Syfte: Syftet med denna studie var att undersöka den fysiska aktivitetens betydelse för att motverka sarkopeni hos äldre individer, samt om protein- och D-vitamin-intag kunde ha betydelse tillsammans med fysisk aktivitet för att motverka sarkopeni utvecklingen hos äldre individer (>65år). Metod: Deskriptiv litteraturstudie med litteratursökning i databaserna Pubmed och Discovery. Tio kvalitetsgranskade artiklar valdes ut som var publicerade från år 2004 och framåt. Resultat: Fysisk aktivitet i kombination med aerob träning och styrketräning, 150 min per vecka har en betydelse för att motverka sarkopeni utvecklingen hos äldre personer men även i ett förebyggande syfte för ungdomar och vuxna individer. Kosten: Proteinintaget för de äldre personerna verkar inte ha någon större betydelse för motverkan av redan konstaterad sarkopeni i de industrialiserade länderna. Däremot ser man en positiv effekt på motverkan av sarkopeni vid intag av D-vitamin hos äldre. Slutsats: Denna studie ger stöd åt uppfattningen att regelbunden riktad fysisk aktivitet för äldre har en motverkande effekt (som är mätbar och därför faktabaserad) på utvecklingen av sarkopeni. Äldre personer med redan konstaterad sarkopeni kan genom riktad fysisk aktivitet återhämta sin fysiska kapacitet som de hade innan sarkopeni utvecklingen. Det visade sig också att D-vitamin nivåerna hos de äldre deltagarna har betydelse för bentäthet och muskelstyrka som motverkar sarkopeni utveckling.

Syftet med studien var att undersöka hur enhetschefer i kommunal äldreomsorg hanterar sjukskrivningar bland omsorgspersonal. I studien användes en kvalitativ metod och sammanlagt genomfördes fem intervjuer med yrkesverksamma enhetschefer inom kommunal äldreomsorg. Vi har inspirerats av kritisk teori som analysmetod. Den teoretiska referensramen i studien är handlingsutrymme, handlingsfrihet och klämsits. Studiens resultat visar att sjukskrivningar bland omsorgsarbetare enligt enhetscheferna är ett omfattande problem. Resultatet visar att enhetschefer själva är ett viktigt verktyg i hanteringen av sjukskrivningar. Samtliga enhetschefer är medvetna om den ram som styr deras handlingsutrymme i form av lagar, regler och organisatoriska förutsättningar, men resultatet visar att de hanterar sjukskrivningar på olika sätt. Hur man skall hantera sjukskrivningar är upp till varje enskild enhetschef att avgöra och det kan ibland vara svårt att parera de olika förväntningar som de har på sig själva och sitt uppdrag. Enhetscheferna beskriver bristande stödfunktioner som en orsak till att det blir svårt och menar att de tvingas utveckla egna strategier för att kompensera för dessa. Resultatet visar också att det finns bristande resurser, både i form av tid och av pengar för att kunna möta de juridiska skyldigheter som enhetscheferna har i sitt arbetsgivaransvar. / The purpose of this study was to examine how first line managers in municipal elderly care manage sick leave among care workers. The study uses a qualitative method and five interviews were performed with first line manager professionals in municipal elderly care. We have been inspired by critical theory when analyze the result. The theoretical framework is space of action, freedom of action and conflict of interest. The result of the study shows that according to first line managers sick leave among care workers is an extensive problem. The result shows that first line managers themselves are an important tool while managing sick leave. They are all aware of the framework that controls their space of action and the framework consists of laws, rules and organizational conditions. The result shows that first line managers manage sick leave in different ways. How to manage sick leave is up to each and every one of them and it can sometimes be difficult to parry the different expectations they have on themselves and on their mission. First line managers describe lack of support functions as a reason why it can be difficult and they say that they are forced to develop their own strategies to compensate for these. The result also shows that there is a lack of resources, in both time and money to meet the legal obligations that first line managers have by their employer's' responsibility.

