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The amount of people retiring in Sweden is increasing and will continue to do so in the future. Politicians have recognized a challenge in this demographic development and it is important that they act in time and in a way that satisfies the need. The disposable income for people above the age of 65 has increased the past years and continues to increase according to the Swedish Statistics forecast, this indicates that the retired people will have more money to spend on housing in the future. There are different types of living for elderly in Sweden; staying at home, senior living, secure living and nursing homes and an interesting question is if these will be adoptable in the future. New solutions, which address the demands for higher standards, will ease the social and security aspects for the residents as well as improve the work environment for the employees in the home care service business. These different solutions are not yet implemented in a large scale, but development show that they are influencing the future direction of building senior residencies. Retired couples who get ill at different times might not get to live together or near each other when they require different levels of assistance to manage daily life. Moving away from a familiar area, family and friends can be stressful. By placing different types of elderly living close to each other is a solution that might help decrease that stress. There are some solutions like this already on the market today and it is a solution worth investigating more. We believe that the availability of new and refurbished buildings needs to be more focused on easing the living for elderly people and may be achieved by implementing a certification system. Implementation and use of this certification system may create goodwill for investors and therefore force construction companies to build according to it. However a certification has to be requested by residents, municipalities and tenants, to be considered by the investors.

Diarrhoeal disease is considered the second most common cause of morbidity and fourth most common cause of mortality, worldwide. Low-income countries such as those in Africa and Asia bear the greatest burden of gastroenteritis. Diarrhoeal disease affects individuals of all ages, however, children <5 years of age, the immunocompromised and the elderly population ≥65 years of age are most severely affected. The elderly population, particularly immunocompromised patients residing in long-term care facilities represent high-risk groups for gastroenteritis and surveillance of these individuals in South Africa is under-represented. It has been observed that an individual’s fucosyltransferase 2 (FUT2) secretor status has been associated with different degrees of infection by rotaviruses and noroviruses. A total of 1 012 stool specimens from elderly patients were collected over an 18-month surveillance period, of which 340 specimens met the inclusion criteria and were tested. Virus screening was performed using a lyophilised real-time multiplex RT-PCR/PCR screening iv assay testing for norovirus GI and GII, rotavirus, human adenovirus, human astrovirus and sapovirus. Careful analysis of the real-time (RT)-PCR amplification plots and export data identified 50 viruses in 40 patient specimens. Seven norovirus GI/GII dual-infections were observed and three co-infections were identified, each with an astrovirus accompanying infection by a rotavirus, sapovirus and human adenovirus. FUT2 genotyping was performed to acquire the secretor status for all the rotavirus- and norovirus-positive individuals. The real-time TaqMan® SNP Genotyping Assay was inconsistent in amplifying the SNP in the FUT2 gene from stool-extracted DNA of elderly patients, and therefore an alternative, conventional genotyping PCR approach was performed. This approach was successful in acquiring the secretor status of 14/21 patient specimens. A total of 10 homozygous secretors, three heterozygous secretors and one homozygous non-secretor were identified. Virus-positive specimens identified in this study were genotyped and subjected to phylogenetic analysis. Overall, 14 norovirus- GI, 12 norovirus- GII, 10 sapovirus-, six human adenovirus-, six human astrovirus- and two rotavirus-positives were identified. From the 14 norovirus GI positives, three polymerase regions and two capsid regions were successfully genotyped. The polymerase strains all belonged to genotype GI.P1 and the capsid sequences were all GI.1 genotypes. Only one virus was successfully dual-genotyped as GI.1[P1]. For norovirus GII, a total of nine polymerase and nine capsid strains were genotyped successfully. All the polymerase sequences belonged to the GII.P31 genotype and eight capsid sequences identified as GII.4 Sydney 2012 strains, with a single GII.6 genotype identified. Three of the six adenovirus positives were genotyped, of which one strain grouped into species C and two strains grouped into species D, and shared a clade with a type 17 reference strain. Human astrovirus dual-genotyping was successful for three strains, which identified as type 2 for both the serine protease and capsid types. A single rotavirus strain was genotyped for VP4 and VP7 and identified as G9P[6]. Only two sapovirus-positives were successfully genotyped as GI.2 and GIV.1, respectively. This study highlights the epidemiological importance of clinical surveillance in the geriatric population, acting as a cornerstone for future studies in South Africa. / Dissertation (MSc (Medical Virology))--University of Pretoria, 2019. / The dissertation is under embargo until September 2022. / National Research Foundation / Poliomyelitis Research Foundation / Medical Virology / MSc (Medical Virology) / Restricted

