Sexuality in the later years — the impact of health and body-image in a sample of older women

Research on sexuality in the elderly is still rather scarce. Quite often, there is an underlying assumption that health problems function as main constraints against sexuality in the later years. This article tries to challenge this view and proposes that health aspects tend to be — at least among women — quite overestimated. The data presented here are from a study on sexuality and ageing. Sixty West German women, born between 1907 and 1936 had been interviewed on their psychosexual development in the context of their life-histories. The results show that health variables are of rather little significance in explaining the development and/or maintenance of sexual interest and activity in old age. More general aspects of the so-called body-image seem to be more valid in shedding some more light on the determinants of psychological well-being and of keeping sexuality alive in old age.     

Analyzing older users’ home telehealth services acceptance behavior—applying an Extended UTAUT model

BackgroundAlthough telehealth offers an improved approach to providing healthcare services, its adoption by end users remains slow. With an older population as the main target, these traditionally conservative users pose a big challenge to the successful implementation of innovative telehealth services.ObjectivesThe objective of this study was to develop and empirically test a model for predicting the factors affecting older users’ acceptance of Home Telehealth Services (HTS).MethodsA survey instrument was administered to 400 participants aged 50 years and above from both rural and urban environments in Slovenia. Structural equation modeling was applied to analyze the causal effect of seven hypothesized predicting factors. HTS were introduced as a bundle of functionalities, representing future services that currently do not exist. This enabled users’ perceptions to be measured on the conceptual level, rather than attitudes to a specific technical solution.ResultsSix relevant predictors were confirmed in older users’ HTS acceptance behavior, with Performance Expectancy (r = 0.30), Effort Expectancy (r = 0.49), Facilitating Conditions (r = 0.12), and Perceived Security (r = 0.16) having a direct impact on behavioral intention to use HTS. In addition, Computer Anxiety is positioned as an antecedent of Effort Expectancy with a strong negative influence (r = −0.61), and Doctor’s Opinion influence showed a strong impact on Performance Expectancy (r = 0.31). The results also indicate Social Influence as an irrelevant predictor of acceptance behavior. The model of six predictors yielded 77% of the total variance explained in the final measured Behavioral Intention to Use HTS by older adults.ConclusionThe level at which HTS are perceived as easy to use and manage is the leading acceptance predictor in older users’ HTS acceptance. Together with Perceived Usefulness and Perceived Security, these three factors represent the key influence on older people’s HTS acceptance behavior. When promoting HTS, interventions should focus to portray it as secure. Marketing interventions should focus also on promoting HTS among health professionals, using them as social agents to frame the services as useful and beneficial. The important role of computer anxiety may result in a need to use different equipment such as a tablet computer to access HTS. Finally, this paper introduces important methodological guidelines for measuring perceptions on a conceptual level of future services that currently do not exist.     

A population-based survey of sleep disturbances in middle-aged women – Associations with health,health related quality of life and health behavior

Objective

To evaluate the prevalence of sleep disturbances and the contributing factors in middle-aged women.

Methods

In a cross-sectional design of the long-term, prospective follow-up study project of 1278 families from a random population sample, the mothers of 15 year-olds were asked to fill in a questionnaire about sleep, health, health related quality of life, and health behavior.

Results

Quality of sleep was reported by 32% of women as good, 43% quite good, 12% average, 10% quite poor and 3% as poor. The most frequent sleep disturbance was awakenings in the night, which 60% of the women experienced at least once a week. Difficulty falling asleep and waking too early in the morning were reported as a weekly occurrence by 16% and 20%, respectively. Morning sleepiness was experienced by 42% and daytime sleepiness by 32%. Chronic diseases and use of medications was associated with various sleep disturbances. Both somatic and mental symptoms increased the risk for sleep disturbances.

Conclusions

Almost one-quarter of middle-aged women is dissatisfied with their quality of sleep. Women who have chronic disease or use of medications for basic diseases often suffer from sleep disturbance, which is also associated with the health related quality of life. Further analysis of the risk factors is needed to improve the sleep health of middle-aged women.     

Shortage of health workers in the Malawian public health services system: how do parliamentarians perceive the problem?

