Internet use by middle-aged and older adults: Longitudinal relationships with functional ability, social support, and self-perceptions of aging.

In an increasingly digital world, those who remain offline may face greater challenges across multiple contexts of everyday life. Besides being less likely to be internet users, older age groups go online less frequently and for fewer activities. Understanding which factors facilitate or prevent internet use in later life is therefore essential to minimize existing age-based digital inequalities. Based on the 2014 and 2017 waves of the German Ageing Survey, comprising 3,479 respondents aged 40 years and older, this study examined the longitudinal relationships of a wide range of often overlooked, yet potentially relevant factors related to functional ability, social support, and self-perceptions of aging with general internet use and seven specific online behaviors. As the only factors relating to general use and a considerable number of specific uses, cognitive functioning and competence-related self-perceptions of aging emerged as the most important correlates of internet use in middle and late adulthood. Better cognitive functioning preceded contacting friends, acquaintances, and relatives, searching for information, banking, and shopping more frequently 3 years later. In turn, competence self-perceptions of aging preceded contacting others, searching for new social contacts, seeking information, banking, engaging in online entertainment, and creating contents more frequently 3 years later. Reciprocal relationships were also found between each factor and general use, suggesting mutual influences. Additionally, physical functioning and received informational support preceded greater use for specific activities. These findings elucidate which factors to consider when developing effective strategies to promote general and specific internet use among middle-aged and older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Too Old for Computers? The Longitudinal Relationship Between Stereotype Threat and Computer Use by Older Adults.

Besides having lower rates of technology adoption than the general population, older adults are commonly stereotyped as lacking technological ability. Stereotype threat, the fear of confirming negative stereotypes targeting their social group, may lead individuals to distance themselves from the stereotyped domain. This suggests that older adults may underuse computer technology due to stereotype threat. A sample of 86 community-dwelling older adults (M age = 78.47, SDage = 7.92) participated in a two-wave longitudinal study aiming to examine the relationship between stereotype threat and computer use in this age group. An autoregressive cross-lagged panel analysis was conducted using structural equation modeling. As expected, stereotype threat predicted lower levels of computer use a year and a half later. In turn, computer use was unrelated to the later experience of stereotype threat in this domain. These findings suggest that stereotype threat may undermine computer adoption in late adulthood, thus contributing to perpetuate the digital inequalities between younger and older generations.

Determinants of Ageism against Older Adults: A Systematic Review.

Ageism is a widespread phenomenon and constitutes a significant threat to older people's well-being. Identifying the factors contributing to ageism is critical to inform policies that minimise its societal impact. In this systematic review, we gathered and summarised empirical studies exploring the key determinants of ageism against older people for a period of over forty years (1970-2017). A comprehensive search using fourteen databases identified all published records related to the umbrella concept of "ageism". Reviewers independently screened the final pool to identify all papers focusing on determinants, according to a predefined list of inclusion and exclusion criteria. All relevant information was extracted and summarised following a narrative synthesis approach. A total of 199 papers were included in this review. We identified a total of 14 determinants as robustly associated with ageism. Of these, 13 have an effect on other-directed ageism, and one on self-directed ageism. The quality of contact with older people and the positive or negative presentation of older people to others emerged as the most robust determinants of other-directed ageism; self-directed ageism is mostly determined by older adults' health status. Given the correlational nature of most studies included in this review, inferences on causality should be made cautiously.

Osteosynthesis of bilateral Vancouver B2 periprosthetic femoral fracture after a bilateral RM® total hip arthroplasty at 24 and 21-years follow-up: A case report.

INTRODUCTION: The management of periprosthetic femoral fractures following hip arthroplasty is challenging, and the choice between osteosynthesis of the fracture and the revision of the prosthesis is still matter of discussion. CASE REPORT: In a 81-year-old male patient, a bilateral Vancouver type-B2 periprosthetic femoral fracture with stem loosening occurred after an accidental fall. The patient had severe medical comorbidities. The radiographic study showed a bilateral Robert Mathys cementless total hip arthroplasty at 24 and 21-years follow-up. The fractures were treated with open reduction and fixation with locking compression plates. Bicortical fixation of the loose stem was obtained by the screws of the locking plate, due to the polymeric composition of the isoelastic femoral stem. Both fractures sites were augmented with bone allografts. At follow-up period of 12 months, the X-rays showed bone union of both fractures and bilateral stable stem fixation. The patient expressed high degree of satisfaction with surgery result. DISCUSSION: The standard treatment for Vancouver type-B2 periprosthetic femoral fractures is the removal of the loose implant, fixation of the fracture, and implantation of a new revision femoral stem. However, the implantation of two long revision hip prostheses is a major operation for an older patient with precarious health condition, which can contribute to higher risk of medical and prosthetic complications. CONCLUSION: In older patients with multiple comorbidities, the use of locking plates can be a valid treatment of bilateral Vancouver B2-periprosthetic femoral fractures following RM® cementless isoelastic stem, as an alternative surgical option to femoral stem revision.

Revascularização do miocárdio sem circulação extracorpórea: experiência e resultados iniciais / Myocardial revascularization without cardiopulmonary bypass: experience and initial results

FUNDAMENTOS: A operação de revascularização do miocárdio sem circulação extracorpórea (CEC) vem sendo utilizada como uma alternativa para o tratamento da insuficiência coronariana. OBJETIVO: Apresentar nossa experiência com este procedimento, descrevendo a técnica empregada e os resultados iniciais. CASUÍSTICA E MÉTODOS: Foram avaliados 23 pacientes submetidos à revascularização do miocárdio sem CEC. Foram selecionados para este estudo pacientes que apresentavam lesões nas artérias coronárias da região ântero-diafragmática do coração. A principal indicação cirúrgica foi insuficiência coronária crônica (78,3 porcento). O sexo masculino predominou em 65 porcento dos casos. A idade variou de 44 a 80 anos (média: 59,6 anos). A abordagem cirúrgica em todos os pacientes foi através de esternotomia mediana. Os enxertos utilizados foram: as artérias torácicas internas, veia safena e artéria radial. RESULTADOS: O tempo médio de operação foi de 3h15 min. Não houve intercorrências intra-operatórias. O número de enxertos por paciente variou de 1 a 3, num total de 36 enxertos realizados, com média de 1,56 enxerto/paciente. A artéria torácica interna esquerda foi o enxerto mais utilizado (41,7 porcento). As artérias coronárias revascularizadas mais freqüentemente foram o ramo interventricular anterior (52,8 porcento) e a coronária direita (30,5 porcento). A mortalidade hospitalar e a incidência de infarto pós-operatório foram de 4,3 porcento. Não ocorreram complicações neurológicas, pulmonares, renais, hemorrágicas ou infecciosas. O tempo médio de internação hospitalar foi de 7 dias. CONCLUSÃO: A revascularização do miocárdio sem CEC é uma técnica eficaz e segura que pode ser realizada em casos selecionados, com baixa morbidade e mortalidade, com redução de custos e do tempo de internação hospitalar