blood coagulation index, change of platelet aggregation rate and change of hemorrheology of patients in two groups were monitored before and after therapy. The level of blood lipid of patients in two groups was measured with American Beckman automatic biochemistry analyzer. Blood flow rate of middle cerebral artery of resting electrocardiogram were measured with American HP SONOS 2500 sonoscope. Neuro-dysfunction score revised in the national conference (1995) was used to evaluate the recovery of neurological function of the patients in two groups at the 3rd, 5th, 7th and 14th days after therapy. ③Therapeutic effect and adverse effect were observed at the same time. MAIN OUTCOME MEASURES: ① Changes of coagulation index, blood lipid level and hemorheology; ② Blood flow rate of middle cerebral artery and NDS of patients with acute ischemic stroke in two groups; ③Adverse effect of drug. RESULTS: Totally 90 patients were enrolled in the experiment. One patient from treated group died of hyperosmolar nonketotic diabetic coma of complicated diabetes mellitus. One patient from control group died of severe pulmonary infection. The rest 88 patients entered the stage of result analysis. ① Change of coagulation index and platelet aggregation rate: prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) of patients after therapy were significantly longer than those before therapy in the treated group and those after therapy in control group [After therapy in treated group: (18.4±1.9), (41.8±2.1), (19.7±1.7) s, Before therapy in treated group: (13.4±1.3), (35.8±1.3), (12.5±0.9) s, After therapy in control group: (16.9±1.5), (39.1±1.1), (11.9±2.1) s, P < 0.05];Concentration of fibrinogen (Fbg) after therapy was significantly lower than that before therapy in the treated group and that after therapy in control group[After therapy in treated group: (3.4±0.4) g/L; Before therapy in treated group: (4.3±0.7) g/L; After therapy in control group:(4.0±0.6) g/L; P < 0.05]. Platelet aggregation rate decreased from (37.92 ±0.85)% before therapy to (26.42±1.01)% after therapy (P < 0.01). ②Change of blood lipid level: Levels of total cholesterol (TC), triacylglycerol(TG) and low density lipoprotein cholesterol (LDL-C) of patients after therapy were significantly lower than those before therapy in treated group and those after therapy in control group [After therapy in treated group: (5.2±0.9), (1.9±0.9), (2.08±1.1) mmol/L, before therapy in treated group:(5.9±1.2), (2.8±0.9), (3.94±0.5) mmol/L, After therapy in control group: (6.0±1.1), (2.6±0.8), (3.84±0.9) mmol/L,P < 0.05]. ③ Change of hemorheology index: Hematocrit of patients of treated group was significantly lower after therapy than before therapy [Before therapy: (43.84±4.55)%;After therapy: (40.48±4.02)%;P < 0.05]. ④ Blood flow rate of middle cerebral artery of patients of treated group was significantly lower before therapy than after therapy [(90±1.2),(97±2.1) cm/s,P < 0.01]. ⑤ NDS of patients in treated group was significantly lower than of control group 14 days after therapy. The total effective rate after therapy was significantly higher in the treated group than in the control group (93%,78%, P < 0.05). ⑥There was no obvious adverse effect. CONCLUSION: Modified hemodilution combined therapy can improve hemorheology, decrease hematocrit, increase blood flow rate of middle cerebral artery, so as to improve the impaired clinical neurological function of elderly patients with acute cerebral thrombosis through anticoagulation and antiplatelet aggregative activity as well as regulating blood lipid.展开更多
The education for the elderly is the last link of life-long education and an important part of spiritually providing for the aged.In the context of rural revitalization,this paper chooses the elderly in the suburbs of...The education for the elderly is the last link of life-long education and an important part of spiritually providing for the aged.In the context of rural revitalization,this paper chooses the elderly in the suburbs of Hangzhou,an eastern developed city,as the survey object.Through the methods of questionnaire survey and quantitative statistics,this paper analyzes and introduces the basic situation of rural education for the elderly,the demand for participating in education for the elderly,the learning evaluation of education for the elderly and the problems existing in the education for the elderly in rural areas.On this basis,some brief conclusions and discussions are put forward.展开更多