The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis. Parliamentarians identified the shortage of health workers as resulting from death, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions and remuneration of health workers are suggested as some of the solutions. Even without the brain drain of health workers to other countries, Malawi's health sector personnel numbers are not adequate to serve the needs of the country. Relying on training more health workers in the numbers normally produced from the prevailing training institutions is unlikely to remove the shortages.     

A systematic review of the impacts of intergenerational engagement on older adults’ cognitive,social, and health outcomes

BackgroundIntergenerational engagement could benefit health and wellbeing within an ageing population. This systematic review evaluated the impacts of intergenerational engagement on cognitive, social, and health outcomes in healthy older adults and older adults with mild cognitive impairment.Research design and methodsComprehensive literature searches were undertaken, with records filtered according to pre-registered criteria. Study quality was formally assessed, and a narrative synthesis of the findings produced.ResultsForty-four studies were reviewed. Regarding quantitative evidence, 4 out of 8 studies found significant intergenerational engagement effects on cognitive outcomes, 15 of 24 on social outcomes, and 21 of 31 on health-related outcomes. Qualitative evidence was also important for understanding perceived impacts and experiences of intergenerational programmes. Only 11 studies fully met criteria for high quality research, of which the majority focused on social outcomes.Discussion and implicationsThere are a range of potential benefits of intergenerational engagement, most notably regarding anxiety, generativity, cross-age attitudes, and physical activity. However, heterogeneity in programme context, sample design, dosage, and duration indicate that more research is required to enable wider implementation and generalisability. Scientific rigour in both quantitative and qualitative research should also be employed as far as possible, to provide the highest quality evidence.     

Patients’ perception of the information security management in health centers: the role of organizational and human factors

Background

Researchers paid little attention to understanding the association of organizational and human factors with patients’ perceived security in the context of health organizations. This study aims to address numerous gaps in this context. Patients’ perceptions about employees’ training on security issues, monitoring on security issues, ethics, physical & technical protection and trust in hospitals were identified as organizational and human factors.

Methods

After the development of 12 hypotheses, a quantitative, cross-sectional, self-administered survey method was applied to collect data in 9 hospitals in Iran. After the collection of 382 usable questionnaires, the partial least square structural modeling was applied to examine the hypotheses and it was found that 11 hypotheses were empirically supported.

Results

The results suggest that patients’ trust in hospitals can significantly predict their perceived security but no significant associations were found between patients’ physical protection mechanisms in the hospital and their perceived information security in a hospital. We also found that patients’ perceptions about the physical protection mechanism of a hospital can significantly predict their trust in hospitals which is a novel finding by this research.

Conclusions

The findings imply that hospitals should formulate policies to improve patients’ perception about such factors, which ultimately lead to their perceived security.

     

Clinical communication and the ‘triangle of care’ in mental health and deafness: Sign language interpreters’ perspectives

Objective To explore the processes by which therapeutic alliance develops in mental health consultations with Sign Language interpreters.Method Semi-structured interviews with 7 qualified interpreters were transcribed and analysed with interpretative phenomenological analysis.Results Two key themes were generated: (1) Nurturing the triangle of care, where the therapeutic process relied on collaboration, continuity, and trust; and (2) Shared vision and knowledge, in which participants felt misunderstood and unsupported; there was a lack of deaf awareness and clinicians appeared to feel deskilled.Conclusions Interpreters should be viewed as valued members of clinical teams and have access to clinical supervision so that they can be supported in interpreting emotional distressing content. Clinicians can aim to be collaborative with interpreters and improve their knowledge of mental health issues that are relevant to deaf people.Practice Implications An aide-memoire of the role and practicalities of working with SL interpreters should be developed and disseminated to relevant services to support collaborative working with clinicians. A core competence in SL interpreter training is reflexivity. This should be embedded in educational curricula and facilitated through clinical supervision. Funding by commissioning services should be subject to services being deaf aware and interpreters being mental health aware.     

Parents: the best experts in child health care? Viewpoints from parents and staff concerning child health services

The aim was to describe what parents and staff think about child health care, to identify agreements and disagreements. A qualitative study was made with semi-structured interviews based on a phenomenographic approach. Sixty parents, 14 nurses and six doctors from southern Sweden were interviewed. Parents and staff emphasized two tasks as being of particular importance: support and check-ups. There was a conflict between parents' need for security versus integrity. Individual nurses experienced a conflict between what they wanted to do and what they felt that they had to do. The parents viewed parental education as a chance to exchange experiences with other parents and receive support from other adults, while the staff mainly saw it as an opportunity to inform parents and strengthen them in their parental role. The study gives grounds for reflection about how the work of child health care can be changed in the future.     

