Why do older people not use the public health services of the integrated aging program? A multidimensional approach in a qualitative study.

OBJECTIVES: The world's population is aging rapidly and a huge amount of services are being provided to meet the needs of the older people. Identifying the factors affecting the non-attendance of the older people to health care centres is of particular importance. We focused on the reasons why older people do not use the services of the integrated aging program in Iran from the perspective of the older people, general practitioners, and primary health providers. METHODS: A qualitative study in Ghaemshahr (IRAN) carried out during 2021. Data were collected through semi-structured interviews in two groups with the participation of 29 older adults and 18 employees of the health centres Purposeful sampling and sample size were determined based on data saturation. Data were analyzed manually using conventional content analysis. RESULTS: Potential barriers to and challenges of older adults were generally categorized into four main themes including individual, systemic-structural, environmental, and social factors. CONCLUSIONS: Both groups agreed on many aspects, including lack of education of the patients and lack of proper medical services. Existing problems in health care relate to both medical and non-medical factors. Improvement in health care delivery requires a deliberate focus on the patients' specific needs.

Effect of BASNEF-based nutrition education on nutritional behaviors among elderly people and Mini Nutritional Assessment on nutritional status in elderly with diabetes with type 2 diabetes (A clinical trial intervention).

INTRODUCTION: The number of elderly people is growing in different communities like Iran, increasingly. Malnutrition prevalence is unknown among elderly patients with diabetes. Malnutrition is a common risk factor in elderly people with diabetes that may affect their health. SUBJECTS AND METHODS: This study is a random clinical trial. There are 200 samples in this study chosen randomly and divided into two intervention and control groups (100 each). Data of both groups were collected in the same way, before and 3 months after the intervention. Educational intervention was based on pretest, baseline BASNEF model, and Mini Nutritional Assessment questionnaire in four sessions. STATISTICAL ANALYSIS USED: Descriptive indices were used to analyze the data while Chi-square, t-test, one-way ANOVA, and correlation tests were used to examine the relationship between variables. RESULTS: The results were significantly different after intervention (P < 0.05), but they were not significantly different in control group after 3 months (P > 0.05). It was clear that 22% of samples had normal nutrition (score >24), 29% of participants were exposed to malnutrition, and 51% of samples were suffering from malnutrition. These numbers were 20% for normal nutrition, 30% for exposing to malnutrition, and 50% for suffering from malnutrition in the control group, respectively. Fifty percent of elderly people with diabetes suffered from malnutrition and almost half of them had normal nutrition that was 20%. CONCLUSIONS: BASNEF-based nutrition education intervention improves nutritional behaviors in addition to knowledge and attitude of elderly people with type 2 diabetes. It led to improve indices of glucose control during 3-month intervention. AIMS: The aim of this study was to investigate the nutritional status of elderly people with diabetes and the effect of educational intervention based on the BASNEF model on promoting nutritional behaviors in the elderly with type 2 diabetes in Babol city, Iran.

Investigating the effect of physical games on the memory and attention of the elderly in adult day-care centers in Babol and Amol.

Background: Physical activity is a behavioral strategy that increases general (public) health, including the mental performance of individuals. The goal of this study was to investigate the effect of group physical games on cognitive performance (memory, attention) of old people in adult day-care centers. Methods: In this quasi-experimental study, 50 elderly people (aged >60 years) were selected from two adult day-care centers using available sampling and divided into two groups: control and intervention. As approval was received from the Babol Hamrah Salamat adult day-care center to modify the design of the center's yard, this center was selected to conduct an intervention program. The intervention group received a physical activity program twice a week for 6 weeks. Questionnaires that were used for collecting data included demographic questions, a standard questionnaire for daily activities of living, and a short-term test, the Abbreviated Mental Test Score. Cognitive function was assessed with the Wechsler Memory Scale (WMS) (Form A), before and after the intervention. Statistical analysis of normal variables was performed using independent and paired t-tests and in non-standard cases with Mann-Whitney and Wilcoxon non-parametric tests at a significance level of P<0.05, using SPSS software (version 22). Results: Statistical analysis showed that the scores of the subjects in the intervention group, compared to the control group, had significantly improved. The calculated mean differences in the intervention groupwere, for memory function d=8.4±3.3 (P=0.001), and for attention and concentration d=4.18±2.38 (P<0.001) (WMS). This level of change in the intervention group was significant. Conclusion: The results of this study showed that a physical exercise program can improve the memory and attention/concentration of the elderly. Therefore, it seems that such activities are a useful method for maintaining cognitive function.

Internet use and loneliness in older adults.

Use of the Internet by seniors as a communication technology may lead to changes in older adult social relationships. This study used an online questionnaire to survey 222 Australians over 55 years of age on Internet use. Respondents primarily used the Internet for communication, seeking information, and commercial purposes. The results showed negative correlations between loneliness and well-being. Multiple regression analyses revealed that greater use of the Internet as a communication tool was associated with a lower level of social loneliness. In contrast, greater use of the Internet to find new people was associated with a higher level of emotional loneliness.

The First Step of Health Policy-Making for Lifestyle Modifications at Middle Age: Problem Identification in 40- to 60-Year-Old Population, Northern Iran.

