Enhanced removal of ciprofloxacin and associated antibiotic-resistant genes from wastewater using a biological aeration filters in combination with Fe3O4-modified zeolite.

Antibiotics release into the water environment through sewage discharge is a significant environmental concern. In the present study, we investigated the removal of ciprofloxacin (CIP) in simulated sewage by biological aeration filter (BAF) equipped with Fe3O4-modified zeolite (Fe3O4@ZF). Fe3O4@ZF were prepared with impregnation method, and the Fe3O4 particles were successfully deposited on the surface of ZF in an amorphous form according to the results of XPS and XRD analysis. The modification also increased the specific surface area (from 16.22 m²/g to 22 m²/g) and pore volume (from 0.0047 cm³/g to 0.0063 cm³/g), improving the adsorption efficiency of antibiotics. Fe3O4 modified ZF improved the treatment performance significantly, and the removal efficiency of CIP in BAF-Fe3O4@ZF was 79%±2.4%. At 10ml/L CIP, the BAF-Fe3O4@ZF reduced the relative abundances of antibiotics resistance genes (ARGs) int, mexA, qnrB and qnrS in the effluent by 57.16%, 39.59%, 60.22%, and 20.25%, respectively, which effectively mitigate the dissemination risk of ARGs. The modification of ZF increased CIP-degrading bacteria abundance, such as Rhizobium and Deinococcus-Thermus, and doubled bacterial ATP activity, promoting CIP degradation. This study offers a viable, efficient method to enhance antibiotic treatment and prevent leakage via sewage discharge.

Late Life Cognitive Function Trajectory Among the Chinese Oldest-Old Population-A Machine Learning Approach.

Informed by the biopsychosocial framework, our study uses the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset to examine cognitive function trajectories among the oldest-old (80+). Employing K-means clustering, we identified two latent groups: High Stability (HS) and Low Stability (LS). The HS group maintained satisfactory cognitive function, while the LS group exhibited consistently low function. Lasso regression revealed predictive factors, including socioeconomic status, biological conditions, mental health, lifestyle, psychological, and behavioral factors. This data-driven approach sheds light on cognitive aging patterns and informs policies for healthy aging. Our study pioneers non-parametric machine learning methods in this context.

Comorbid Dementia and Cancer Therapy Decision-Making: A Scoping Review.

Comorbid dementia complicates cancer therapy decision-making in older adults. We aimed to synthesize the recent literature (<5 years) on the challenges associated with cancer therapy decision-making among older people living with dementia (PLWD) and their caregivers. Of the 20,763 references, 8767 had their title and abstract screened, and eight met the inclusion criteria. Six studies were qualitative, one study employed mixed methods, and one study was quasi-experimental. Most studies were conducted in the UK (89%) and reported homogeneity in race and geography. Breast (56%) and prostate (45%) were the most frequent reported cancers. Five studies (56%) reported multiple types of dementia, with two (22%) indicating stages. The studies indicated that communication between patients, caregivers, and clinical teams might alleviate stress caused by worsening health prospects and potential ethical concerns. Information from this review can lead to better-informed, patient-centered treatment decision processes among older PLWD and cancer, their caregivers, and clinicians.

Beyond the treatment: The role of race, sex, and education in health trajectories between cancer survivors and noncancer older adults.

INTRODUCTION: The number of older, long-term cancer survivors is increasing. However, little is known about how cancer and aging affect the health trajectories of older adults differently. In addition, the impact of race, sex, and education on the processes of aging and the cancer experience needs further investigation. The current study aims to address this knowledge gap by combining two National Cancer Institute (NIC)-funded longitudinal studies conducted in Cleveland from 1998 to 2010. MATERIALS AND METHODS: The unique cross-sequential design facilitates a comparison between the health changes in long-term (five years +) older cancer survivors (breast, prostate, and colorectal cancer) and demographically matched older adults without a history of cancer in the same geographic area within the same period. The study also captured comprehensive information on how socioeconomic status interacts with cancer and aging over time. General linear models were employed in the data analysis. RESULTS: The findings showed that early cancer experience did not affect long-term cancer survivors' health status in later life. Conversely, comorbidities, being an African American, being female, and having education less than a college degree significantly decreased the health trajectory in later life for all older adults. Moreover, compared to other groups, older African American cancer survivors reported a dramatic decrease in self-reported health after controlling for other conditions. DISCUSSION: Study findings can inform public policy and social services to offer comprehensive treatment plans and help individuals overcome their diseases and lead longer and healthier lives.