Comparison of the Ultrastructural and Immunophenotypic Characteristics of Human Umbilical Cord-derived Mesenchymal Stromal Cells and in Situ Cells in Wharton’s Jelly

ABSTRACT

The umbilical cord contains mucinous connective tissue, called Wharton's jelly. It consists of stromal cells, collagen fibers, and amorphous ground substances composed of proteoglycan. Recently, these stromal cells have been redefined as a new cell therapy source, named human umbilical cord-derived mesenchymal stromal cells (hUCMSCs). However, there are few studies on the ultrastructural features and immune-phenotypic characteristics of isolated hUCMSCs and comparisons with the cells found in original cord tissues. In this study, the authors describe and compare the phenotypic characteristics of hUCMSCs with cells in the umbilical cord in order to know the kinds of cells and ultrastructural changes. Isolated hUCMSCs showed similar ultrastructure with few structural differences from in situ stromal cells, and they are relatively homogenous and well-developed mesenchymal cells that demonstrate a myofibroblastic phenotype.     

Injuries in special transport services—Situations and risk levels involving wheelchair users

Previous research has shown that wheelchair-seated passengers using special transportation services (STS) have been injured without being involved in a vehicle crash. In order to estimate incident rate and societal costs for these vehicle-related injuries, the focus needs to be adjusted towards a traveler/incident-oriented perspective. The aim of the project was to utilize such a perspective, related to travelers using STS in Sweden.In order to address the chosen perspective, a mixed method approach was used, involving quantitative as well as qualitative research techniques applied on four different sets of data: one hospital-based record, two sets of STS incident report databases, and interviews with wheelchair-seated STS passengers.The results showed that the injury incidence rate in STS is considerable, i.e. 10 per 100,000 trips. However, this high incidence rate is not due to road traffic collisions, but to non-collision injury incidents involving many elderly and frail passengers, who easily sustain traumas ranging from minor to moderate. The costs were estimated to be 23 million USD per annum or 14 USD per trip. Results suggest that future injury prevention measures should focus on safety in boarding and alighting procedures, as well as the continuing development of WTORS.     

Comparison of the unlabeled and labeled pre-mRNA splicing assays in vitro

Pre-mRNA splicing is a fundamental process required for the expression of most metazoan genes. It is carried out by the spliceosome that catalyzes the removal of non-coding intron sequences to ligate exons into mature mRNA prior to transport and translation. The purpose of our study is to explore whether the in vitro unlabeled pre-mRNA splicing assay could be performed as an alternative method of splicing reaction other than the radiolabeled one. Two different splicing methods in vitro , P labeled and unlabeled pre-mRNA as the substrates in the reaction, were investigated. The radiolabeled products were visualized by autoradiography while the unlabeled products were observed by Ethidium Bromide (EB) staining. As a result, although there are more unspecific bands in the EB staining assay than 32P labeled one, the RNA products of in vitro splicing could be observed clearly. This suggests that the unlabeled pre-mRNA splicing assay can be an optional substitution for the isotope-labeled assay.     

Which aspects of socio-economic status are related to health in mid-aged and older women?

A population-based study was conducted to validate gender- and age-specific indexes of socio-economic status (SES) and to investigate the associations between these indexes and a range of health outcomes in 2 age cohorts of women. Data from 11,637 women aged 45 to 50 and 9,510 women aged 70 to 75 were analyzed. Confirmatory factor analysis produced four domains of SES among the mid-aged cohort (employment, family unit, education, and migration) and four domains among the older cohort (family unit, income, education, and migration). Overall, the results supported the factor structures derived from another population-based study (Australian Bureau of Statistics, 1995), reinforcing the argument that SES domains differ across age groups. In general, the findings also supported the hypotheses that women with low SES would have poorer health outcomes than higher SES women, and that the magnitude of these effects would differ according to the specific SES domain and by age group, with fewer and smaller differences observed among older women. The main exception was that in the older cohort, the education domain was significantly associated with specific health conditions. Results suggest that relations between SES and health are highly complex and vary by age, SES domain, and the health outcome under study. The research on which this article is based was conducted as part of the Australian Longitudinal Study on Women’s Health (Women’s Health Australia). Kylie Ball is supported by a Public Health Postdoctoral Research Fellowship from the Australian National Health and Medical Research Council, ID 136925.     

