Background: Research showed that older people's sexual health is not addressed adequately in the health sector. It is a subject that is very limited or non-existent during basic training for nursing students. Older peoples sexually health has improved and hence there will be an even more important area for the nurse, who is responsible for the patient's health. Existing prejudices about sexuality of elderly people means that more knowledge is needed. Aim: The aim was to describe: 1. elderly person's experience of their sexual health and the health care receptions. 2. health care workers' attitudes towards older patients' sexual health. Method: A literature overview. Four qualitative and six quantitative studies between the years 2000- 2015 were analyzed. Results: Three main themes were identified; older people's experiences, that showed that older patients are healthier and more sexually active than before. The second main theme; health care workers experience of older people's sexual health showed that the patient's greatest obstacles to exercising their sexuality is the lack of private spaces. The nurse usually had a negative attitude to the elderly persons' sexual health, which could be due to nurses' ignorance and that sexuality is a sensitive subject. The third theme showed factors which affect sexual health in elderly. Conclusion: More information is needed about the elderly person's sexual health for patients and more training in nursing. Many older suppress their sexuality because of different standards and taboos in society, which may lead to unnecessary suffering.

La dépression et la malnutrition ne sont pas des conditions inévitables du vieillissement et elles représentent des problèmes de santé très importants étant donné leur prévalence élevée et leurs effets néfastes sur les capacités fonctionnelles. Précédemment, aucun travail de recherche ne s'est intéressé à étudier l'effet explicatif de la nutrition dans la relation entre la dépression et la capacité fonctionnelle. Objectifs. 1) Déterminer l'effet du risque nutritionnel (RN) dans la relation entre les symptômes dépressifs (SD) et la capacité fonctionnelle (CF) des personnes âgées. Méthodologie. Les données de base (TI) des 1,793 hommes (48 %) et femmes (52 %) (74,4[plus ou moins]4,1 ans) de la cohorte NuAge ont été utilisées pour les analyses. La CF a été mesurée par le score global de 4 tests de performance physique selon la méthode proposée par Guralnik et coil. (Timed"up & go", vitesse de marche (4 m), levée de chaise (5X), équilibre unipodal). Un résultat [supérieur ou égal à] 11 ou [inférieur ou égal à] 20 à l'Échelle de dépression gériatrique indique la présence de SD et un score [supérieur ou égal à] 3 au Dépistage nutritionnel des aînés (DNA[copyright]), un RN. Des analyses de variance ont été utilisées pour comparer les groupes suivants sur leur CF : saris RN et sans SD, avec RN et sans SD, sans RN et avec SD, avec RN et avec SD. La régression linéaire multivariée a permis de tester l'effet modificateur du RN VII dans la relation SD/CF ainsi que les associations entre le score global de CF et plusieurs variables sociodémographiques et sanitaires. Résultats. Le RN est présent chez 51% des sujets et sa prévalence est plus élevée dans les groupes plus âgés dans les 2 sexes ([rhô][inférieur à]0,001). La prévalence des SD est plus élevée chez les femmes (12,7%) que chez les hommes (7,7%) ([rhô]=0,001) de même que le score de CF (H: 10,59[plus ou moins]3,41; F: 9,25[plus ou moins]3,40; [rhô][inférieur à]0,001). Chez les deux sexes, la meilleure performance a été observée chez les plus jeunes et chez ceux qui rapportaient plus d'activités physiques. Par contre, le score de CF est plus faible dans le groupe avec RN et avec SD (8,86[plus ou moins]3,42) en comparaison avec le groupe sans RN et sans SD (10,55[plus ou moins]3,28) ([rhô]=0,001). L'inclusion du RN dans un modèle comprenant l'âge, le sexe et les SD a montré que le RN a un effet additionnel indépendant sur la CF ([rhô][inférieur à]0,001), lequel persiste après l'ajustement selon la scolarité, le revenu, l'indice de masse corporelle, le fardeau de la maladie et l'activité physisque. Par contre, l'interaction (RN*SD) n'est pas significative indiquant que le RN ne modifie pas la relation entre les SD et le score de CF. Ce dernier modèle explique 34% de la variabilité observée dans le score de la CF. Conclusion. Le risque nutritionnel est associé, de façon indépendante, à une capacité fonctionnelle réduite, mais ne modifie pas la relation entre cette dernière et les symptômes dépressifs. Étant donné l'importance des capacités fonctionnelles pour le maintien de l'autonomie, le développement de programmes comprenant la prévention du risque nutritionnel est une voie plausible et raisonnable d'intervention. De plus, ces programmes devraient inclure des composantes psychosociales qui auraient le potentiel de soulager les symptômes dépressifs. Malgré leurs limites liées aux analyses transversales, nos résultats proposent des hypothèses pour identifier les personnes âgées les plus à risque de présenter des limites fonctionnelles.

