Predictors of postoperative persistent low back pain following lumbar fusion in patients older than 75 years: An analysis of a minimum 2-year follow-up.

PURPOSE: This study aimed to evaluate pre- and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged > 75 years. METHODS: This single-center retrospective study examined 310 patients aged > 75 years who underwent lumbar fusion for lumbar degenerative disease (104 males, 206 females; mean age, 79 [75-90] years). The visual analog scale (VAS) score for LBP was examined preoperatively and 2-year postoperatively. The persistent LBP group comprised patients with a 2-year postoperative LBP-VAS score ≥ 3. The demographic and preoperative radiographic parameters were also reviewed. A multivariate stepwise logistic regression analysis was performed of variables with values of P < 0.2 on the univariate analysis. RESULTS: Ninety-nine patients (32%) experienced persistent postoperative LBP. Multivariate logistic regression analysis revealed that age < 82 years, history of previous lumbar decompression, and greater preoperative VAS score for LBP were associated with greater postoperative persistent LBP after lumbar fusion, whereas other factors, such as gender, body mass index, osteoporosis, diabetes mellitus, depression, symptom duration, operative time, estimated blood loss, and spinopelvic sagittal parameters, were not. CONCLUSIONS: This study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.

Intercepting the Intussusception: A Rare Case of Adult Intussusception With a Cecal Neuroendocrine Tumor Lead Point.

Intussusception is the invagination of one segment of the bowel into the adjacent bowel segment leading to obstruction, intestinal ischemia and, in severe cases, peritonitis and perforation. While the condition is more common in children, adult intussusception does occur and is often attributed to malignancy. In this case report, we discuss an adult man who presented for weight loss and intermittent abdominal pain and was ultimately found to have ileocecal intussusception on CT imaging. A colonoscopy with cold biopsy was performed and pathology reports displayed a well-differentiated neuroendocrine tumor lead point; a rare event with only a few cases reported. Ultimately, the patient was taken to the operating room, and an ileocecectomy was performed with primary anastomosis. Prompt diagnosis and management are crucial in adult intussusception as a missed event can lead to tumor progression, bowel ischemia, bleeding and necrosis.

[Services for the elderly as a segment of the silver economy in the megalopolis: expert assessment. Part 1.]

The article examines the service sector for the elderly as a segment of the silver economy market. The author's classification of services provided to the elderly is given according to an expanded set of criteria. During the expert survey, medical and social services that are of primary demand among the elderly were identified. Legal services and transportation services came in second place. The underestimation of the factor of psychological support for both the aging process itself and possible concomitant processes was noted.

Factors influencing inpatient bowel preparation: a scoping review.

BACKGROUND AND AIM: Inpatients undergoing colonoscopy experience a higher-than-average rate of inadequate bowel preparation (compared to outpatients) leading to canceled procedures, increased stress on the patient, increased time in hospital, and increased cost to the healthcare system. The aim of this scoping review was to identify research surrounding inpatient bowel preparation and to identify modifiable and non-modifiable factors that influence the adequacy of bowel preparation in hospitalized patients undergoing colonoscopy and establish areas where nursing interventions may help improve overall bowel preparation rates. METHODS: An initial search of MEDLINE, CINAHL, Scopus, and Embase was undertaken to identify seed articles, followed by a structured search using keywords and subject headings. Studies conducted between 2000 and 2022 and published in English were included. A total of 37 full-text studies were screened for inclusion, with 22 meeting inclusion criteria. RESULTS: Advanced age, decreased mobility, constipation, extended length of stay, and multiple comorbidities were identified as non-modifiable factors associated with inadequate bowel preparation. Narcotic use, failure to follow preparation instruction, and delayed time to colonoscopy were identified as modifiable factors associated with poor bowel preparation. CONCLUSIONS: Educational interventions and interprofessional programs, using a multifaceted approach, increase the odds of adequate bowel preparation, including nursing tip sheets, troubleshooting flowsheets, and bowel movement assessment scoring.

Analysis of risk factors and predictive efficacy of senile osteoporosis fracture based on biochemical indicators of bone metabolism.