The implementation of a vaccine against COVID-19 is one of the most important health strategies to mitigate the spread of the disease. The objective of this study was to estimate the prevalence of the intention to be vaccinated against COVID-19 and its predictors in older Peruvian adults. This is a cross-sectional study, where information was collected through an online survey regarding vaccination intention of the participants, as well as sociodemographic and psychological variables. A multiple regression analysis was applied to identify predictors of intention to be vaccinated against COVID-19. We evaluated 245 participants, who had a mean age of 72.74 years old (SD = 6.66). 65.5% of these older adults expressed a high likelihood of accepting vaccination, while 20.9% expressed a low likelihood of accepting vaccination, and 13.6% were hesitant. Eleven predictors were identified that explained 66.69% of the intention to vaccinate against COVID-19. This identified place of residence, perceived likelihood of contracting COVID-19, severity of previous infection with COVID-19, fear of the disease, previous refusal of a vaccine, concerns about vaccine sales and speculation, and trust toward vaccines against COVID-19, as the main predictors. Our results show that confidence in vaccines and previous vaccine refusal are relevant predictors of intention to vaccinate against COVID-19 in older adults; these findings may be useful to guide the development of campaigns for the immunization of this vulnerable group in the current pandemic. © 2021, Associação Brasileira de Psicologia.

Denna uppsats berör det rådande digitala utanförskap som många äldre svenskar i åldrarna 66+ idag upplever. Fokus har riktats mot anledningarna till vad utanförskapet beror på och vilka eventuella lösningar mot detta som går att ta fram. Studieprocessen är av slaget Design and Creation och består av både kvantitativa och kvalitativa data. Förutom att utföra litteraturstudier har datainsamlingar uträttats genom analys av stora datasets, enkätundersökningar och andra metoder som Customer Journey Mapping.Den främsta anledningen till att denna studie utförts är att det blir allt mer fundamentalt att ta del av de nya, digitala alternativ till de samhällstjänster som svenskarna behöver tillgång till jämt. Därmed innebär det att om man själv inte är villig eller inte har möjlighet att delta i övergången från analogt till digitalt så riskerar man att uppleva konsekvenser av detta på flera olika plan, inte minst ekonomiska.Forskningsfrågan som studien avser besvara är “Hur kan man bistå de äldre i digitalt utanförskap för att motivera dem till att börja använda internet?” och har sedermera brutits ner till fyra underfrågor för att lättare angripa de olika problemområden som ligger till grund för problematiken bakom den stora forskningsfrågan.Studien kastar ljus på heuristiska riktlinjer och principer som kan användas för att designa och utveckla mjukvara särskilt anpassad för äldre såväl som kvantitativa data som visar användningsstatistik m.m.Några viktiga slutledningar som går att dra från denna studie är vikten av att utvecklare börjar ta äldre människor i större beaktande när de utvecklar. Vidare har det tydligt framgått att de äldre som antingen inte vill eller känner att de kan använda internet och annan mjukvara kan och bör motiveras att övervinna sina farhågor. Detta görs bäst genom övning med hjälp av instruktioner. / This essay addresses the prevailing digital exclusion that many older Swedes aged 66+ are experiencing today. The focus has been on the reasons for what the exclusion is due to and what possible solutions to this can be developed. The study process is of the design and creation type and consists of both quantitative and qualitative data. In addition to conducting literature studies, data collections has been conducted through analysis of large datasets, survey surveys and other methods such as Customer Journey Mapping.The main reason why this study was carried out is that it is becoming increasingly fundamental to take advantage of the new, digital alternatives to the community services that the Swedes need access to constantly. This means that if you yourself are not willing or do not have the possibility to participate in the transition from analog to digital, you risk experiencing the consequences of this on several different levels, not least financial ones.The research question that the study aims to answer is "How can we assist the elderly in digital exclusion to motivate them to start using the internet?" and has subsequently been broken down to four sub-questions to more easily address the various problem areas that underlie the major research issue.The study sheds light on heuristic guidelines and principles that can be used to design and develop software specially adapted for older as well as quantitative data showing usage statistics etc.Some important conclusions that can be drawn from this study are the importance of developers starting to take older people into consideration when developing. Furthermore, it has become clear that the elderly who either do not want or feel that they can use the internet and other software can and should be motivated to overcome their fears. This is best done through practice with the help of instructions.

