Problem solving,sense of coherence and instrumental ADL of elderly people with depression and normal control group

The purpose of this study was first, to explore the separate contribution and interaction between verbal and performance based problem solving and sense of coherence; and second, to examine the association of these variables with Instrumental Activities of Daily Living (IADL) function among elderly people with depression living in the commuinity and a normal control group. The participants included elders receiving ambulatory care for depression (n=31; mean age=73, SD=9.3); and normal elders (n=30; mean age=78, SD=5.8). Screening for general cognitive ability and level of depression was done using the Mini Mental Status Examination (MMSE) and the Geriatric Depression Scale (GDS). All participants underwent evaluation using the Large Allen Cognitive Level Test (LACL) (a measure of performance based problem solving); the Problem Solving Verbal Reaction to everyday problematic situations (PSVR); the Sense of Coherence questionnaire (SOC) and the Routine Task Inventory (RTI) (a measure of IADL from the cognitive perspective). Wilcoxon statistical analysis indicated highly significant differences between the two groups for all of the study variables. In the depressive group, significant correlations were found between the components of problem solving (LACL and PSVR) and IADL (r=0.70 and r=0.53), while the SOC did not correlate with IADL in either group. Results of ANCOVA controlling for LACL showed that it has a significant effect (F=13.63, p=0.001); however, beyond it verbal problem solving still has a significant effect on IADL (F=4.77, p=0.02), and SOC in interaction with verbal problem solving was significant (F=3.97, p=0.035). The findings suggest that depression in elderly people is associated with lower functioning in problem solving and IADL function, and lower sense of coherence; hence, attention to these factors should be integral to intervention with elderly people. However, it is recommended that further study be made of the relationships of variables found in this study with the current instruments, and also with additional tools because of confounding effects, in order to further support and validate the findings. As the sample size was small compared with the number of measures, it is important to replicate the study with larger groups to have more power. Copyright © 1999 Whurr Publishers Ltd.     

Preparing Older People to Cope after a Fall

Clinical experience and previous research show that older people at risk of falling can become anxious at the thought of being on the floor, therefore physiotherapists and occupational therapists may be reluctant to teach them how to get up.Old people's reactions to two different methods of teaching them this skill are compared (three groups, mean age 84 years). The conventional method requires people to be helped down to the floor and then to learn how to get on to their knees prior to getting up with the help of furniture. An alternative method, based on backward-chaining principles, does not require that people start from the floor and reduces the likelihood of them experiencing failure. The activity is broken down into small steps — the last step in the chain being taught first.It is concluded that:

1 The backward-chaining method of teaching elderly people how to get up from the floor is much less stressful to older people and to staff than the conventional method.

2 Older people are slightly more likely to learn successfully how to get up from the floor by the backward-chaining method which, even if they are not successful, provides them with functionally relevant exercise.

3 Older people who cannot learn to get up from the floor should be helped to develop alternative strategies for summoning help and for preventing the consequences of the long lie.

Bright light treatment for night-time insomnia and daytime sleepiness in elderly people: comparison with a short-acting hypnotic

Night-time bright light (BL) treatment and triazolam (0.125 mg/day) were given to three healthy elderly people in a cross-over design. They kept a daytime sleepiness test and a sleep log, and their wrist-activity was monitored simultaneously. Subjectively, BL increased daytime sleepiness and naps, and decreased night-time sleep. Triazolam decreased daytime sleepiness and naps, and increased night-time sleep. Actigraphic night-time sleep and naps on the first day were similar to these results. However, on the fourth day night-time insomnia induced by BL had recovered, and naps were shorter than the baseline. Triazolam increased actigraphic naps as the days passed.     

北京市部分地区老年人消化性溃疡患病率及相关因素调查分析

本文系 1993年 7～ 10月对北京市部分地区 34 4 0名 60岁以上老年人进行的消化性溃疡病 ( PU)的患病率及影响因素的调查。采取入户问卷调查的方式 ,结果表明 :老年人 PU的患病率在 4 .1% ;男性高于女性 ( 5.3% ,2 .9% ) ;低龄老人高于高龄老人 ;山区高于城区和郊区。在与 PU有关的影响因素中 ,抑郁、脑力劳动、吸烟、大量饮酒及高文化程度是老年 PU的危险因素 ,饮食结构及少量饮酒与 PU的患病率在统计学上未见显著差异。提示老年人 PU患病率在不同年龄、性别、地区、文化程度及职业上均有差异 ,同时心理因素对 PU的影响也不容忽视。     