A total of 254 elderly OS patients diagnosed and treated in our hospital during May 2019 to April 2022 was randomly picked, of which 100 patients were finally enrolled. Patients were divided into OS fracture group and non-fracture group according to whether they had OS fracture. The contents of bone mineral density (BMD) and bone metabolism biochemical indexes, including Dickkopf1 (DKK-1), sclerostin (SOST), osteoprotegerin (OPG), osteopontin (OPN), osteocalcin (BGP) and 25 hydroxyvitamin D (25 (OH) D) were detected in lumbar L2c4 and left femoral greater trochanter. The correlation between bone metabolism and BMD was evaluated using Pearson analysis. The risk factors of OS fracture were analyzed using Multivariate logistic regression analysis. The predictive value of biochemical indexes of bone metabolism on the risk of OS fracture was analyzed using ROC curve.

[Multidimensional Social Deprivation Impacts on Frailty in the Elderly: The Mediating Effect of Depression]. / 多维社会剥夺感对老年人衰弱的影响−抑郁的中介效应分析.

Objective: To investigate the mediating role of depression in the association between multidimensional social deprivation and frailty among the elderly. Methods: A total of 533 elderly individuals were enrolled from a district in Chengdu using a convenience sampling method. The participants responded to a questionnaire survey. Spearman rank correlation coefficient was employed to assess the correlations among social deprivation, depression, and frailty. MacKinnon's product-of-coefficients method was used to test the significance of the mediating effect of depression between social deprivation and frailty. Results: Among the participants, the average score for social deprivation among the participants was 48.9±7.1, the depression detection rate was 12.8%, and the frailty incidence rate was 8.4%. Social deprivation was positively correlated with frailty (r=0.212, P<0.001) and depression (r=0.399, P<0.001), while depression was positively correlated with frailty (r=0.248, P<0.001). The results of the mediation analysis showed that depression partially mediated the relationship between social deprivation and frailty (P<0.05), accounting for 64.95% of the mediation effect. Specifically, depression partially mediated the relationship between socio-economic status, comprehensive feeling, and frailty (P<0.05), accounting for 70.30% and 64.76% of the mediating effect, respectively. Depression fully mediated the relationship between family and social support, political and social participation dimensions, and frailty (P<0.05). Conclusion: Social deprivation can influence frailty in elderly people, with depression partially mediating this association.

Diagnostic information in GP referral letters to a memory clinic: a cohort study.

BACKGROUND: Dementia diagnostics can often be performed in primary care, yet older persons with memory complaints are frequently referred to memory clinics (MCs). AIM: To compare diagnostic information in general practitioner (GP) referral letters of patients with and without an eventual dementia diagnosis. DESIGN & SETTING: Retrospective cohort study in a Dutch academic geriatric MC. METHOD: We collected electronic health record (EHR) data of consecutive patients aged≥65 referred by their GP between 2016-2020. EHR data included patient characteristics, diagnostic information in referral letters, ancillary investigations performed at the MC, and established diagnoses. Chi-square tests were applied to compare groups. RESULTS: Of 651 patients included, the average age was 78.0 (SD: 6.8), and 348 (53.5%) were diagnosed with dementia. Most people with dementia were diagnosed without ancillary investigations (235/348, 67.5%). In GP referral letters of people with dementia compared with people without dementia, a collateral history, any physical examination, a differential diagnosis including dementia, an MMSE score, interference with daily functioning, and decline from previous levels of functioning were mentioned more often. Furthermore, the more diagnostic criteria mentioned in the referral letter, the more often dementia was diagnosed at the MC (no criteria: 35.4%, one criterion: 47.3%, two criteria: 53.4%, three criteria: 69.9%, four or five criteria: 83.3%). CONCLUSION: GPs often correctly mention diagnostic information and dementia criteria in referral letters of people with dementia, and they are often diagnosed without ancillary investigations. This suggests that referral is often unnecessary, and GPs can be empowered to diagnose dementia themselves.

The prediction model of fall risk for the elderly based on gait analysis.