Process and Structure: Service Satisfaction and Recommendation in a Community-based Elderly Meal Service in Shanghai.

Informed by Donabedian's quality-of-care framework, this study aims to examine elderly clients' service satisfaction and service recommendation for community-based meal services in Shanghai. We analyzed secondary survey data from randomly sampled elderly clients of a community-based meal service in the old Jing'an District in Shanghai (N= 690). Quality of food and caregivers' attitudes were key to respondents' service recommendation while tidiness of tableware and interactions with caregivers were positively related to their service satisfaction. Overlaps and differences between structure and process factors are discussed. We also provide tailored policy recommendations.

A Self-Reliant Umbrella: Defining Successful Aging Among the Old-Old (80+) in Shanghai.

The Chinese old-old (80+) population has steadily increased in recent years; however, limited studies have examined how this group ages. The purpose of this study is to explore how the old-old in urban China define successful aging. Guided by grounded theory, we conducted semi-structured, in-depth interviews with community-dwelling old-old participants (N = 97). Participants identified self-reliance as the goal of successful aging, which was supported by four proactive behaviors: physical activity, financial security, community connectedness, and willing acceptance of reality. In our model, we conceptualized these four proactive behaviors to constitute the ribs of an umbrella, supporting a canopy to protect the pole of self-reliant successful aging. This study offers new understanding of the dynamic and nuanced ways that the old-old in urban China age successfully and of their valiant efforts to maintain self-reliance.

Factors Affecting Perceptions of Disability and Self-Rated Health Among Older Adult, Long-Term Cancer Survivors.

OBJECTIVE: This article examines the relative importance of cancer-related and noncancer illness factors as they predict the health quality of life among older adult, long-term cancer survivors. Specifically, it examines the effects that continuing cancer symptoms and comorbidities have on functional difficulties and how they in turn affect perceptions of disability and self-rated health. METHOD: Data from an National Cancer Institute (NCI)-funded, tumor registry-based 10-year study of 321 older adult (age 60+), long-term (5+years post diagnosis) survivors of breast colorectal and prostate cancer are examined using regression analyses. RESULTS: The analyses documented the independent effects of both cancer-related and age-related health factors as they contribute to explaining functional difficulties, perceptions of disability and self-rated health. Gender and racial differences in health quality of life were also identified. DISCUSSION: The findings suggest that geriatricians, geriatric nurses, and clinical gerontologists who work with cancer survivorsneed to be aware of the ways in which both cancer and noncancer illness factors work together in producing threats to health quality of life through the extent and nature of functional impairments.

"Their Today Is Our Future": Direct Carers' Work Experience and Formal Caring Relationships in a Community-Based Eldercare Program in Shanghai.

The purpose of this study is to explore direct carers' work experience and formal caring relationships with older adults in a community-based eldercare program in Shanghai. Existing evidence has primarily focused on direct carers' work experience in residential care settings. However, direct carers' experiences of caring older adults in the community also deserve exploration. This qualitative study purposively sampled direct carers who worked in government-sponsored programs. Carers participated in semi-structured, in-depth interviews ( N = 37). Results reveal that despite occasional frustration, direct carers undertook demanding workloads and fostered strong emotional attachments with older adult clients. "Karma" was a critical cultural factor pertaining to their work ethic and motivated their care provision to benefit their future elderly selves. This study recognizes the cultural aspects of caring relationships that contribute to the quality of care of the community-based older adults in urban China.

Role of Marital Quality in Explaining Depressive Symptoms After Marital Termination Among Older Adults.