The aim of this study was to understand how assistant nurses in the care of elderly experiences partial shifts. It was based on six different semi-structured interviews with assistant nurses in the elderly care and then analyzed. It is a qualitative research of subjective thoughts and experiences from assistant nurses. The study shows that the assistant nurses experienced dissatisfaction with the work environment due partial shifts and low fact of influence on the schedule. The assistant nurses complained of deficiencies in care of the elderly, which ought to be correlated with the structure of partial shifts and the lack of energy and patience that brings with it. On the other hand some participants could find positive aspects of partial shifts regarding time to rest and be there for the caretakers. The impact of the private life was palpable, and despite some aspects to have time to rest, the work-life balance was hard to fulfill and all assistant nurses with schedules containing partial shifts on the weekdays wanted a schedule without it.

Magister Artium - MA / Osteoarthritis (OA) is the major cause of pain and disability in the elderly, as well as people younger than the age of 45. Research reported the importance of conservative management of OA in the early stages, as it has proved to be effective in slowing down the progression of the disease, as well as reducing the secondary effects of decreased functional ability and disability. Early referral could assist with effective pain management, decrease in disease progression and increase in functional ability and quality of life. Therefore, the overall aim of the study was to establish a profile of patients with OA, as well as to explore the perceptions and experiences of health professionals regarding the conservative management of OA at a tertiary hospital in Nigeria. The study employed a sequential exploratory mixed method approach, using a retrospective and exploratory study design for the quantitative and qualitative phases respectively. Data was collected from one hundred and thirty-five medical records of patients with OA, meeting the inclusion criteria of the study, and admitted at the University of Calabar Teaching Hospital (UCTH) from 1 January 2012 to 31 December 2016. The patient sample was predominantly female (n=80; 93%), with a mean age of 51.85 years old (SD=13.73). Thirteen (13) health professionals, eight (8) physiotherapists and five (5) orthopedic surgeons participated in the interviews. The Statistical Package for Social Sciences (SPSS) version 24 was used to analyse quantitative data. Inferential and descriptive statistics were used to describe the results in terms of frequencies, percentages, means and standard deviation. Alpha level was set at 5%. Audio-taped qualitative data was transcribed verbatim, and analysed using categories and themes.

Magister Curationis - MCur / Studies have indicated that the global population of older people will reach 1.53 billion by 2050. The ageing population is a large consumer of health-care services and this remains a global concern due to the impact on existing health care systems. To have an adequately prepared workforce, nurses must have enough knowledge and skills to care for older people and positive attitudes toward them. This is because nurses’ attitudes towards older people might influence the quality of care they provide. Studies have documented nurses’ reluctance to care to work with older people, but little is known about the attitudes and knowledge of nursing students towards caring for older people in South Africa. The aim of this study was to examine undergraduate nursing students’ knowledge about ageing and their attitudes towards caring for older people. A quantitative descriptive survey, utilizing a self-administered questionnaire was used. A pre-tested self-report questionnaire was used to collect the data from a stratified sample of 240 nursing students across 5 levels of Bachelor of Nursing programme, from the foundation year to the 4th year.. Data were analyzed using SPSS version 25. The response rate was 100%. The findings showed that the first- and second-year students had minimal clinical exposure to older people while the third and fourth year had extensive contact with patients in clinical and other health settings. The students had an average level of knowledge with a generally positive attitude towards older people, though significant differences were found between the year levels. Just over half of the respondents reported that they intend to work with older people after graduation. The study recommended the improved training of nursing students in caring for older people.

Thesis advisor: Alicia Munnell / Since 1975, Social Security retirement benefits have been tied to the Consumer Price Index to adjust for inflation. The CPI measures price changes for a market basket of goods and services designed to replicate the average consumer's expenditures. The elderly, however, consume a market basket different from that of the typical person. In particular, the elderly tend to purchase more medical services than other consumers. Because the price of medical care increases more rapidly than other prices, the inflation rate experienced by the elderly is greater than the inflation rate for the general population, even when controlling for the upward quality bias in the medical care component of pricing data. However, given that this difference in inflation rates is less than the size of the total measurement error in the CPI, recipients of Social Security retirement benefits are actually overcompensated for increases in inflation. Over the course of a beneficiary's retirement, this overcompensation results in a total benefit that is 5.4 – 6.6% greater than what the total benefit would have been under an ideal inflation indexing scheme. / Thesis (BA) — Boston College, 2005. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Economics Honors Program.