INTRODUCTION: Early screening and identification are crucial for fall prevention, and developing a new method to predict fall risk in the elderly can address the current lack of objectivity in assessment tools. METHODS: A total of 132 elderly individuals over 80 years old residing in some nursing homes in Shanghai were selected using a convenient sampling method. Fall history information was collected, and gait data during a 10-meter walk were recorded. Logistic regression was employed to establish the prediction model, and a nomogram was used to assess the importance of the indicators. The Bootstrap method was utilized for internal validation of the model, while the verification set was used for external validation. The predictive performance of the model was evaluated using the area under the ROC curve, calibration curve, and decision curve analysis (DCA) to assess clinical benefits. RESULTS: The incidence of falls in the sample population was 36.4%. The Tinetti Gait and Balance Test (TGBT) score (OR = 0.832, 95% CI: 0.734,0.944), stride length (OR = 0.007, 95% CI: 0.000,0.104), difference in standing time (OR = 0.001, 95% CI: 0.000,0.742), and mean stride time (OR = 0.992, 95% CI:0.984,1.000) were identified as significant factors. The area under the ROC curve was 0.878 (95% CI: 0.805, 0.952), with a sensitivity of 0.935 and specificity of 0.726. The Brier score was 0.135, and the Hosmer-Lemeshow test (χ2 = 10.650, P = 0.222) indicated a good fit and calibration of the model. CONCLUSION: The TGBT score, stride length, difference in standing time, and stride time are all protective factors associated with fall risk among the elderly. The developed risk prediction model demonstrates good discrimination and calibration, providing valuable insights for early screening and intervention in fall risk among older adults.

Neurosurgery in the elderly: Findings from a cohort in the Philippines.

BACKGROUND: Better living conditions and health care advancements have improved life expectancy worldwide, increasing the number of older patients who require neurosurgery. We would like to report our experience with geriatric neurosurgical patients at our institution. METHODS: This is a retrospective study on geriatric patients (aged ≥ 65 years) who underwent neurosurgery at our center between 2015 and 2022. Data on age, sex, comorbidities, pre-morbid status, type of admission, diagnosis, operation, complications, short-term outcome, hospital length of stay (LOS), and 30-day readmission were collected. Descriptive statistics and multiple regression analysis were used. RESULTS: A total of 327 patients were included. The mean age was 70.4 years and 51.3 % were female. Majority (70.6 %) had at least one comorbid condition, most commonly hypertension. Most patients were admitted through emergency systems (80.1 %), with 40.4 % consulting for traumatic brain injury. The top diagnoses were chronic subdural hematoma (35.2 %), ruptured intracerebral aneurysm (15.6 %), and meningioma (10.1 %). The most common procedures were burrhole drainage of hematoma (34.8 %), brain tumor excision (16.7 %), and aneurysm clipping (14.6 %). The post-operative complication rate was 15.2 %, and mean LOS was 16.7 days. Majority of patients (86.9 %) were discharged home, and 2.8 % were readmitted within 30 days. The 30-day mortality rate was 13.1 %. Lower pre-operative GCS, certain comorbidities, and intra- and post-operative complications were significantly associated with mortality and LOS. CONCLUSION: Advanced age alone should not be a contraindication to surgery; other factors such as frailty and comorbid conditions should also be considered. Proper patient selection and preoperative preparation are key to achieving good outcomes.

Intrinsic capacity decline as a predictor of functional disability in the elderly: A systematic review and meta-analysis.

OBJECTIVES: To examine the predictive value of intrinsic capacity decline on functional disability among the elderly. DESIGN: Meta-analysis. METHODS: PubMed, EMBASE, Web of Science, The Cochrane Library, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched for relevant studies published from the inception until June 1, 2024. Stata 17.0 software was used to perform the meta-analysis. The methodological quality was evaluated using the Newcastle Ottawa Scale. The overall quality of evidence used GRADE guidelines to assess. A study protocol was registered in PROSPERO (CRD42023475461). RESULTS: The meta-analysis included 8 cohort studies including 9744 elderly people. Functional disability including ADL disability (n = 6) and IADL disability (n = 7). The results showed that intrinsic capacity decline could predict ADL disability (HR = 1.08, 95 %CI 1.04-1.12; I2 = 98.2 %, P < 0.001) and IADL disability (HR = 1.11, 95 %CI 1.05-1.17; I2 = 96.4 %, P < 0.001). The overall risk of bias was low. And the grade of evidence that assessed by GRADE guidelines was rated as moderate. CONCLUSIONS: Intrinsic capacity decline is a predictor of functional disability in the elderly. Therefore, screening intrinsic capacity decline has important clinical implications for early identifying the risk of functional disability, which contributes to providing individualized interventions ahead of potential functional disability for the elderly, thereby preventing functional disability, improving the quality of life and promoting healthy aging.

