Taste detection ability of elderly nursing home residents

Due to the rapid rise of aged populations throughout the world, it is essential to elucidate the cause of taste dysfunction, because it may reduce appetite, leading to inadequate dietary intake. We aimed to compare taste detection ability between dependently and independently living geriatric individuals of nearly the same age with oral status. Forty‐three elderly individuals considered to be cognitively eligible and residing in nursing homes in Japan were enrolled (n = 43, 82·3 ± 8·5 years) and were compared with an independently living elderly group (n = 949, 79·9 ± 0·8 years), aiming to compare taste detection ability between dependently and independently living elders of nearly the same age. Information regarding comorbidity and medication was obtained as general health status, and oral status including number of present teeth, denture usage and maximal occlusal force was also noted. In the dependently living group, 69·4%, 14·3%, 16·3% and 8·2% of participants could detect sweet, sour, salty and bitter tastes, respectively, which was significantly lower than the independently living group for each taste (97·9%, 70·8%, 89·6% and 43·8% for sweet, sour, salty and bitter tastes, respectively). The multivariate logistic regression analysis revealed that residing in nursing homes was associated with reduced sensitivity for four different tastes. The diseases and the situation of dependent elders were more likely the cause of the decreased taste sensitivity.     

Managing HIV-positive sero-status in Ghana’s most HIV concentrated district: self-perceived explanations and theoretical discourse

As of December 2015 there were 37 million persons living with HIV/AIDS (PLWHAs), 70% of whom are in sub-Saharan Africa. Ghana, which contributes a relatively small number to Africa’s HIV burden, has a generalised HIV epidemic. The current national prevalence is 1.47%. Agormanya, one of the HIV sentinel sites in the county and where this study was conducted, has current prevalence of 11.6%. This makes it critical to explore how persons infected with HIV manage their lives, especially in the midst of entrenched stigma and discrimination. However, available information on how PLWHAs in sub-Saharan Africa handle their day-to-day lives mostly dwell on food and nutrition. Thus, there is dearth of information on how PLWHAs in Ghana particularly handle the circumstances of their daily lives which are mostly coloured by their HIV-positive statuses, given their stigmatised identity. We explore how PLWHAs respond to the experiences and challenges of living with HIV/AIDS in Lower Manya Krobo, consistently most HIV-infected district in Ghana. Data were collected from 38 combined purposive and randomly selected HIV-positive persons in two leading hospitals (St Martins Depores Agormanya and Atua Government hospitals which provide specialised HIV care in the district. Using in-depth interviews, we studied how PLWHAs managed their routine livelihoods in the midst of extreme stigma. We combined the social capital and resilience theoretical frameworks to show that our respondents were mostly resilient and strategically mostly drew upon extended family social support to cope with their livelihood challenges. We recommend that community opinion leaders and other stakeholders sensitise community members in Lower Manya Krobo to better understand the mode of HIV infection and encourage/strengthen family and community cohesion and social support.     

Long-term gait pattern assessment using a tri-axial accelerometer

In this article, we present a pervasive solution for gait pattern classification that uses accelerometer data retrieved from a waist-mounted inertial sensor. The proposed algorithm has been conceived to operate continuously for long-term applications. With respect to traditional approaches that use a large number of features and sophisticated classifiers, our solution is able to assess four different gait patterns (standing, level walking, stair ascending and descending) by using three features and a decision tree. We assess the algorithm detection performances using data that we retrieved from a validation group composed by nine young and healthy volunteers, for a total number of 36 tests and 12.5?h of recorded acceleration data. Experimental results show that in continuous applications the proposed algorithm is able to effectively discriminate between standing (100%), level walking (～99%), stair ascending (～84%), and descending (～85%), with an average classification accuracy for the four patterns that exceeds 92% in continuous, long-lasting applications.     

Surgical treatment of peri‐implantitis: Prognostic indicators of short‐term results

Aim

To evaluate the clinical and radiographic short‐term (6 months) effect of surgical treatment of peri‐implantitis, and to identify prognostic indicators affecting the outcome using a multilevel statistical model.