Urban park is one of the few green spaces that retain natural traces and are easy for the elderly to reach,and it has become the main place for the elderly to carry out leisure,entertainment,physical fi tness and inte...Urban park is one of the few green spaces that retain natural traces and are easy for the elderly to reach,and it has become the main place for the elderly to carry out leisure,entertainment,physical fi tness and interpersonal activities.The reasonable layout of urban parks is of great signifi cance to improve the quality of life of the elderly in old age.In this article,using the network analysis method in ArcGIS software,the accessibility of urban parks in Xihu District of Nanchang City based on elderly walking was evaluated and analyzed,and three strategies for optimizing the layout of the urban parks were proposed,including increasing the number of urban parks,improving the urban traffic network,and strengthening urban greenway planning and construction.The research results can provide reference for the optimal layout of urban parks in Xihu District,Nanchang City,so that the urban parks can better meet the outdoor leisure needs of the elderly,and the elderly’s sense of well-being and gain is enhanced.展开更多
The construction of a livable environment for the elderly is an important measure to address the challenges of aging and improve their livelihood and well-being.Based on China’s national conditions and combined with ...The construction of a livable environment for the elderly is an important measure to address the challenges of aging and improve their livelihood and well-being.Based on China’s national conditions and combined with the actual development needs of the cities,it is of great significance to explore the coupling and coordination characteristics and influencing factors within the livable environment system for the elderly for the coordination and stable development.This article was based on the three subsystems of’living service environment,socioeconomic environment and ecological livable environment’,following the research framework of’process-pattern-trend-impact’,constructs an evaluation index system for the livable environment for the elderly.Entropy weight-TOPSIS evaluation model,coupling coordination degree model,center of gravity and standard deviation ellipse model and the geographic detector model were used starting from the evolution of coupling coordination types to study the spatial and temporal pattern and dynamic trend characteristics and influencing factors of internal coupling coordination types in the livable environment system for the elderly from2010 to 2019.The results showed that:1)The coordinated development of life service environment system and ecological livable environment system(LE)and socioeconomic environment system and ecological livable environment system(SE)in the livable environment for the elderly decreased from the intermediate coordination level coordination areas to the low-level quality improvement and optimization areas:coordinated transition type.The overall development level of life service environment system and socioeconomic environment system(LS)was low,and it was always at a low level.2)The coupling degree of livable environment system for the elderly was high,the coupling coordination type shown a gradually decreasing layer structure with Zhejiang,Beijing and Guangdong high-level leading demonstration areas as the axis belt.3)The coupling coordination center of the elderly livable environment system was located in Henan,and the standard deviation ellipse was distributed in the northeast-southwest direction.The development center and the ellipse of the high-level leading demonstration areas and the intermediate coordination level areas were concentrated in the central and eastern regions,while the low-level coordination areas for improving quality and efficiency are mainly located in the western region.4)Urban development,green facilities,infrastructure,government macroscopic regulation and control,economic stimulus,and housing construction were all important factors affecting the coordinated development of the livable environment system for the elderly,exerting a varying degree of effect on the level of coordinated development of various types of systems.展开更多
Persons aged 80 and above are the fastest growing age group in the United States population, having increased 50% since 1990 and predicted to grow another 25% by 2020.
Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hyper...Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hypertension (HTN) plus coronary artery disease (CAD) and she is on angiotensin converting enzyme inhibitor (ACEI), furosemide, digoxin,spironolactone, low dose beta blocker and nitrates. Her beta-natriuretic peptide (BNP) in clinic is 3030 pg/ml, heart rate (HR) 100, blood pressure (BP) 89/43.展开更多
基金supported by the National Natural Science Foundation of China(Nos.62172287,62102273)。
文摘Depression is one of the most severe mental health illnesses among senior citizens.Aiming at the low accuracy and poor interpretability of traditional prediction models,a novel interpretable depression predictive model for the elderly based on the improved sparrow search algorithm(ISSA)optimized light gradient boosting machine(LightGBM)and Shapley Additive exPlainations(SHAP)is proposed.First of all,to achieve better optimization ability and convergence speed,various strategies are used to improve SSA,including initialization population by Halton sequence,generating elite population by reverse learning and multi-sample learning strategy with linear control of step size.Then,the ISSA is applied to optimize the hyper-parameters of light gradient boosting machine(LightGBM)to improve the prediction accuracy when facing massive high-dimensional data.Finally,SHAP is used to provide global and local interpretation of the prediction model.The effectiveness of the proposed method is validated by a series of comparative experiments based on a real-world dataset.
基金supported by the National Social Science Fund of China under Grant No.17BJL044。
文摘This study empirically examines whether child characteristics mitigate the negative impact of widowhood on the elderly’s mental health using follow-up survey data from the China Health and Retirement Longitudinal Study(CHARLS).A total of 5,326 older adults aged 60 years and older are selected from three waves of panel data(2013,2015,and 2018).Thefindings suggest that respondents who experienced widowhood exhibit an increase in depressive symptoms.However,the higher income of children and frequent face-to-face emotional interactions improve the mental health of the widowed elderly.Moreover,heterogeneity analyses show that the buffering effect of higher child income is more significant among men and the Midwestern widowed elderly,and frequent face-to-face emotional interactions are more effective in improving the psychological status of women and the Midwes-tern widowed elderly.In the special social and cultural background of China,family members remain the main support for the elderly,and the current social pension system is still imperfect.Therefore,children should strengthen emotional communication with their parents while increasing their economic income.In that way,widowhood can achieve both material and spiritual prosperity.The government should identify the vulnerable groups among the elderly widows and introduce policies aimed at improving their mental health and reducing the disparity in mental health status.
基金funded by Research Institute of Chinese Medicine,MOHW,and the project number is MOHW106-NRICM-C-124-000005。
文摘The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.Based on previous literature,the article aims to introduce the publishing trend of medical books on health cultivation and prolonging life on since modern times,generally describe its significance,and initially analyze the contents related to health cultivation for the elderly.The article finds out that after the scientific concepts were imported into China in large quantities from the beginning of the 20th century,the past superstitions rose again.The sciences of nutrition,bacteriology,and physiology in such books had all verified that the road to immortality was possible.The concept of longevity at the time emphasized a concept that could be controlled by science.With the advancement of scientific research and health concepts,people believed that they could eventually achieve immortality.It was obvious that people were filled with optimism about science at that time,thus gradually subverting the definition of the elderly.
基金partly supported by Biotronik for data processing。
文摘Background Several liver function tests have been identified as predictors of hospitalization for heart failure(HF) and death in patients with chronic HF. The relationship between serum γ-glutamyltranferase(GGT) and albumin(SA) levels with the response to cardiac resynchronization therapy(CRT) has not been reliably determined. The aim of the study was to evaluate the impact of liver function tests on the results of CRT in the elderly. Methods Baseline GGT and SA were assessed before CRT device implantation in the elderly(> 70-year-old) patients. The endpoints were:(1) CRT response defined as > 5% left ventricular ejection fraction improvement and no hospitalization for HF or cardiovascular death;(2) hospitalizations;and(3) mortality. Results Eighty of 138(58%) included patients were responders at nine months. Compared to responders, the SA levels were not significantly different(35.1 ± 5.4 vs. 33.6 ± 5.5 g/L, P = 0.103);but the GGT levels, higher(81.6 ± 69.3 vs. 54.7 ± 49.6 U/L, P = 0.013) in non-responders to CRT. GGT level was independently associated with non-response to CRT(P < 0.001, OR = 0.17;95% CI: 0.08–0.38, P < 0.001). GGT cut-off value ≥ 55 U/L was highly predictive of non-response [AUC = 0.65, 64% Sensitivity, 69% Specificity(95% CI: 0.56–0.74)]. GGT ≥ 55 U/L was also associated with higher risk of hospitalization for atrial fibrillation(AF)(95% vs. 83%, P = 0.024). Both SA and GGT had no impact on overall(P = 0.220, P = 0.723) mortality. Conclusions Higher level of GGT is an independent predictor of non-response to CRT in patients over age 70 years and is associated with higher risk of hospitalization for AF. Baseline serum levels of albumin and GGT and have no impact on mortality in elderly patients undergoing CRT.