Communicating about sexual concerns within cardiac health services: Do service providers and service users agree?

Objective

Sexual assessment and counselling is a recommended, yet underprovided and challenging, aspect of cardiac rehabilitation. We compared the views of cardiac healthcare providers and patients in terms of their experiences of communication about sexual issues.

Methods

Cardiac patients (n = 382) completed telephone surveys and hospital cardiac rehabilitation staff (n = 60) and general practitioners (n = 61) returned postal questionnaires.

Results

Patients reported that sex was rarely discussed, yet nearly half of patients said they would have liked this opportunity. Most general practitioners (70%) reported not addressing sex with their patients and the majority of cardiac rehabilitators (almost 61%) reported that sexual problems were poorly addressed in their service. Patients perceived fewer barriers to communication (the main barrier was lack of privacy) than health professionals (the primary barrier for general practitioners was lack of time, and for cardiac rehabilitation staff, lack of training).

Conclusion

All participants agreed that sexual assessment and counselling is currently poorly implemented. A gap exists: patients, who generally want sexual issues to be addressed, perceive fewer barriers to communication than healthcare providers, who fear causing anxiety and discomfort by raising sexual issues with their patients.

Practice implications

Developing brief interventions for healthcare providers and information materials for patients are recommended.     

Comparison of length judgments and the Müller-Lyer illusion in monkeys and humans

Visuo-spatial magnitude judgements are abstract in that they are detached from the specific sensory parameters on which they are based. Nevertheless, the visual system is actively reconstructing and interpreting the outside world, which sometimes causes reproducible geometric illusions. Here, we investigated the visual length perception of rhesus macaques, an Old World monkey species, in a delayed match-to-sample task and compared the non-human primates' performance to the length judgment of human participants under identical conditions. The quantitative analysis of the length discrimination shows that humans and macaques both show a distance and size effect in judging length and have almost identical length judgment characteristics as determined by the widths of the discrimination functions and the Weber fractions. Moreover, both monkeys and humans were subject to the geometric Müller-Lyer illusion caused by inward or outward pointing 'arrows' at the ends of a line, resulting in over- or underestimation of length, respectively. The strength of the illusion effects (i.e., the magnitude of length misjudgement for stimuli with inward and outward pointing arrows at the end of the lines) was in the range between 1.17 and 1.57° of visual angle for both monkeys and the human participants, and thus very similar between the two primate species. Our results suggest that the visuo-spatial mechanisms underlying simple horizontal line-length perceptions in the human and macaque monkey are qualitatively and quantitatively similar, offering the possibility to investigate the neural correlates of geometric illusions in the monkey and to translate the findings to the human visual system.     

High prevalence of torque teno sus virus in China and genetic diversity of the 5’ non-coding region

Members of the family Anelloviridae are emerging circular DNA viruses infecting many species of vertebrates including pigs. To date, members of two distinct genera, Iotatorquevirus, including torque teno sus virus 1a and torque teno sus virus 1b (TTSuV1a and TTSuV1b), and Kappatorquevirus, including torque teno sus virus k2a and torque teno sus virus k2b (TTSuVk2a and TTSuVk2b), have been identified in domestic pigs and wild boars. The goal of this study was to evaluate the prevalence and genetic diversity of these viruses based on 5’ non-coding genes in Chinese swine herds experiencing clinical symptoms. One hundred eighty-five clinical samples from 11 different regions, collected during 2008-2009, were analyzed using a PCR method, and the results revealed a high TTSuV-positive rate of 78.9 % (146/185) in pigs. Moreover, we detected co-infection with multiple TTSuV strains in the same pig. Nucleotide sequencing results revealed greater genetic diversity within the genus Kappatorquevirus than within the genus Iotatorquevirus. In addition, TTSuVk2b, a novel virus discovered in New Zealand in 2012, was also identified in this study. In summary, the present work helps us obtain more knowledge about the epidemiology and genetic diversity of TTSuVs.