This research focused on the implementation of a reliable intelligent fall detection system so as to reduce accidental falls among the elderly people. A video-based detection system was used because it preserved privacy while monitoring the activities of the senior citizens. Another advantage of the video-based system is that the senior citizens are able to move freely without experiencing any hassles in wearing them as opposed to portable fall detection sensors so that they can have a more independent and happy life. A scientific research method was employed to improve the existing fall detection systems in terms of reliability and accuracy. This thesis consists of four stages where the first stage reviews the literature on the current fall detection systems, the second stage investigates the various algorithms of these existing fall detection systems, the third stage describes the proposed fall detection algorithm in detecting falls using two distinct approaches. The first approach deals with the use of specific features of the silhouette, an extracted binary map obtained from the subtraction of the foreground from the background, to determine the fall angle (FA), the bounding box (BB) ratio, the Hidden Markov Models (HMM) and the combination of FA, BB, and HMM. The second approach used is the neural network approach which is incorporated in the algorithm to identify a predetermined set of situations such as praying, sitting, standing, bending, kneeling, and lying down. The fourth stage involves the evalua- tion of the developed video-based fall detection system using different metrics which measure sensitivity (i.e. the capacity of the fall detection system to detect as well as declare a fall) and specificity (i.e. the capacity of the algorithm to detect only falls) of this algorithm. The video camera was properly positioned to avoid any occluding objects and also to cover a certain range of motion of the stunt participants performing the falls. The silhouette is extracted using an approximate median filtering approach and the threshold criteria value of 30 pixels was used. Morphological filtering methods that were dilation and erosion were used to remove any spurious noises from the extracted image prior to subsequent feature analysis. Then, this extracted silhouette was scaled and quantised using 8 bits/pixel and compared to the set of predetermined scenarios using a neural network of perceptrons. This neural network was trained based on various situations and the falls of the participants which represent inputs to the neural network algorithm during the neural learning process. In this research study, the built neural network consisted of 600 inputs, as well as 10 neurons in the hidden layer together with 7 distinct outputs which represent the set of predefined situations. Furthermore, an alarm generation algorithm was included in the fall detection algorithm such that there were three states that were STATE NULL (set at 0), STATE LYING (set at 1) and STATE ALL OTHERS (set at 2) and the initial alarm count was set to 90 frames (meaning 3 seconds of recorded consecutive images at 30 frames per second). Therefore, an alarm was generated only when the in-built counter surpassed this threshold of 90 frames to signal that a fall occurred. Following the evaluation stage, it was found that the combination of the first approach fall detection algorithm method (fall angle, bounding box, and hidden Markov) was 89% with specificity and 84.2% with sensitivity which is better than individual performance. Moreover, it was found that the second approach fall detection algorithm method (neural network performance) 94.3% of the scenarios were successfully classified whereby the specificity of the developed algorithm was determined to be 94.8% and the sensitivity was 93.8% which altogether show a promising overall performance of the fall detection video-based intelligent system. Moreover, the developed fall detection system were tested using two types of handicaps such as limping and stumbling stunt participants to observe how well this detection algorithm can detect falls as in the practical situations encountered or present in elderly people. In these cases it was found that about 90.2% of the falls were detected which showed still that the developed algorithm was quite robust and reliable subjected to these two physical handicaps motion behaviours.

<p>A publicly funded elderly care that is widely available at people’s homes has been described as unique for the Nordic countries. There is much research that focuses on the relationship between caregivers and <em>care receivers</em>, and also about how work is organized in these organizations. However, research into how care work is organized in organizations that have implemented a salutogenic approach is limited. This is a qualitative study aimed to <em>examine how caregivers feel that the organization of work in elderly care change after implementation of salutogenic elements in their daily work.</em> The study conducted six semi-structured interviews with caregivers that have experienced different ways of organizing care work. Study shows that the organization of care work has gone from a Tayloristic, task-oriented and routinized work towards a salutogenic, person-oriented and personalized approach. The study also shows that dilemmas may arise in the new way to organize care work when caregivers and <em>care receivers</em> values and opinions differ. Caregivers then orient between sins of omission and abuse.</p>

The primary purpose of this study was to explore the relationships among vulnerability, self-transcendence, and well-being in Japanese hospitalized elders. With their declining functional health and diminishing social network, elderly people are considered as a vulnerable population, which require special care and attention in the field of nursing. Self-Transcendence is identified as one of the developmental resources that promote well-being in later adulthood during increased vulnerability; however, applicability of the concept of self-transcendence as well as its theory has never been tested in Japanese population. Thus, the current study specifically tested and refined a theoretical model of self-transcendence in Japanese elders.In this study, a nonexperimental descriptive design was used to examine relationships among the variables. A total of 105 elderly patients were recruited from 4 hospitals in Sapporo, Japan. The respondents' level of vulnerability was assessed by three aspects: vulnerability in health status, vulnerability in resource availability, and past vulnerable experience. Well-being was examined from the level of depression and life satisfaction. Besides psychosocial self-transcendence, spiritual self-transcendence from Japanese perspective was conceptualized and evaluated.Reliability testing provided adequate supports for all the study instruments. Findings of multiple regression analyses indicated mediating effects of psychosocial self-transcendence on the relationship between vulnerability in resource availability and well-being variables. Psychosocial self-transcendence also demonstrated direct effects on well-being. Spiritual self-transcendence did not show any mediating and moderating effect in the relationship between vulnerability and well-being; however, it was found to be the strongest predictor for the level of life satisfaction. In addition, the findings revealed that vulnerability in health status had a direct effect on the level of depression, but past vulnerable experience had no effect on both self-transcendence and well-being.Findings of this study provided further evidence of universality of the concept of self-transcendence and applicability of its theory to Japanese hospitalized elders. This study not only contributes to Japanese nursing research by adding the body of knowledge about self-transcendence and spirituality but also can be a basis for formulating interventions that help enhance well-being in vulnerable elderly patients.

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