文摘1 Introduction Societies are ageing at an accelerated pace.This scenario is a well-known challenge for health care systems,as chronic diseases,multiple comorbidities and dependency are all entities that often converge in the elderly.Besides,there is an issue regarding a reduction in the general incidence of acute coronary syndrome(ACS)together with a delayed in the age of presentation,which,in sum,lead to an increase in both incidence and prevalence of ACS with age,especially non-ST elevation myocardial infarction(NSTEMI).
基金financial support provided by the Fundamental Research Funds for the Central Universities,China(BLX201945)。
文摘Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the impact of clan culture on the mental health of elderly people in rural China.The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly.Further,there was no gender difference with respect to the impact of clan culture on the depression score of the elderly.At the same time,the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development.Exploration of the mechanisms involved indicated that in areas with stronger clan culture,older people receive more social support.This study enriches our understanding of the impact of informal institutions on the welfare of rural residents.At the same time,it can also provide a certain decisionmaking reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.
基金the National Key Research and Development Program of China(2017YFC0908803&2018YFC1312501&2016YFC0900901&2016YFC1301002&2020YFC2004803).
文摘Background It is unclear whether catheter ablation(CA)for atrial fibrillation(AF)affects the long-term prognosis in the elderly.This study aims to evaluate the relationship between CA and long-term outcomes in elderly patients with AF.Methods Patients more than 75 years old with non-valvular AF were prospectively enrolled between August 2011 and December 2017 in the Chinese Atrial Fibrillation Registry Study.Participants who underwent CA at baseline were propensity score matched(1:1)with those who did not receive CA.The outcome events included all-cause mortality,cardiovascular mortality,stroke/transient ischemic attack(TIA),and cardiovascular hospitalization.Results Overall,this cohort included 571 ablated patients and 571 non-ablated patients with similar characteristics on 18 dimensions.During a mean follow-up of 39.75±19.98 months(minimum six months),24 patients died in the ablation group,compared with 60 deaths in the non-ablation group[hazard ratio(HR)=0.49,95%confidence interval(CI):0.30-0.79,P=0.0024].Besides,6 ablated and 29 non-ablated subjects died of cardiovascular disease(HR=0.25,95%CI:0.11-0.61,P=0.0022).A total of 27 ablated and 40 non-ablated patients suffered stroke/TIA(HR=0.79,95%CI:0.48-1.28,P=0.3431).In addition,140 ablated and 194 non-ablated participants suffered cardiovascular hospitalization(HR=0.84,95%CI:0.67-1.04,P=0.1084).Subgroup analyses according to gender,type of AF,time since onset of AF,and anticoagulants exposure in initiation did not show significant heterogeneity.Conclusions In elderly patients with AF,CA may be associated with a lower incidence of all-cause and cardiovascular mortality.
文摘<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.
文摘BACKGROUND The number of elderly individuals with diabetes is dramatically increasing.Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management.Understanding of self-management from the patients’perspectives is important to nurses,healthcare providers,and researchers and benefits people by improving their self-management skills.AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.METHODS Electronic databases were searched,including MEDLINE,CINAH,PsycINFO,PubMed,CNKI,and WANFADATA.Relevant research was identified by manually searching reference lists and gray literature.Only English and Chinese publications were included.The Critical Appraisal Skills Program was used to assess the quality of the research.The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.RESULTS A total of 10 qualitative studies were included,and content analysis was performed.Five themes were identified:The need for knowledge about diabetes care,support systems,functional decline,attitudes toward diabetes,and healthy lifestyle challenges.CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.
