There is a national, state and local concern that focuses upon the rapid growth of our elder population as well as those within the cohort that suffer with mental illness. However, other than the numerous Alzheimer’s related headlines, there is little national or state consideration being given to non-dementia-related elder mental illnesses. The lack of existing mental health service programs to assist the elderly community merits attention. The Constructionist paradigm was the basis for this study, due to its reliance upon recognized leaders in the field engaging in an interactive group process. These leaders included politicians, governmental agencies, non-profit organizations, and other community leaders. Outcomes from this study produced five action oriented initiatives: Leadership, Funding Campaign, Elder Sensitivity Campaign, Enhancement of Existing Programs, and New Program Expansion. These initiatives, if implemented, could drive change and positively affect the elderly population with mental illness within this central California county research site.

B. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Background: In a group of the elderlies (older person) in Sharpeville, Gauteng, South Africa, the majority live in poverty with a poor nutritional status. This makes them susceptible to develop infectious diseases as well as the risk of Chronic Diseases of the Lifestyle (CDL) such as cancer, diabetes, heart attack, obesity and hypertension. One of the most constant features of aging is the progressively elevated levels of coagulation factors such as FVII, fibrinogen, and impairment of fibrinolysis might play a role in the ageing process. These are associated with increased susceptibility to Cardiovascular diseases (CVD) commonly found. An association between elevated levels of FVII and R353Q polymorphism has been established as a risk factor for CVD. This genetic polymorphism R353Q characterizes the substitution in the exon 8 of the FVII gene of guanine-to-adenine, which results in the replacement of arginine (R) by glutamine (Q) in codon 353 of the F7gene. Objectives: The aim of this study was to evaluate the prevalence of R353Q polymorphism in correlation with haemostatic markers within an urban elderly community in South Africa. Method: This study was ethically approved, and it is an experimental research design on the prevalence of R353Q polymorphism in correlation with homeostatic status (Factor VII, Fibrinogen and PAI-1). The study was done in a black elderly population living in the Vaal triangle region of Sharpeville, attending a day care center, who gave consent to participate in the study. A purposely selected sample of 102 subjects, who met the inclusion criteria were used. The homeostatic status was measured by factor VII and fibrinogen measuring coagulation and PAI-1 measuring fibrinolysis. Results: The prevalence of R353Q genetic polymorphism was established in 14.5% of the sampled population. The prevalence of the RQ (AG) genotype was determined in the sample population with 6.5 % of elevated factor VII levels, 7.8% of increased fibrinogen levels (coagulation) and 10.5 % of decreased levels of PAI-1. The R(A) allele, was detected in 1.3% of the sampled population of normal levels of FVII, fibrinogen and PAI-1. The dominant allele G(Q) was present in 76.3% of the sampled population. An imbalance haemostatic marker was established in the sampled population with 61% of elevated levels of factor VII, 70% of elevated levels of fibrinogen and 88% had a decreased level of PAI-1. Conclusion: The prevalence of R353Q polymorphism was established in this sample population, having an imbalanced haemostatic status of hypercoagulation (factor VII and fibrinogen) and imbalance fibrinolysis (PAI-1), which are strongly associated to CVDs.

