Public Policy and Aging in the Gerontology Curriculum:

This paper presents suggestions for a model master's level course in public policy and aging. Course content should focus on the historical context of aging policy development, the policy making process, and the legislative history and current content of specific aging policies. Suggestions for teaching resources and class assignments are included.     

“Let's Celebrate Aging”: A Case Study of a Community Wide Educational Program

Abstract

This article describes the planning, implementation and evaluation of “Let's Celebrate Aging,” a community wide educational program for older adults held in Harrisonburg, Virginia. The purpose of this event is to celebrate the achievements and programs that promote total wellness for older citizens. “Let's Celebrate Aging” is an excellent example of collaboration between institutions of higher learning, local agencies and citizens in highlighting the potentialities of aging and retirement.     

High‐value transitional care: translation of research into practice

Objective To evaluate the impact of translating into a large US health plan, the Transitional Care Model (TCM), an evidence‐based approach to address the needs of chronically ill older adults throughout acute episodes of illness. Methods A prospective, quasi‐experimental study of 172 at‐risk Aetna Medicare Advantage members in the mid‐Atlantic region who received the TCM. A baseline and post‐intervention (average of 2 months) comparison of enrolees' health status and quality of life was conducted. Member and physician satisfaction were assessed within 1 month post intervention. Health resource utilization and cost outcomes were compared to a matched control group of Aetna members at multiple intervals through 1 year. Results Improvements in all health status and quality of life measures were observed post‐ intervention compared to pre‐intervention. Among 155 stringently matched pairs, a significant decrease in number of re‐hospitalizations (45 vs. 60, P < 0.041) and total hospital days (252 vs. 351, P < 0.032) were observed at 3 months. Reductions in other utilization outcomes or time points were not statistically significant. The TCM was associated with a short‐term decrease of $439 per member per month in total health care costs at 3 months and cumulative per member savings of $2170 at 1 year (P < 0.037). Conclusions Findings demonstrate that a rigorously tested model of transitional care for chronically ill older adults can be successfully translated into a real‐world organization and achieve higher value.     

老年患者不同部位动脉粥样硬化斑块稳定性的相关性分析

目的探讨老年患者不同部位动脉粥样硬化（AS）斑块稳定性的相关性。方法对15例老年尸解者的股动脉、颈总动脉及左冠状动脉前降支进行连续取材,常规行病理检查;并选取部分节段行平滑肌肌动蛋白（SMA）、CD68、bax免疫组化染色;分析不同部位AS斑块中SMA、CD68、bax表达的相关性。结果三种AS斑块在SMA、CD68、bax表达方面均无相关性（P均〉0.05）。结论对老年患者不同部位的AS斑块稳定性及药物疗效评估等应分别进行监测。     

老年疾病康复知识图谱构建与应用探索

目的/意义构建面向老年疾病康复的知识图谱,以探索预防、康复一体化的居家老年人自主管理体系,提高智能老年疾病康复和照护体系的个性化水平和效能,为应对人口老龄化提供助力。方法/过程通过自然语言处理算法、医学专家人工标注构建面向老年疾病康复的知识图谱,使用Med-BERT+BiLSTM+CRF组合算法进行实体抽取,并搭建基于知识图谱的智能问答系统。结果/结论新设计的面向老年疾病康复的知识图谱质量达到预期,基于知识图谱的问答系统能够为老年用户提供交互友好的知识获取方式。     

高龄重症急性胆管炎患者内镜治疗与外科手术治疗对比观察(附84例报告)

目的:探讨内镜治疗70岁以上高危重症急性胆管炎(ACST)患者的临床应用价值。方法：70岁以上高危ACST84例,分成外科手术组(n=48)及内镜治疗组(n=36),观察治疗结果。结果:临床治愈72例,其中手术治疗组治愈率81．2％,内镜治疗组治愈率91．6％;与手术治疗组比较,内镜治疗组病死率由18．8％降至9．1％,并发症发生率由37．5％降至13．9％,平均引流时间由39．4天降至18．6天,总治疗时间由46．2天缩短至22．8天。结论:内镜治疗是高龄高危ACST患者的首选治疗方法,具有操作简便、微创、安全有效的特点,尤其适用于一般情况差、伴发多器官功能不全综合征(MODS)以及有胆道手术史者。     

槐耳颗粒对老年乳腺癌TC方案辅助化疗安全性及免疫功能的影响

目的探究槐耳颗粒联合TC方案辅助化疗治疗老年乳腺癌术后的安全性和对免疫功能的影响。方法将65例老年乳腺癌术后的患者随机分为治疗组35例及对照组30例,治疗组采用槐耳颗粒联合TC方案化疗,对照组只采用TC方案化疗。评估并比较2组患者在治疗前后生活质量改变,以及术后3个月、1年血清T细胞亚群的构成比变化。结果治疗组在与对照组比较,治疗组KPS提高率明显增加(P<0.05);CD^4+细胞百分率,CD^4+/CD^8+比值,NK细胞百分率在术后各时间点均明显高于对照组(均P<0.05)。结论槐耳颗粒联合辅助化疗治疗老年乳腺癌术后患者安全性高,可提高老年患者的生活质量,增强老年患者的免疫力。     

老年人结直肠癌62例临床特点分析

目的: 探讨老年人结直肠癌的临床特点和诊断治疗。方法: 对2000~2002年收治的62例患者(≥70岁)的临床资料进行回顾性分析。结果: Dukes C和D期占62.9%(39/62),并发急性肠梗阻者为29.8%(18/62),有并发症者占87.1%(54/62),本组根治性手术占51.6%(32/62)。误诊、迟诊在老年患者中相当普遍,影响预后。结论: 强调重视老年患者的早期症状,建议血常规、大便隐血、直肠指检、结肠镜和CT等规范检查,早诊断早治疗能改善临床结果     

Evaluation of a Novel Artificial Intelligence System to Monitor and Assess Energy and Macronutrient Intake in Hospitalised Older Patients

Malnutrition is common, especially among older, hospitalised patients, and is associated with higher mortality, longer hospitalisation stays, infections, and loss of muscle mass. It is therefore of utmost importance to employ a proper method for dietary assessment that can be used for the identification and management of malnourished hospitalised patients. In this study, we propose an automated Artificial Intelligence (AI)-based system that receives input images of the meals before and after their consumption and is able to estimate the patient’s energy, carbohydrate, protein, fat, and fatty acids intake. The system jointly segments the images into the different food components and plate types, estimates the volume of each component before and after consumption, and calculates the energy and macronutrient intake for every meal, based on the kitchen’s menu database. Data acquired from an acute geriatric hospital as well as from our previous study were used for the fine-tuning and evaluation of the system. The results from both our system and the hospital’s standard procedure were compared to the estimations of experts. Agreement was better with the system, suggesting that it has the potential to replace standard clinical procedures with a positive impact on time spent directly with the patients.     

基于转化医学和全科医学理念开展老年病学临床教学改革与实践

随着社会不断发展,我国已进入老龄化社会,培养熟练全面掌握老年病学知识的人才显得日益重要。老年病学教学是医学教育的重要组成部分,也是发展老年病学的重要环节。作者在老年病学临床教学中引入转化医学和全科医学的理念,开展老年病教学模式的改革,重视转化医学和全科医学思维的培养,同时采用传统授课模式、PBL教学法等多种授课方式,取得了良好的教学效果。