Background: The purpose of this study was to determine the current situation of lifestyle behaviors and related outcomes, as the first step to make proper local health policies for improvement of health lifestyle behaviors. Materials and Methods: This analytic research has been conducted as a cross-sectional study on the middle-aged (40-60 years old) population of Amirkola, Northern Iran. The Persian translation of the Health-Promoting Lifestyle Profile II questionnaire and the International Physical Activity Questionnaire were used for data collection. Also, anthropometric variables, blood pressure, fasting blood sugar, and serum lipids profile were examined. Results: Three hundred one individuals have been enrolled in the study. Results showed that 10.6% of the participants had unhealthy lifestyle behaviors in the subdomain of spiritual growth; 46.8% in the subdomain of health responsibility; and 48.2% in the subdomains of stress management, physical activity, and nutrition; men had more physical activity than women (p < 0.001). Totally, 189 persons (63.9%) had serum cholesterol greater than or equal to 200 mg/dL; seventy-five individuals (25%) had high blood pressure. One hundred twenty-six persons (81.8%) of women and 103 (70.1%) of men were overweight or obese. Conclusions: Health lifestyle behaviors in 40- to 60-year-old population need a proper intervention to improve the current situation.

Emergency department management of falls in the elderly: A clinical audit and suggestions for improvement.

INTRODUCTION: Falls are a major source of injury in the elderly and their incomplete management is a cause for concern by health systems. The present study looks at the current state of managing fall victims in Iran and offers suggestions for improvement. METHODS: This was a clinical care audit comparing the state of current care with an institutionally approved optimum. Patients aged 60 years and over presenting with a fall were evaluated and deficiencies in their care were recorded and categorized. These were presented to an expert panel, where the Delphi method was used to come up with a list of actions to address the deficiencies. Furthermore an educational program was implemented based on these suggestions. Chi-squared and t-test were used to evaluate the efficacy of this program in improving treatment. Linear regression analysis was used to find factors affecting care. RESULTS: Overall 431 cases were reviewed. The most common errors during clinical examination were: not performing Romberg test (92.75%) and lack of physiotherapy consultation (82.75%). The educational program had a modest effect on improving the clinical audit processes (ß = 3.79; P < 0.001) and medical interventions (ß = 2.004; P = 0.002); however, performing the correct diagnostic tests was worse after the program (ß = -1.21; P = 0.008). CONCLUSION: There is a wide gap between the care services delivered in the management of falls and international standards. Therefore, measures should be adopted to close this gap. Education may have a modest positive effect in this regard.

CD44 and CD74: The promising candidates for molecular targeted therapy in oral squamous cell carcinoma.

BACKGROUND: Considering molecular target therapy concept in the treatment of oral squamous cell carcinoma (OSCC), many attempts have been performed to introduce an effective molecular marker during recent years. Several investigations have emphasized on the role of CD44 in various cancers and few studies have mentioned CD24 and CD74. The purpose of this study was to investigate the relationship between CD44, CD24 and CD74 expressions and several clinical or histopathological factors in OSCC patients. MATERIALS AND METHODS: In our analytical cross-sectional study, forty primary OSCC specimens were immunohistochemically stained for CD44, CD24, and CD74 proteins. Then, the relationship between their expressions and age, sex, lymph node metastasis, and histopathologic grading was statistically analyzed using Mann-Whitney nonparametric and t-test. Furthermore, P < 0.05 was considered as significant. RESULTS: CD44 and CD74 proteins were significantly over-expressed in OSCC patients with high grade (P = 0.001 and P = 0.001) as compared to those with low grade. Furthermore, CD74 immunoreactivity showed significantly higher expression in patients with lower age (P = 0.039). Considering lymph node metastasis, we observed significant overexpression of CD74 in patients with no lymph node involvement (P = 0.033). CONCLUSION: Our observations support the significant role of membranous CD44 protein in progression of OSCC and also introduce CD74 protein as a probable interfering factor in different aspects of OSCC.

The assessment of early glycosaminoglycan concentration changes in the kidney of diabetic rats by critical electrolyte concentration staining.

Glycosaminoglycan (GAG) has a pivot role in renal function and homeostasis. Analysis of GAG amount generally serves to determine GAG alteration due to diabetes mellitus. Critical Electrolyte Concentration (CEC) staining can be an efficacy method to study GAG amount changes. Based on an experimental study, 20 male rats were randomly divided equally into two experimental and control groups. Diabetes mellitus was induced by a single sub cutaneous injection (120 mg/kg) of alloxan monohydrate. After 8 weeks, diabetic kidneys were paraffin embedded and sectioned at 5µm on a microtome. Slides were prepared and studied after staining by Critical Electrolyte Concentration (CEC 1 -4). In this study, we succeeded to show a decrease of hyaluronic acid and chondroitin sulfate concentration in diabetic kidney at 8 weeks diabetic rats which are earlier signs compared to those reported previously. In contrary, no significant changes in heparin sulfate and keratin sulfate have been seen. Diabetic nephropathy is a progressive disease and earlier diagnosis makes a better treatment design to reduce its development. CEC staining is able to determine degradation of hyaluronic acid and chondroitin sulfate synthesis in diabetic kidney of rats in an earlier time.

Participation of older adults in cyberspace: how Australian older adults use the Internet.

AIM: The present study explores how Australian older adults use the Internet. METHOD: Older adults were recruited online to complete an online survey. RESULTS: Participants primarily used the Internet for interpersonal communication, followed by information seeking, commerce and entertainment. CONCLUSION: The Internet is an important technology in helping older adults lead independent and social lives.

Internet use as a predictor of sense of community in older people.

The Internet opens new options for communication and may change the extent to which older people use other modes of communication. The importance of older adults' participation in cyberspace has increased as Internet use for commerce and communication has increased. The present study explores how older adults' Internet use affects their sense of community. An online survey was conducted at the University of Sydney to determine the associations between Internet use and seniors' sense of community and well-being. Participants were recruited online. There was a positive association between a sense of belonging to an online community, sense of community, and well-being. Seniors' use of the Internet for communication and information, and the frequency and history of their Internet use, were consistently related to a greater sense of community.