Immersive virtual reality in a northern Queensland haemodialysis unit: Study protocol for a cross-over randomized controlled feasibility trial (ACTRN12621000732886).

Introduction: Despite being a life-preserving medical treatment, the demands of haemodialysis are a significant impost on individuals, posing considerable burdens on their work, vocational activities and involvement with family and community. In our region, patients who have had to relocate considerable distances to a regional city for dialysis, and First Nations people, are less likely to attend all scheduled dialysis sessions. Virtual reality (VR) has been shown to improve engagement with care of people on haemodialysis.This manuscript describes the protocol for a cross-over randomised controlled trial (RCT) that will explore the impact of an immersive VR experience for patients attending a northern Queensland, Australia, haemodialysis service. Methods: The design is a crossover RCT, with 8 clusters according to haemodialysis location and schedule. Clusters (5 participants in each) will be randomized by computer program. Participants in the trial will be patients who undergo haemodialysis three times/week at one of two dialysis units. During the 4-week intervention period (12 haemodialysis sessions), participants will be provided a headset with vision representative of the natural environment, and with audio. The 4-week control period will comprise usual activities, such as watching television, reading and sleeping. Outcomes will be measured by participants': attendance at scheduled dialysis sessions; adherence to lifestyle modifications; wellbeing, anxiety and depression; acceptability and usability of VR; and adverse events such as nausea. The feasibility and acceptability of the intervention from clinicians' perspectives will also be explored. Discussion: If this VR intervention is feasible, then participants may engage more with haemodialysis regimens and self-care in this very clinical environment. Trial registration: ACTRN12621000732886.

Integrated social and health care services among societies in transition: Insights from Turkey.

Societies experiencing rapid demographic transition may expect to face challenges such as accelerated population aging and increasing care-related needs. Decentralization of welfare states and resultant fragmentation of services is gaining increasing attention. In this study, we offer suggestions of how developing countries might move from fragmentation to integration of social and health care services. Using the Health Survey of Turkey (HST-2012) data with 15,000 households of populations' age 15 and older, we explore challenges to integrating social and health care service strategies in Turkey. Findings include inequities in material and service accessibility between rural and urban settings. Increasing numbers of older widowed women, especially in rural environments, will require direct income assistance over the coming decades. Additional findings include the need for primary and preventative health care services for middle age groups and strategies to address both unemployment among younger generations and barriers to work force participation for women. In conclusion, among rapid transition societies, it will take time to resolve decentralization-related regional inequalities in social and health services. Therefore, information and communications technologies (ICT) should be employed from an intersectionality perspective to more quickly bridge the services integration - regional inequalities gap in Turkey and possibly other societies in transition.

Higher education in gerontology: A comparison of master's programs in Japan, Taiwan, and Turkey.

As of 2015, there is only one master's program of gerontology acknowledged by each of the following countries: Japan, Taiwan, and Turkey. All three programs have fewer than 15 years of history. These three countries differ in society types based on the proportion of older adults, rate of population aging, and population size. However, in terms of gerontological education, they seem to share great commonalities. Common challenges are a lack of awareness of the field of gerontology, insufficient numbers of gerontology programs and faculty members to produce trained gerontologists within society, and the inadequacy of opportunities for trained gerontologists to play an active role in various fields. This study intends not only to compare the differences and similarities among three countries and programs, but also to elucidate characteristics of a unique gerontology program in each country and identify challenges and possibilities from the perspective of gerontological educators.