L’objectif général de ce travail de thèse est d’investiguer l’effet de techniques de rééducation utilisées couramment en médecine physique (vibrations corps entier –V.C.E.- et stimulation électrique fonctionnelle –S.E.F.-) sur la capacité d’équilibration lors de l’initiation de la marche (I.M.) du sujet âgé sans pathologie impactant la marche et avec pathologie impactant la marche (maladie de Parkinson idiopathique).L’hypothèse générale est que l’usage de ces techniques de rééducation améliorera l’équilibration dynamique du sujet âgé et illustrera la capacité du système nerveux central à prévoir et s’adapter à une contrainte biomécanique externe qui lui est imposée.L’objectif de la première étude est d’analyser les effets immédiats des V.C.E. sur la performance motrice et sur les mécanismes de contrôle de l’équilibre de l’I.M. du sujet âgé en comparaison avec les mêmes effets sur le sujet adulte jeune.L’objectif de la deuxième étude est d’analyser les effets immédiats des V.C.E. sur la performance motrice et les mécanismes de contrôle de l’équilibre de l’I.M. du sujet âgé atteint de la maladie de Parkinson.L’objectif de la troisième étude est d’analyser les effets immédiats de la S.E.F. sur la performance motrice et les mécanismes de contrôle de l’équilibre de l’I.M. du sujet âgé atteint de la maladie de Parkinson.En conclusion, il ressort que le système nerveux est en capacité de s’adapter à une contrainte externe globale qui lui est appliquée –V.C.E- en compensant les éventuels défauts d’un ou plusieurs des mécanismes reflétant le bon déroulement de l’I.M. chez l’adulte jeune, mais que ce mécanisme est altéré avec l’âge et dans le contexte de la maladie de Parkinson. Le système nerveux du sujet parkinsonien présente une capacité partielle à s’adapter à une contrainte externe loco-régionale qui lui est appliquée –S.E.F.-. / The main purpose of this thesis work is to investigate the effect of rehabilitation techniques commonly used in physical medicine (whole body vibration - W.B.V. - and functional electrical stimulation - F.E.S.-) on the gait initiation (GI)'s balance for the elderly with no walking disease and for the elderly with walking impairment as in the idiopathic Parkinson's disease.The general hypothesis is that the use of these rehabilitation techniques will improve the elderly's dynamic balanceand illustrate the ability of the central nervous system to predict and adapt itself to an external biomechanical stress imposed on it.The first experience’s aim is to analyze the immediate effects of W.B.V. on motor performance and on GI's balance control mechanisms in the elderly in comparison with the same effects on the young adult subject. The second experience's aim is to analyze the immediate effects of W.B.V.. on GI's motor performance and balance control mechanisms in the elderly suffering from Parkinson's disease.The third experience's aim is to analyze the immediate effects of F.E.S on GI's motor performance and balance control mechanisms in the elderly suffering from Parkinson's disease.As a conclusion, it appears that the nervous system is able to adapt itself to a global external stress - W.B.V. here - by compensating for possible defects in one or more of the mechanisms that reflect the proper functioning of GI in young adults, but that this mechanism is altered with age and in the context of Parkinson's disease. The parkinsonian's nervous system has a partial capacity to adapt itself to an external local-regional stress applied to it -F.E.S. here-.

The purpose of this study was to explore cultural differences between America and Japan concerning four domains: past family relationships, current family relationships, the support network, and well-being. Concern and consensus in the family are the principal background issues in this study. In America there has been a change from consensus (sharing basic similarity of values or attitudes and interests) to concern (an intense emotional involvement and affectional closeness). In contrasting the American and Japanese societies, consensus and concern constitute different orders from a more traditional context to the current societal context. This cultural difference impacts the relationship between the dynamics of the family in the early formative years, and how the individual responds within the current family. Ramifications are apparent in the quality of the current relationships, use of informal and formal support networks, and individual well-being. The Family of Origin Scale was used to measure past family relationships. The Positive Affect Index and Interaction Index were used to measure current family relationships. The support network was measured by questions selected from the Older Americans Resources and Services Program. The revised version of the Philadelphia Geriatric Center Moral Scale, the Life Satisfaction Index A, and the LSI-K (1990) constituted the measurement devices for personal well-being. The sample consisted of elderly individuals 70 to 79 years of age, 77 from America and 42 from Japan. The major finding in America was that this society has changed from a consensus to a concern orientation. For example, autonomy is positively related to personal well-being. The relationship holds true in terms of past family experiences as well as current family relationships. The data also show the impact of rapid social change in the nation of Japan. Japanese culture reflects an orientation change from traditional family concern to more of a consensus perspective. Family and personal well-being are related to perceived family intimacy in the past. A positive perception of current family relations was related to solidarity. It was concluded that rapid social change and modernization in Japan have brought about these major changes in terms of consensus and concern. Shifts on these two dimensions have implications for the adjustment and well-being of the elderly in a family context.