A terceira idade é considerada uma etapa da vida em que são observadas muitas barreiras, mas também muitos avanços nas tecnologias assistivas a essa população, que ao passar dos anos, têm aumentado não somente sua expectativa de vida, mas também sua atuação com relação às questões sociais e políticas, com engajamento inclusive no mercado de trabalho. No entanto, nesse momento do envelhecimento ocorrem degenerações funcionais e estruturais, ocasionando prejuízos observados nas situações de interação do idoso com o meio em que vive. O processo de envelhecimento das funções auditivas traz consigo a necessidade de novos estudos para a quebra dos paradigmas em relação ao processo de seleção, verificação e adaptação dos AASIs em idosos. Assim, o objetivo dessa pesquisa foi estudar o impacto das medidas de prescrição na adaptação do indivíduo deficiente auditivo idoso, analisando comparativamente os valores dos alvos prescritos pelos métodos DSL m[i/o] v5.0 e NAL-NL2, nas curvas de respostas em função da frequência, na mensuração da percepção de fala no silencio e no ruído, como também, nas habilidades auditivas finais com o uso da amplificação. As programações foram mensuradas e comparadas em relação ao seu desempenho nas avaliações da Real Ear Aided Response (REAR), do Hearing in Noise Test (HINT), na utilização do algoritmo de datalogging e também por meio do questionário Client Oriented Scale of Improvement (COSI). O estudo foi realizado com 28 idosos submetidos à etapa de pré-adaptação, que consistiu na realização de testes domiciliares em dois momentos distintos, utilizando-se alternadamente os métodos DSL m[i/o] v5.0 e NAL-NL2 para programação dos AASIs, que foram testados individualmente por 15 dias, confrontando os resultados em busca da melhor programação para o prosseguimento em etapa posterior. Na etapa pós-adaptação, foram realizados três retornos (30, 60 e 90 dias), reavaliando a cada retorno, a otimização da programação escolhida, obtendo-se ao final, os resultados da melhora do desempenho auditivo individual objetivo e subjetivo. As avaliações mostram que na etapa 1 (pré-adaptação), a melhor programação para toda a amostra foi proposta pelo método DSL m[i/o] v5.0, prosseguindo-se para a etapa 2, onde foi verificada melhora do seu desempenho a cada retorno realizado após a adaptação dos aparelhos de amplificação sonora individuais (AASIs). Dessa forma, o estudo concluiu que a programação proposta pelo método DSL m[i/o] v5.0 demonstrou-se superior a NAL-NL2 para todos os participantes do estudo em todas as avaliações realizadas, confirmando a hipótese de que a programação NAL-NL2 suprime o ganho necessário às perdas auditivas mais incidentes nos idosos decorrentes da presbiacusia. / Old age is considered a stage of life in which many barriers are observed, but also many advances in assistive technologies for this population, which over the years have increased not only their life expectancy but also their performance in relation to the issues social and political, with an engagement in the labor market. However, at this time of aging, functional and structural degenerations occur, causing damages observed in situations of interaction of the elderly with the environment in which they live. The process of aging of the auditory functions brings with it the need of new studies for the breakdown of the paradigms in relation to the process of selection, verification and adaptation of hearing aids in the elderly. Thus, the objective of this research was to study the impact of prescription measures on the adaptation of the elderly hearing impaired individual, comparing the values of the targets prescribed by the DSL m[i/o] v5.0 and NAL-NL2 methods in the response curves as a function of frequency, in the measurement of speech perception in silence and noise, as well as in the final auditory abilities with the use of amplification. The schedules were measured and compared in relation to their performance in the Real Ear Aided Response (REAR), Hearing in Noise Test (HINT), the use of the datalogging algorithm and also in the application of the Client Oriented Scale of Improvement (COSI). The study was carried out with 28 elderly subjects undergoing preadaptation, two home tests of 15 days were applied, one with each schedule, confronting their results in search of the best programming for the continuation in a later stage. In the post-adaptation stage, three returns (30, 60 and 90 days) were performed, re-evaluating the optimization of the chosen program at each return, obtaining at the end the results of improvement of individual and objective auditory performance. The evaluations show that in step 1 (pre-adaptation), the best programming for the entire sample was proposed by the DSL m[i/o]v5.0, proceeding to step 2, where it was verified improvement of its performance to each return made after the adaptation of the individual sound amplifiers (AASIs). Thus, the study concluded that the programming proposed by the DSL m[i/o]v5.0 was shown to be superior to NAL-NL2 in every sample for all the evaluations performed, confirming the hypothesis that NAL-NL2 programming suppresses the gain needed for hearing losses more incidental in the elderly due to presbycusis.