台灣地區由於國民平均壽命延長，加速了人口結構轉型、老人人口快速增加，因此衍生許多老人居住安養之課題。為探討影響都會區民眾選擇老人住宅之因素，本研究以台北縣永和市為研究範圍。透過問卷調查收集所需資料，以安德遜服務使用行為模式之個人因素及影響服務使用之限制因素為基礎，透過卡方檢定、因子分析、羅吉特迴歸分析及交叉分析等量化分析方法，實證影響台北縣永和市50歲以上人中、老年人選擇老人住宅服務的相關因素。 本研究結果發現，在個人決定方面，性別、年齡、健康情況、現有子女數、家庭總收入、目前居住型態及理想居住型態等變項對入住老人住宅之意願有顯著影響。在限制因素方面，老人住宅之資訊、可近性、租金及老人住宅類型等變項對入住老人住宅之意願有顯著影響。大部份受訪者認為複合化、多機能的老人住宅及降低收費最能提高入住老人住宅之意願。另最廣為受訪者接受之老人住宅類型為規模在50戶以內、與醫療保健設施或社會教育設施以分棟型態複合開發之老人住宅。 本研究建議老人住宅開發業者以複合化、多樣化、小型化的開發模式興建老人住宅；建議政府應重視老人住宅出租市場，加強宣導鼓勵民眾居住老人住宅，建立老人住宅資訊平台，以活絡老人住宅出租市場，增加需求量，吸引更多優質廠商投資。在對台北縣永和市老人住宅政策之建議方面，建議老人住宅服務對象應從選擇性服務擴大到全民性服務，中興社區安養堂應轉型為多機能、複合化的老人住宅。 / In Taiwan, with the advances of medical technology, the life span of people has been extended. As a result, the population of senior people has increased dramatically; therefore, their accommodation and domiciliary care became a big issue in modern society.This research studies the middle-aged and senior people whose age over 50 and live in Yonghe City,Taipei County. Collecting data by questionnaire and using quantity methodology of Andersen model, Chi-square test, Factor Analysis, Logistic Regression and Cross Analysis to understand the factors that affect senior people to choose elderly housing. The result shows, in term of personal decision, the factors of gender, age, healthy conditions, number of children, household income, current living pattern and ideal living pattern etc. will affect senior people to choose elderly housing. In term of limiting factors, the information of elderly housing, residence distance with relatives, a rental and type of elderly housing etc. will affect senior people’s choices. Most interviewers think composite and multifunctional elderly housing as well as cheaper charge would increase the desire to live in elderly housing. Meanwhile, the most popular elderly housing type is less than 50 apartments with medicinal facilities or educational services in the community. This research suggests house building company should develop composite and multifunctional elderly housing in a small community for senior people. In addition, government should think seriously of elderly housing letting market by publicizing the information to encourage senior people to live in elderly housing. Once the house demand increased, it will attract more decent building companies developing more elderly housing to promote for senior people. Furthermore, this research suggests the housing policy in Yonghe City, Taipei County should broaden elderly housing service from selectivity senior people to general elderly. And the Jhong-sing Elderly Community Shelter should be transformed into composite and multifunctional elderly housing.

M. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Background: Increased serum homocysteine is well known as an independent cardiovascular risk factor. Hyperhomocysteinemia may be due to several factors such as nutritional deficiencies and genetics. The MTHFR C677T polymorphism is associated with increased serum homocysteine. Folate and vitamin B12 play essential roles in lowering homocysteine levels. Limitations have been identified using serum vitamin B12 as a marker for vitamin B12 status due to lack an efficient of test. Holotranscobalamin has been reported as a more accurate marker for vitamin B12 status. Cardiovascular risk due to hyperhomocysteinemia has been confirmed among the elderly in Sharpeville. Knowledge of the prevalence of MTHFR C677T polymorphism among Black elderlies in South Africa is limited. Objectives: The main aim of the study was to evaluate the prevalence of MTHFR C677T polymorphism as a cardiovascular risk in an elderly black population in Sharpeville. Correlations between the presence of MTHFR C677T polymorphism and homocysteine metabolic markers were evaluated. Holotranscobalamin as a diagnostic test for vitamin B12 status was also assessed in this study. Materials and methods: This study was ethically approved by the Vaal University of Technology ethics committee (20140827-1ms). It was an observational, experimental study conducted in 102 elderly (≥60 years) attending the day-care centre in Sharpeville. Real-Time PCR was used to determine MTHFR genotypes. Folate and vitamin B12 were measured with AIA-PACK. Homocysteine levels were determined with an automated Konelab™ 20i and holotranscobalamin by ELISA. STATA 12 software was used for analysis of descriptive and inferential statistics. Results: The prevalence of MTHFR C677T polymorphism in this sample population was 19%. Heterozygous CT single nucleotide polymorphism was 17% and mutant homozygous TT was 2%. The majority (81%) of the subjects had wild type homozygous CC genotypes. No associations were found between MTHFR C677T genotypes and homocysteine and folate levels. Hyperhomocysteinemia was high (54%) and low (5%) folate deficiency found. No vitamin B12 deficiency was found however 7% were on the category of likely to be deficient. Sensitivity and specificity of holotranscobalamin were 100% and 95% respectively. Conclusion: The conclusions drawn from the study is that the prevalence of MTHFR C677T polymorphism is low within elderly in Sharpeville. There is a high risk of cardiovascular disease as a result of high prevalence of hyperhomocysteinemia. An intervention to lower homocysteine concentration of elderlies residing in Sharpeville is needed. Other genetic predisposing factors of increased homocysteine levels should be investigated.