This study assesses whether prior marital quality moderates the impact of divorce or widowhood on subsequent depression. Poor marital quality may buffer depression associated with divorce/widowhood; conversely, the effect of divorce/widowhood on depression could be exacerbated by previous marital quality. Three waves from the National Survey of Families and Households based on respondents, ages 50 and older, (N = 2,570) included eight marital quality measures. We find limited evidence suggesting higher marital quality elevates, while lower marital quality decreases, depression after divorce. No moderating effects were found for widowhood. Additionally, health condition is more important than current marital status for elders' well-being after divorce or widowhood. Heterogeneity in the context of the marriage before divorce should be considered when examining marital termination effects on elders' depression.

Mealtime Interactions and Life Satisfaction Among Older Adults in Shanghai.

OBJECTIVE: We examined the association between older adults' mealtime interactions at senior centers in Shanghai and their life satisfaction. Competing hypotheses, derived from socioemotional selectivity theory and activity theory, were tested. METHOD: Data were obtained from the 2011 Shanghai senior center service utilization survey ( N = 320). Relationships between respondents' mealtime interactions and life satisfaction were tested using multilevel regression modeling. RESULTS: After adjusting for demographics, interactions with tablemates (companionship, self-disclosure, and instrumental support) were positively associated with respondents' life satisfaction. These associations varied by senior centers. However, the number of tablemates was not significantly associated with respondents' life satisfaction. DISCUSSION: Findings support the activity-theory-based hypothesis that mealtime interactions are related to older adults' life satisfaction independent of the number of tablemates. This study illuminates the value of social interactions in the context of community dining programs for the rapidly increasing older population in urban China.

The influence of domestic living arrangement and neighborhood identity on mental health among urban Chinese elders.

OBJECTIVES: The primary purposes of the present study were (1) to assess the living arrangements among urban Chinese elders, (2) to examine the relationship between household living arrangement and elders' mental health, and (3) to investigate how individuals' neighborhood identity affects their mental health. METHOD: The random sample was collected in 2011, including 939 respondents aged 60 and above who lived in the Jing'an district of Shanghai, China. The study examined well-being and depression of elders. The domestic living arrangements were assessed by a single item with five options: 'With whom are you living together?' The neighborhood identity was measured by four items: the sense of belonging, the sense of pride, volunteer work, and monetary donation for the neighborhood. RESULTS: Urban Chinese elders' living arrangement had transited from a traditional intergenerational co-residence pattern to a more self-independent style. However, living with children was positively associated with elders' mental health after controlling for demographic variables. Although the neighborhood identity had no interaction with living arrangement, it also contributed to elders' mental health. CONCLUSION: The study highlighted the importance of living with children and spouse, the sense of belonging, volunteer work, and the feelings of pride on elders' mental health. Results of the current study suggested implications for both government and non-governmental organizations to design family-based support for eldercare and improve neighborhood identity for elders.

The role of children's support in elders' decisions to live in a yanglaoyuan (residential long-term care) : children's support and decision to live in a yanglaoyuan.

The purpose of this study is to investigate the role of children's support in elders' decisions to live in a yanglaoyuan (residential long-term care) in Shanghai based on their intentions and actual experiences, drawing on both quantitative and qualitative data. The 2005 Shanghai Elderly Citizen Longitudinal Tracking Study (SECLTS) examines a stratified sample of community-dwelling elders and their intention to live in a yanglaoyuan (N = 1,512). Eleven semi-structured, retrospective interviews described how children participated in residents' decision-making to live in a yanglaoyuan. Logistic regression analyses reveal that satisfaction with children's support-financial, instrumental, and emotional-is negatively associated with respondents' intention to live in a yanglaoyuan. Higher levels of respondents' satisfaction with their children's support are associated with lower levels of intention to live in a yanglaoyuan. Such support, however, does not necessarily determine elders' decision to live in a yanglaoyuan. Qualitative analyses suggest that children participated throughout residents' actual process of deciding to live in a yanglaoyuan. Children helped residents to make the decision to live in a yanglaoyuan. Residents reported how their children contributed to instrumental support to face family caregiving challenges and how they experienced and shared the emotional process in the decision-making. Quantitative and qualitative findings complement each other to provide a holistic understanding of the role of children's support in elders' intention to live in a yanglaoyuan, as well as in their actual decision-making experiences. These findings also suggest the evolving nature of children's support in family caregiving in contemporary Chinese society.