文摘Heart failure (HF) is a major health problem for the geriatric population. In the United States, most of the 5 millions patients with HF are elderly.1 Seventy-five percent of HF hospitalizations occurred in patients older than 65 years and 50% in patients 75 years and older.1 In the Framingham population, the prevalence of HF increased eightfold among men from the fifth decade of life to the seventh decade.2 However, despite of considerable improvement in the treatment, the mortality of HF patients remained relatively constant between 1948 and 1997.
文摘More old residential communities have become unsuitable for the elderly because of the aging of outdoor physical environment and functional degradation. This paper investigated behaviors and mental activities of the elderly, problems of outdoor environment in old residential communities, and proposed strategies for the renovation of old residential communities from the perspectives of outdoor environment, road, greening and public supporting facilities according to demands of the elderly on outdoor environment, so as to provide them a comfortable and reasonable outdoor environment.
文摘Telemedicine is the use of information and communication technology to deliver healthcare at a distance.It has been resorted to during the COVID-19 pandemic to lessen the need for in-person patient care decreasing the risk of transmission,and it can be of benefit afterward in the management of cardiac disease.The elderly population has unique challenges concerning the use of telehealth technologies.We thus review the advances in telemedicine technologies in treating elderly cardiac patients including in our discussion only studies with a mean age of participants above 60.Remote monitoring of blood pressure,weight,and symptoms,along with home ECG recording has been found to be superior to usual in-clinic follow up.Combining remote monitoring with video conferencing with physicians,patient education websites,and applications is also of benefit.Remote monitoring of Implantable Cardioverter Defibrillators(ICD)and Cardiac Resynchronization Therapy Defibrillators(CRT-D)is also beneficial but can be at the cost of an increase in both appropriate and inappropriate interventions.Implantable sensing devices compatible with remote monitoring have been developed and have been shown to improve care and cost-effectiveness.New smartphone software can detect arrhythmias using home ECG recordings and can detect atrial fibrillation using smartphone cameras.Remote monitoring of implanted pacemakers has shown non-inferiority to in clinic follow up.On the other hand,small-scale questionnaire-based studies demonstrated the willingness of the elderly cardiac patients to use such technologies,and their satisfaction with their use and ease of use.Large-scale studies should further investigate useability in samples more representative of the general elderly population with more diverse socioeconomic and educational backgrounds.Accordingly,it seems that studying integrating multiple technologies into telehealth programs is of great value.Further efforts should also be put in validating the technologies for specific diseases along with the legal and reimbursement aspects of the use of telehealth.
文摘BACKGROUND: The study aims to investigate the occurrence of post-traumatic stress disorder(PTSD) after earthquakes among the elderly. METHODS: Data from cross-sectional studies focusing on the prevalence of PTSD after earthquakes among the elderly were collected from Pub Med, EMBASE, Cochrane Library, and China National Knowledge Infrastructure in December 2019. The search terms included post-traumatic stress disorder, earthquake, and elderly. This study used Review Manager 5.0 to evaluate the impact of the results. In addition, forest plots, sensitivity analysis, and bias analysis were carried out on the included articles. The combined estimate of the risk ratio and the standard deviation of the 95% confidence interval(95% CI) were measurements of the size of the effect.RESULTS: There were 4,834 patients included from 10 eligible studies. The sample sizes of PTSD group and non-PTSD group were 1,277 and 3,557, respectively. The meta-analysis showed that the overall occurrence of PTSD after earthquakes among the elderly was 0.25;the occurrence in females was higher than that in males, and the occurrence in the same province indicated little difference(Wenchuan city 0.25 and Ya'an city 0.24).CONCLUSIONS: After earthquakes, the occurrence of PTSD is higher among the elderly than among other age groups, and higher among the females than among the males, while there is little difference among different areas within the same province. This indicated that prioritized specific psychological interventions should be provided to the aged and the females.