天津口岸出入境人员梅毒血清学检测结果分析

目的 通过对梅毒检测结果的分析，掌握出入境人员的梅毒感染情况，有针对性的进行梅毒的防治。方法 对24503名经天津口岸出入境的各类人员进行梅毒血清学检测，并对检测结果进行统计分析。结果 24503名出入境人员中共检出梅毒阳性39例，阳性率为1．59％o，分析发现各年份检出梅毒阳性率呈逐年递增的趋势，不同职业人群中船员的梅毒阳性率为2．01‰，远远高于其他人群的0．88‰。结论 出入境船员作为一个特殊人群，是梅毒感染的高危人群，需加强卫生保健意识，减少感染梅毒的机会，进一步说明梅毒血清学检测在国境口岸传染病监测中的重要性。     

老年人膳食维生素K1摄入量及其主要来源

目的 :了解老年人膳食中维生素 K1 的摄入量和主要来源。方法 :对 113名 6 0岁以上老年人进行 7d膳食记录。用国内文献发表的食物中维生素 K1 含量资料和英国食物中维生素 K1 含量资料计算膳食中维生素 K1 摄入量。对所有食物按绿叶蔬菜、其它蔬菜、水果、油脂类、粮谷类、奶及蛋类、鱼肉类及其它食物进行分类 ,分别统计得出每类食物的维生素 K1含量。结果 :该人群膳食维生素 K1 摄入量为 347± 182 μg/天 ,膳食中维生素 K1 的主要来源是绿叶蔬菜占 82 % ,食用油脂占11%。菠菜、韭菜和大白菜是绿叶蔬菜中提供维生素 K1 的主要来源 ,占绿叶蔬菜提供维生素 K1 的 82 %。结论 :本研究中的老年人膳食维生素 K1 摄入量较高。多食绿叶蔬菜和植物油可提高人群膳食维生素 K1 摄入量。     

贯穿以人为本管理思想 建设新时期医院文化

医院文化建设是医院管理的重要组成部分 ,是精神文明建设的主要内容 ,也是医院可持续发展的关键要素。贯穿以人为本的管理思想 ,把医院文化建设作为重点 ,与医院发展同步进行 ,与精神文明建设紧密结合 ,打造医院品牌 ,树立医院形象 ,提高综合效率。     

杭州市老年人主要食物摄入量与营养调查

目的了解杭州市老年人的年主要食物摄入量与营养状况,找出存在的主要问题,探讨解决的对策。方法随机抽样调查了杭州市老年大学学员的体质指数、年主要食物摄入量、营养相关疾病患病率及对营养与膳食知识的了解与需求程度。结果杭州市老年人体质指数为22.3±3.1,人均每年主要食物摄入量为:口粮98.6kg,豆类30.1kg,蔬菜110.1kg,水果63.3kg,食用植物油16.2kg,食糖5.0kg,肉类20.1kS,蛋类19.7kg,奶类56.8kg,水产品34.7kg。营养相关疾病患病率较高。结论接受调查的人群年主要食物摄入量基本达到2010年城乡居民食物与营养发展目标中的城市居民人均每年主要食物摄入量的要求,膳食结构基本合理,但仍需加强营养指导。     

对深圳市健康体检人群开展艾滋病健康教育的效果评价

目的了解深圳市健康体检人群对艾滋病相关知识和传播途径的认识,并对健康教育效果进行评价。方法采用自行设计的问卷对体检者进行艾滋病知识健康教育前后的调查。结果深圳市健康体检人群已掌握一定的艾滋病知识,但不全面,健康教育后对艾滋病知识的掌握率明显上升,差异有显著性意义的有13项;知识来源主要是大众媒介。结论一对一的健康教育,是提高健康体检人群预防艾滋病的有效措施。     

菏泽市一中学生近视发生的现状与分析

目的了解山东省菏泽市中学生近视发生的现状和影响因素,为探索相关预防措施提供依据。方法对菏泽一中在校高一、高二学生2268人进行视力检查,用自行设计的不良用眼卫生情况调查表,对435名单纯性近视学生和265名视力正常学生进行问卷式调查,同时随机抽取1596名学生,对其父母视力情况进行调查。结果菏泽市高中生近视发生率为83.02%。长时间、近距离看电视,阅读书写姿势不正确,阅读书写时间过长,经常玩电脑、电子游戏机、上网等是引起近视的重要因素。遗传因素与近视发生有直接关系。结论应针对引发近视的原因,开展相应的健康教育,控制近视高发。