Materials & Methods

A total of 143 implants (45 patients) with a diagnosis of progressive peri‐implantitis (progressive bone loss (PBL) ≥2.0 mm and bleeding on probing (BoP)/suppuration) received surgical treatment. Clinical and radiographic parameters were assessed 6 months postoperatively. Potential prognostic indicators on subject, implant and site level prior to surgery were analysed to evaluate the effect on individual and composite outcomes using multilevel logistic regression analysis.

Results

At the 6‐month evaluation, none of the implants demonstrated PBL and 14% of the implants were registered with the absence of bleeding and no pocket probing depth ≥6 mm. Multilevel regression analysis identified, among others, suppuration, pocket probing depth >8 mm, bone loss >7 mm and the presence of plaque as criteria associated with the outcome.

Conclusion

Resective peri‐implantitis surgery seemed to reduce the amount of peri‐implant inflammation. However, most of the sites continued to have BoP/suppuration. Thus, long‐term maintenance and evaluation is warranted. The effect of treatment was reduced by some prognostic indicators such as the presence of suppuration prior to interception and peri‐implant bone loss exceeding 7 mm.     

Effects of individual characteristics and school environment on cigarette smoking among students ages 13–15: A multilevel analysis of the 2007 Global Youth Tobacco Survey (GYTS) data from Vietnam

Abstract

This paper aims to estimate the prevalence of cigarette smoking among students in Vietnam ages 13–15 and examines its relationship with compositional and contextual factors. The data used in this paper were obtained from the 2007 Global Youth Tobacco Survey conducted in nine provinces in Vietnam. A multilevel logistic regression model was applied to analyse the association between the current incidence of cigarette smoking and factors on both the individual and school level. The prevalence of cigarette smoking among students was 3.3% overall. The prevalence of smoking among male students (5.9%) was higher than that among females (1.2%). Parental smoking was a significant risk factor for smoking among the students. Having a friend who smoked was the strongest predictor of smoking status among the study subjects. We have demonstrated that school-level factors appeared to impact the prevalence of cigarette smoking among students ages 13–15. This paper highlights the importance of utilising an extensive range of actions to prevent students from using tobacco in Vietnam. These actions should include providing specific curricula for students that address both individual characteristics and the school environment. Further, prevention programmes should also target both parental- and peer-smoking issues.     

When Is Age Choosing Ageist Discrimination?

When the Covid‐19 pandemic reached the United States in spring 2020, many states and hospitals announced crisis standards of care plans that used age as a categorical exclusion criterion. Such age choosing was quickly flagged as discriminatory, and so some states and hospitals shifted to embedding age as a tiebreaker deeper in their plans. Different rationales were given for using age as a tiebreaker: that younger patients were more likely to survive than older patients, that saving younger patients would save more life years, and that younger patients deserved a chance to live through life's stages. We provide a critical analysis of these three rationales, noting the differences between them, and then questioning the ethical and legal justifications for such age choosing.     

Age-related changes in cutaneous sensation in the healthy human hand

Cutaneous sensation deteriorates with age. It is not known if this change is consistent over the entire hand or if sensation is affected by changes in skin mechanics. Cutaneous perceptual thresholds were tested at eight sites in the glabrous skin and two in the hairy skin of both hands in 70 subjects (20–88 years), five male and five female per decade, using calibrated von Frey filaments, two-point discrimination, and texture discrimination. Venous occlusion at the wrist (40 ± 10 mmHg) and moisturizer were used to alter skin mechanics. Cutaneous thresholds increased significantly with age (p < 0.001); von Frey thresholds were 0.04 g [0.02–0.07] (median and interquartile range) in the 20s and 0.16 g [0.04–0.4] in the 80s, with differences between hands for older females (p = 0.044) but not males. The pattern of changes in cutaneous sensation varied according to the site tested with smaller changes on the fingers compared to the palm. Two-point discrimination deteriorated with age (p = 0.046), but with no interaction between sex, handedness, or changes in skin mechanics. There were no significant differences for texture discrimination. Changes in skin mechanics improved cutaneous thresholds in the oldest males after moisturizing (p = 0.001) but not otherwise. These results emphasize the complex pattern of age-related deterioration in cutaneous sensation with differences between sexes, the hands, sites on the hand, and the mode of testing. As the index fingertip is not a sensitive indicator of sensory decline, the minimum assessment of age-related changes in cutaneous sensation should include both hands, and sites on the palm.