文摘 In this issue of the Journal of Geriatric Cardiology,Rigatelli and colleagues tackled the issue of concomitant noncoronary atherosclerosis among elderly patients undergoing cardiac surgery.1 Ilio-femoral disease, renal artery stenosis, carotid stenosis, and even disease of supra-aortic vessels may variously impact the patient's recovery from surgery. Also, the fact that involvement of two or more arterial beds are more common among the elderly makes this article all the more relevant at this time.……
基金the Grant from Science and Technology Development Foundation of Railway Bureau of Shanghai, No. 3402052304/A
文摘BACKGROUND: Thrombolysis therapy is not suitable for the elderly patients with acute ischemic stroke who delayed to be diagnosed for more than 3 hours, but traditional medicine is also not very ideal. OBJECTIVE: To observe the clinical therapeutic effect of modified hemodilution combined therapy applied in elderly patients with acute cerebral thrombosis and analyze the mechanism of this therapeutic method. DESIGN: 1∶1 paired grouping according to gender and controlled observation. SETTING: Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University. PARTICIPANTS: Totally 90 elderly patients with acute ischemic stroke who received the treatment in the Cadre Ward and Mental Ward, Department of Internal Medicine, Chengzhanyuan District, First Hospital Affiliated to Zhejiang University from March 1996 to June 2004 were recruited. They all met the diagnosis criteria revised by the Fourth Academic Conference of National Cerebrovascular Diseases in 1995 and were diagnosed as acute ischemic stroke by skull CT. They were informed of therapeutic plan and detected items. According to 1∶1 paired principle in gender, 90 enrolled patients were assigned into treated group (n=45) and control group (n=45). There were 39 male and 6 female in the treatment group, and they were aged (76±6)years, ranging from 71 to 84 years, and hospitalized at the 14th to 76th hours after onset. There were 39 male and 6 female in the control group, and they were aged (76±6)years , ranging from 70 to 82 years, and hospitalized at the 16th to 72th hours after onset. METHODS: Therapeutic method: Patients of treated group received modified hemodilution combined therapy. 200 mL whole blood of patients was exchanged with 500 mL dextran-40 (including 20 mL danshen parenteral solution and 32 mg heparin) at the beginning of therapy; From the 2nd day, compound huangqi tea bag (Huangqi mainly, including danshen, honghua, chuanxiong, shishao and a little acetyl salicylic acid) was made, twice a day, 1 bag once. At the same time, the above-mentioned dextran-40 liquid of 500 mL was intravenously injected, once a day, 14 days in total; On the 6th day after therapy, the above-mentioned aseptic autoblood stored in refrigerator at 4 ℃ was transfused back into the patients following pre-treatment of high-concentration oxygenation and ultraviolet irradiation by light quantum instrument. Patients of control group were intravenously injected of 0.4 g venoruton(Traditional Chinese medicine compound parenteral solution for promoting blood circulation and removing blood stasis ) and 50 g/L glucose of 500 mL, 75 mg acetosal was taken orally, once a day, 14 days in total. ② Measurement and observation of index: Blood coagulation index, change of platelet aggregation rate and change of hemorrheology of patients in two groups were monitored before and after therapy. The level of blood lipid of patients in two groups was measured with American Beckman automatic biochemistry analyzer. Blood flow rate of middle cerebral artery of resting electrocardiogram were measured with American HP SONOS 2500 sonoscope. Neuro-dysfunction score revised in the national conference (1995) was used to evaluate the recovery of neurological function of the patients in two groups at the 3rd, 5th, 7th and 14th days after therapy. ③Therapeutic effect and adverse effect were observed at the same time. MAIN OUTCOME MEASURES: ① Changes of