[Clinical effect of the warm acupuncture of Mongolian medicine on insomnia in the elderly and its brain-gut peptide mechanism: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect and safety of the warm acupuncture of Mongolian medicine in treatment of insomnia in the elderly, and to explore its underlying brain-gut peptide mechanism. METHODS: Sixty elderly patients with insomnia were randomly divided into a warm acupuncture group and a western medication group, 30 cases in each group. In the warm acupuncture group, the warm acupuncture of Mongolian medicine was operated at Dinghuixue (at the center of the vertex, the crossing site of the anterior midline and the line connected the upper edges of two ear apexes), Heyixue (at the depression of the spinous process of the 7th cervical vertebra) or Xinxue (at the depression of the spinous process of the 6th thoracic vertebra) in each treatment. Only one of the above points was selected and stimulated for 20 min one treatment and the three points were used alternatively. The treatment was given once every day or every other day, 3 times a week, and for a total of 3 weeks. In the western medication group, estazolam tablets were administered orally, once a day, 1 mg before bedtime, consecutively for 3 weeks. Before and after treatment, as well as in 1-month follow-up visit after the treatment completion, the scores of the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI) were observed in the two groups. The serum brain-related peptide markers (substance P [SP], neuropeptide Y [NPY], 5-hydroxytryptamine 1A [5-HT1A] and 5-hydroxytryptamine 2A [5-HT2A]) were measured before and after treatment, and the clinical efficacy and safety was evaluated in the two groups. RESULTS: After treatment and in follow-up, the scores of sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total scores of PSQI, and ISI scores were all reduced in the two groups (P<0.05, P<0.01); and the scores in the warm acupuncture group were lower than those of the western medication group (P<0.05, P<0.01). After treatment, the levels of serum SP and 5-HT2A were decreased (P<0.01) and the levels of serum NPY and 5-HT1A were increased (P<0.01) when compared with those before treatment in the two groups. The levels of serum SP and 5-HT2A in the warm acupuncture group were lower than those of the western medication group (P<0.05), and the levels of serum NPY and 5-HT1A were higher than those of the western medication group (P<0.05). After treatment, the total effective rate was 93.3% (28/30) in the warm acupuncture group, which was higher than 83.3% (25/30) of the western medication group (P<0.05). No serious adverse reactions were found in the two groups. CONCLUSION: Warm acupuncture of Mongolian medicine can effectively improve the sleep quality of the elderly patients with insomnia, and its mechanism may be related to the regulation of the levels of serum SP, NPY, 5-HT1A and 5-HT2A.

Reference values for heart rate variability in older adults: A systematic review.

Heart rate variability (HRV) is an early marker of risk for various health conditions, and its analysis serves as a valuable tool for assessing older adults. This study aimed to describe the reference values of HRV parameters in older adults through a systematic review of the literature. The review included searches in MEDLINE (via PubMed®), EMBASE, Latin American and Caribbean Health Literature, Scopus, and Web of Science (WOS). Studies presenting reference values for at least one HRV linear analysis measure in older adults were considered eligible. Out of 1618 studies identified, only 11 met the inclusion criteria. Sample sizes of older adults ranged from 21 to 6250 subjects. The HRV measures assessed (mean RR intervals, SDNN, RMSSD, PNN50, LF, HF, and LF/HF ratio) varied significantly between studies, with no standardized methods for HRV analysis. We concluded that reference values for HRV measures in older adults vary widely between studies. The scientific literature on HRV reference values in older adults is still limited, and future studies should standardize assessment methods for HRV measures in this population.

Texture differences of microchambers and macrochambers in heel pads between the elderly with and without diabetes.

OBJECTIVE: This study aims to use the texture analysis of ultrasound images to distinguish the features of microchambers (a superficial thinner layer) and macrochambers (a deep thicker layer) in heel pads between the elderly with and without diabetes, so as to preliminarily explore whether texture analysis can identify the potential injury characteristics of deep tissue under the influence of diabetes before the obvious injury signs can be detected in clinical management. METHODS: Ultrasound images were obtained from the right heel (dominant leg) of eleven elderly people with diabetes (DM group) and eleven elderly people without diabetes (Non-DM group). The TekScan system was used to measure the peak plantar pressure (PPP) of each participant. Six gray-level co-occurrence matrix (GLCM) features including contrast, correlation, dissimilarity, energy, entropy, homogeneity were used to quantify texture changes in microchambers and macrochambers of heel pads. RESULTS: Significant differences in GLCM features (correlation, energy and entropy) of macrochambers were found between the two groups, while no significant differences in all GLCM features of microchambers were found between the two groups. No significant differences in PPP and tissue thickness in the heel region were observed between the two groups. CONCLUSIONS: In the elderly with diabetes who showed no significant differences in PPP and plantar tissue thickness compared to those without diabetes, several texture features of ultrasound images were found to be significantly different. Our finding indicates that texture features (correlation, energy and entropy) of macrochambers could be used for early detection of soft tissue damage associated with diabetes.