The purpose of this paper was to attempt to identify variables which may enhance the ability of older widowed persons to adjust to viii bereavement. Depression and perceptions of physical health were the two aspects of adjustment selected for study. Several variables which current literature suggests may mediate grief adjustment were examined for their potential relationship to bereavement outcome. These were gender, level of grief, anticipatory grief and social network. The possible relationship between depression and perceptions of physical health was also examined for. Subjects were 75 men and women, age 55 and over, who were recently widowed, and 29 non-bereaved men and women who served as controls. All subjects were caucasian, Mormon, and lived in small rural communities. To gather data on the variables in question, these instruments were used: the Beck Depression Inventory, and the Texas Inventory of Grief. Information on anticipatory grief, social network, and self-ratings of physical health was obtained using a structured interview developed at the Andrus Gerontology Center at the University of Southern California. Data was gathered at two times. The initial interview was held within two months of the death of each bereaved subject's spouse, and again six months later. Control subjects were interviewed twice, six to eight months apart. Multiple regression equations with foreward inclusion were computed to identify those variables which accounted for most of the cvariance in depression scores and self-ratings of physical health. Gender and bereavement status (whether a subject was bereaved or control) were not found to be significantly related to depression or self-ratings of physical health. Social network variables were found to facilitate lower depression scores and higher ratings of physical health, although the aspects of social network which were significant varied over time (initially family, then later non-family relationships were most important.) Depression and self-ratings of physical health were closely related. High level of grief was closely associated with high depression scores, but not with self-ratings of physical health. Expectation of the spouse's death was associated with lower self-ratings of physical health.

The reaction time of four groups of elderly human subjects were examined to determine the effects of stimulus presentation and task practice. Each group practiced different tasks, each requiring a response when more than one alternative was available. Two tasks involved making responses based on either visually or auditorily presented stimuli only. One task required decisions to be made on the basis of both auditory and visual stimuli. The fourth group acted as a comparison group and did not practice a reaction-time task; although they did perform a task on the computer and their reaction times were measured. Before and after practicing these tasks, each group was given a single trial involving a completely different decision-making task, and reaction time was measured. Results show that practice led to decreased reaction times on the practiced task in all treatment groups. The comparison group did not improve. Practicing any of the three reaction time tasks also led to decreased reaction time on the unpracticed task. These findings indicate that elderly individuals can decrease their reaction time with practice and that after practicing one task, changes will generalize to a different task. If the older population can alter performance on this task, then they nay also be capable of altering performance on other tasks.

BACKGROUND: Age-related deterioration in the nervous system results in the decline of motor and cognitive abilities, which both have been identified as contributing to fall risk in older adults. Dual-task gait, which involves walking while performing a secondary cognitive task, is a common way to assess the interactions between cognitive and motor function. Previous work has established associations between the cost of the cognitive load on gait parameters (e.g., velocity) and fall risk in older adults. However, to date, no study has explored the potential value of combining a direct measure of performance on the cognitive component of the dual-task with the gait measures in fall risk prediction modeling. RESEARCH QUESTIONS: Does including measures of performance on the cognitive task in dual-task walking with the gait velocity measures enhance the capacity to predict fall risk. Is this predictive capacity different in models employing dual-task gait velocity versus models including the cost of the cognitive load on gait velocity? METHODS: Thirty-two community-dwelling older adults (76 years ± 3.44) were classified as fallers (n = 17) and non-fallers (n = 15) based on self-report of having at least one fall in the past 12 months. They completed single-task and dual-task walking on a pressure-sensing electronic walkway system. A progressively enhanced series of logistic regression models were performed commencing with gait velocity during the dual-task (Loaded Gait Velocity, LGV) as the covariate in predicting fall risk. This model was subsequently augmented by adding a measure of cognitive performance covariate and then further augmented with the addition of the interaction variable between the LGV and the cognitive performance variables. This stepped series of modelling was then repeated with the dual-task cost gait velocity (DTCGV, difference in gait velocity between single and dual-task). RESULTS: With the addition of the cognitive measures (CM) and the interaction variables between the GV and CM variables, in both the LGV and DTC_GV models, the Nagelkerke’s R square increased as did the models’ respective sensitivity. Notably, the model including the LGV, CM and the interaction variables achieved 88.2% sensitivity, 80% specificity, with an overall classification accuracy of 84.4%. DISCUSSION: This study is the first to show that the ability to identify fallers and non-fallers is enhanced by using both gait and cognition measures as well as interaction variables between gait and cognition measures. Further, our findings suggest that the added value of the cognitive measures is best realized with LGV rather than DTCGV. It reasons that because DTC already encompasses the cost of the cognitive load on the motor performance (gait velocity), combining it with cognitive metrics does not enhance its predictive capacity. This work suggests there is clinical utility of including cognitive performance measures in fall risk modeling as well as it provides further evidence of the interplay between cognitive and motor function in fall risk. / Graduate