coagulation index, blood lipid level and hemorheology; ② Blood flow rate of middle cerebral artery and NDS of patients with acute ischemic stroke in two groups; ③Adverse effect of drug. RESULTS: Totally 90 patients were enrolled in the experiment. One patient from treated group died of hyperosmolar nonketotic diabetic coma of complicated diabetes mellitus. One patient from control group died of severe pulmonary infection. The rest 88 patients entered the stage of result analysis. ① Change of coagulation index and platelet aggregation rate: prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) of patients after therapy were significantly longer than those before therapy in the treated group and those after therapy in control group [After therapy in treated group: (18.4±1.9), (41.8±2.1), (19.7±1.7) s, Before therapy in treated group: (13.4±1.3), (35.8±1.3), (12.5±0.9) s, After therapy in control group: (16.9±1.5), (39.1±1.1), (11.9±2.1) s, P < 0.05];Concentration of fibrinogen (Fbg) after therapy was significantly lower than that before therapy in the treated group and that after therapy in control group[After therapy in treated group: (3.4±0.4) g/L; Before therapy in treated group: (4.3±0.7) g/L; After therapy in control group:(4.0±0.6) g/L; P < 0.05]. Platelet aggregation rate decreased from (37.92 ±0.85)% before therapy to (26.42±1.01)% after therapy (P < 0.01). ②Change of blood lipid level: Levels of total cholesterol (TC), triacylglycerol(TG) and low density lipoprotein cholesterol (LDL-C) of patients after therapy were significantly lower than those before therapy in treated group and those after therapy in control group [After therapy in treated group: (5.2±0.9), (1.9±0.9), (2.08±1.1) mmol/L, before therapy in treated group:(5.9±1.2), (2.8±0.9), (3.94±0.5) mmol/L, After therapy in control group: (6.0±1.1), (2.6±0.8), (3.84±0.9) mmol/L,P < 0.05]. ③ Change of hemorheology index: Hematocrit of patients of treated group was significantly lower after therapy than before therapy [Before therapy: (43.84±4.55)%;After therapy: (40.48±4.02)%;P < 0.05]. ④ Blood flow rate of middle cerebral artery of patients of treated group was significantly lower before therapy than after therapy [(90±1.2),(97±2.1) cm/s,P < 0.01]. ⑤ NDS of patients in treated group was significantly lower than of control group 14 days after therapy. The total effective rate after therapy was significantly higher in the treated group than in the control group (93%,78%, P < 0.05). ⑥There was no obvious adverse effect. CONCLUSION: Modified hemodilution combined therapy can improve hemorheology, decrease hematocrit, increase blood flow rate of middle cerebral artery, so as to improve the impaired clinical neurological function of elderly patients with acute cerebral thrombosis through anticoagulation and antiplatelet aggregative activity as well as regulating blood lipid.
基金2015 General Project of Zhejiang Provincial Department of Education:"Research on the Innovation of Community Endowment Service Model Promoted by the Open University for the Elderly:A Case Study of Zhejiang Province"(Y201534067)Famous Economic Management Teacher Studio Project Zhejiang Radio and TV University+1 种基金312 Talent Training Project of Zhejiang Radio and TV UniversityProfessional Teaching Team Project of Zhejiang Radio and TV University in 2018.
文摘The education for the elderly is the last link of life-long education and an important part of spiritually providing for the aged.In the context of rural revitalization,this paper chooses the elderly in the suburbs of Hangzhou,an eastern developed city,as the survey object.Through the methods of questionnaire survey and quantitative statistics,this paper analyzes and introduces the basic situation of rural education for the elderly,the demand for participating in education for the elderly,the learning evaluation of education for the elderly and the problems existing in the education for the elderly in rural areas.On this basis,some brief conclusions and discussions are put forward.