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study.

Objective: To analyze the effectiveness of an educational intervention among nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly people. Methods: this is a quasi-experimental study carried out with 20 people (7 nurses and 13 formal caregivers). A questionnaire was applied during the pre-intervention stage, then professional training was carried out and finally, the questionnaire was reapplied 6 months after the intervention. The prevalence profile and factors associated with urinary infections in 116 elderly people was evaluated before and after the educational interventions. Statistical analysis was performed using association and correlation tests, logistic regression model comparison and prevalence rates. Results: The average number of correct answers by the nursing professionals and caregivers after the educational intervention increased from the pre to the post-test by 52% regarding signs of urinary infection, 32% regarding its symptoms, 72.5% regarding its treatment, 40% regarding personal/behavioral and morbidity-related risk factors, 59% regarding conditional factors and 43.8% regarding its preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost every question (p<0.05). The length of time working in elderly care showed no positive correlation with any variable (R< p>0.05). The prevalence of urinary tract infection in the pre-intervention period was 33.62%, and 20% in the post-intervention period. Conclusion: The educational intervention was effective in preventing urinary tract infections in the elderly. The increased knowledge acquired by nurses and caregivers was associated with a reduction in the infection rate and an improvement in the most prevalent modifiable factors for the development of this type of pathology.

Help or Hurt? The Impact of Digital Finance on the Physical Health of the Elderly in China.

Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance the physical health of the elderly. This study aims to investigate the impact of DF on the physical health of the elderly by utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. The results reveal a significant positive impact of DF on enhancing the physical health of the elderly. Furthermore, the study demonstrates that this impact is particularly pronounced among the elderly with higher educational attainment, stronger intergenerational links, and those residing in central cities. A mechanism analysis further reveals that DF contributes to improving the physical health of the elderly by augmenting household disposable income, alleviating liquidity constraints, and enhancing the utilization of medical services. These findings offer valuable insights for the future development of DF and the implementation of policies promoting healthy aging and active aging.

Balloon aortic valvuloplasty bridge to transcatheter aortic valve replacement is associated with worse in-hospital mortality.

BACKGROUND: Balloon aortic valvuloplasty (BAV) has gained renewed interest as a bridge to transcatheter aortic valve replacement (TAVR) for patients with aortic stenosis (AS). However, it is unclear whether they patients should undergo TAVR directly or receive a staged bridge to BAV before TAVR is unclear. We used a national database to examine the association between BAV and TAVR in patients with TAVR and its effect on in-hospital mortality. METHODS: Using the nationwide inpatient database of the Japanese registry of all cardiac and vascular diseases and the combination of the diagnosis procedure combination, we retrospectively analyzed 27,600 patients with AS who underwent TAVR between October 2013 and March 2021. Outcomes of the direct TAVR group (n = 27,387) were compared with those of the BAV bridge to TAVR group (n = 213), which received BAV at least 1 day before TAVR. RESULTS: The median age was 85 (interquartile range: 82-88) years, with 33.3% (n = 9188) being male. Unplanned/emergent admissions increased with TAVR, whereas the use of BAV bridge to TAVR decreased. The in-hospital mortality rate was 1.3% and decreased over time. However, the BAV bridge to TAVR had a significantly higher in-hospital mortality than direct TAVR (5.6% vs. 1.3%; p < .0001). Factors associated with in-hospital mortality included age, body mass index, chronic renal disease, percutaneous coronary intervention, and BAV bridge to TAVR. CONCLUSIONS: In unplanned/emergent and planned admission settings, the in-hospital mortality rate for BAV bridge to TAVR is worse than that for direct TAVR. Practical criteria for BAV bridge to TAVR should be proposed to improve outcomes.

General practitioners' reflections on prescribing addictive hypnotics to elderly: a qualitative study.

BACKGROUND: The European Guideline for the Diagnosis and Treatment of Insomnia recommends, for all age groups, restrictive, short-term and periodic use of potentially addictive hypnotics. As in other European countries, in Norway, actual practice involving elderly patients differs substantially from this recommendation, as shown by the persistent high frequency of regular prescriptions of addictive hypnotics. AIM: To explore experienced Norwegian general practitioners' (GPs') views of the regular prescription of addictive hypnotics to patients older than 70 years living at home. DESIGN & SETTING: In-depth individual interviews of a purposive sample of experienced specialists in family medicine at GP offices in Southern Norway. METHOD: Reflexive thematic cross-case analysis. RESULTS: Most of the 11 GPs interviewed had more than 10 elderly patients who were prescribed hypnotics for daily use and the same number for intermittent prescription. Almost all prescriptions were of z-hypnotics. The GPs knew this was contrary to the guideline. Many were at ease with this fact. They emphasised the need to avoid creating new dependencies. The GPs considered these patients a selected minority within this age group with serious sleep problems, for whom few realistic alternatives were available and whose tolerance over time was better than expected. This logic of pragmatic practice reflected a patient-centred approach and respect for the patients' view in a shared decision-making process combined with challenges of limited alternatives and resources. CONCLUSION: A zero vision on the prescription of addictive hypnotics to the elderly may neither be prudent nor realistic in the context of general practice.

The Effect of Education and Monitoring via Tele-Nursing to Elderly Cancer Patients Using Oral Anticancer Agents on Self-efficacy and Medication Adherence: A Randomized Controlled Trial.

OBJECTIVES: This study was conducted as a randomized controlled trial to determine the effect of the education and monitoring provided via tele-nursing to elderly cancer patients using oral anticancer agents on their medication treatment adherence self-efficacy and medication adherence. METHODS: The sample of the study consisted of 60 elderly cancer patients who presented to the oncology outpatient clinics of a medical faculty hospital in Turkey. An Elderly Information Form, the Oral Chemotherapy Adherence Scale, the Medication Adherence Self-Efficacy Scale, a Tele-nursing Evaluation Form, and a Telephone Monitoring Form were used to collect data. Patients in the intervention group were sent text messages and educational videos via WhatsApp® for the first four weeks, and after the fifth week, they were monitored by phone for eight weeks. Data collection tools were applied to the control and intervention groups at weeks 1, 8, and 12. Independent samples t-test, Repeated measurements analysis of variance chi-square test, and Pearson correlation test were used to analyze the data. RESULTS: In the study, while there was no significant difference between the mean scores of the intervention and control groups on the pretest application of the Oral Chemotherapy Adherence Scale and the Medication Adherence Self-Efficacy Scale (p > .05), a significant difference was found between the mean posttest scores of the groups (p < .05). CONCLUSIONS: In this study, it was determined that the education and monitoring provided to elderly cancer patients via tele-nursing positively affected their self-efficacy and medication adherence. IMPLICATIONS FOR NURSING PRACTICE: In line with the research results, it is recommended that nurses use tele-nursing applications in the care of elderly cancer patients using oral anticancer agents.

Examining the non-linear association between ambient temperature and mental health of elderly adults in the community: evidence from Guangzhou, China.

The association between ambient temperature and mental health has been explored previously. However, research on the psychological effect of temperature in vulnerable groups and neighborhood scales have been scarce. Based on the survey and temperature data collected from 20 neighborhoods in Guangzhou, China, this study estimated the association between ambient temperature and community mental health among the elderly, adopting a fixed-effects methodology. According to this empirical analysis, compared to a comfortable temperature range of 20℃-25℃, measures of worse mental health among elderly were significant in high and low temperatures with increases in negative outcomes observable at both ends of the temperature range, leading to the U-shaped relationship. Second, the association between ambient temperature and worse mental health was found in the subcategories of gender, income, and symptom events. Specifically, from the hot temperature aspect, elderly males were more sensitive than elderly females. The effect on the low was far more than on the middle-high income group, and the probability of each symptom of the elderly's mental health significantly increased. From the cool temperature aspect, the temperature in the range of 5ºC-10ºC was significantly associated with the probability of some symptoms (feeling down, not calm, downheartedness, and unhappiness) and the middle-high income group. Our research enriches the empirical research on ambient temperature and mental health from a multidisciplinary perspective and suggests the need for healthy aging and age-friendly planning in Chinese settings.