基金General Project of Humanities and Social Science Research of Ministry of Education,China(16YJC760073)Social Science Planning Project of Jiangxi Province(18YS07)+1 种基金Humanities and Social Science Research Project for Colleges and Universities in Jiangxi Province(YS1531)Innovation and Entrepreneurship Training Program for Undergraduates in Jiangxi Agricultural University(S202010410015).
文摘Urban park is one of the few green spaces that retain natural traces and are easy for the elderly to reach,and it has become the main place for the elderly to carry out leisure,entertainment,physical fi tness and interpersonal activities.The reasonable layout of urban parks is of great signifi cance to improve the quality of life of the elderly in old age.In this article,using the network analysis method in ArcGIS software,the accessibility of urban parks in Xihu District of Nanchang City based on elderly walking was evaluated and analyzed,and three strategies for optimizing the layout of the urban parks were proposed,including increasing the number of urban parks,improving the urban traffic network,and strengthening urban greenway planning and construction.The research results can provide reference for the optimal layout of urban parks in Xihu District,Nanchang City,so that the urban parks can better meet the outdoor leisure needs of the elderly,and the elderly’s sense of well-being and gain is enhanced.
基金Under the auspices of Natural Science Foundation of Heilongjiang Province(No.LH2019D008)Youth Fund for Humanities and Social Sciences of the Ministry of Education(No.19YJC630177)+1 种基金Innovative Youth Talent Cultivation Plan of Heilongjiang Provincial Universities(No.UNPYSCT-2018194)Human Civilization and Social Science Supportive Program for Excellent Young Scholars of Harbin Normal University(No.SYQ2014-06)。
文摘The construction of a livable environment for the elderly is an important measure to address the challenges of aging and improve their livelihood and well-being.Based on China’s national conditions and combined with the actual development needs of the cities,it is of great significance to explore the coupling and coordination characteristics and influencing factors within the livable environment system for the elderly for the coordination and stable development.This article was based on the three subsystems of’living service environment,socioeconomic environment and ecological livable environment’,following the research framework of’process-pattern-trend-impact’,constructs an evaluation index system for the livable environment for the elderly.Entropy weight-TOPSIS evaluation model,coupling coordination degree model,center of gravity and standard deviation ellipse model and the geographic detector model were used starting from the evolution of coupling coordination types to study the spatial and temporal pattern and dynamic trend characteristics and influencing factors of internal coupling coordination types in the livable environment system for the elderly from2010 to 2019.The results showed that:1)The coordinated development of life service environment system and ecological livable environment system(LE)and socioeconomic environment system and ecological livable environment system(SE)in the livable environment for the elderly decreased from the intermediate coordination level coordination areas to the low-level quality improvement and optimization areas:coordinated transition type.The overall development level of life service environment system and socioeconomic environment system(LS)was low,and it was always at a low level.2)The coupling degree of livable environment system for the elderly was high,the coupling coordination type shown a gradually decreasing layer structure with Zhejiang,Beijing and Guangdong high-level leading demonstration areas as the axis belt.3)The coupling coordination center of the elderly livable environment system was located in Henan,and the standard deviation ellipse was distributed in the northeast-southwest direction.The development center and the ellipse of the high-level leading demonstration areas and the intermediate coordination level areas were concentrated in the central and eastern regions,while the low-level coordination areas for improving quality and efficiency are mainly located in the western region.4)Urban development,green facilities,infrastructure,government macroscopic regulation and control,economic stimulus,and housing construction were all important factors affecting the coordinated development of the livable environment system for the elderly,exerting a varying degree of effect on the level of coordinated development of various types of systems.
文摘Persons aged 80 and above are the fastest growing age group in the United States population, having increased 50% since 1990 and predicted to grow another 25% by 2020.
文摘Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hypertension (HTN) plus coronary artery disease (CAD) and she is on angiotensin converting enzyme inhibitor (ACEI), furosemide, digoxin,spironolactone, low dose beta blocker and nitrates. Her beta-natriuretic peptide (BNP) in clinic is 3030 pg/ml, heart rate (HR) 100, blood pressure (BP) 89/43.