Orientador: José Eduardo Corrente / Resumo: Qualidade de vida neste inicio de século não tem sido apenas uma expressão popular, mas tem se tornada meta do ser humano na busca de uma experiência harmoniosa nos seus hábitos de vida. Qualidade de vida deixou de representar apenas vida sem doença física, mas passou a representar busca de felicidade e satisfação pessoal em todos os aspectos da vida: nos âmbitos profissional, social, fisiológico, emocional e espiritual, em equilíbrio. o presente estudo se propôs a pesquisar o estilo e a qualidade de vida na população de sessenta anos ou mais residente em um município de pequeno porte (Bofete SP). Cidade localizada a 192 km da capital paulista tendo como fonte de economia a agricultura e a exploração imobiliária do turismo ecológico. Foram entrevistados 280 idosos sendo que 200 residentes na zona urbana e 80 residentes na zona rural, utilizando-se uma adaptação para nossa realidade da escala de qualidade de vida de FLANAGAN traduzida e validada por HASHIMOTO et ai, e o perfil do estilo de vida individual proposto por NAHAS. Os idosos entrevistados possuíam na sua maioria renda de 1 salário mínimo, escolaridade muito baixa. Com relação à qualidade de vida, estes se encontravam satisfeitos, principalmente no que diz respeito às relações com outras pessoas e à constituição familiar. Mesmo os possuidores de alguma morbidade também estavam satisfeitos não ocorrendo diferenças entre os moradores da zona urbana e rural. Através da análise da questão aberta os idosos foram classificados segundo a coincidência de suas respostas em dois grupos. O grupo 1 valorizou o lazer, ter hábitos saudáveis, ser uma pessoa caridosa entre outras enquanto que o grupo 2 valorizou as relações com outras pessoas, ter uma boa saúde e desfrutar de bens materiais. Os resultados nos mostraram que mesmo com pouco dinheiro e pouca escolaridade... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Quality of life in the beginning of this century has not been only a popular expression but has became an aim of the human being to reach an harmonious experience of his life habits. Quality of life does not represent only life without physical disease, but has represented the search of feHóty and personal satisfaction in ali aspects of the life: professional social, physiological, emotional and spiritual, in harmony. This work aimed to study lifestyle and quality of life from a population of more than sixty years-old form a small city (Bofete - SP), located at 192 km from the capital of the São Paulo State, in which the main source if income is agriculture and the exploitation of the ecological tourism. A number of 280 elderly people were interviewed in which 200 from the urban zone and 80 from the rural zone, using an adaptation of the quality of life scale from FLANAGAN, translated and validated by Hashimoto et ai, and the lifestyle individual profile, proposed by NAHAS. The most of the interviewed elderly people had one minimal wage of income and school levei very low. Related to quality of life, they were satisfied, mainly about the relationship with other people and the familiar environment. Even the ones that had some morbidity, they were also satisfied without any differences between the habitants from urban or rural zone. The analysis of an open question, two groups of elderly people were obtained according to the coincidence of the response. Group one has valued leisure, healthy habits and charity... (Complete abstract, click eletronic address below) / Mestre

Resumo: Sentir-se saudável ou doente é uma condição subjetiva. Mensurar o grau ou o significado de uma enfermidade para um determinado indivíduo é, portanto, uma atividade complexa. A subjetividade inerente ao processo saúde-doença resulta em grande variação na identificação de diagnósticos clínicos e, nesse sentido, a utilização de instrumentos padronizados aumenta a concordância entre os profissionais de saúde. Aferir e validar a coerência e consistência de instrumentos utilizados para a avaliação clínica de idosos. Estudo epidemiológico do tipo transversal. A base de dados provém de uma pesquisa de 2002. Foram entrevistados em domicílio 353 idosos com os questionários: Atividades Básicas da Vida Diária (AVD), Atividades Instrumentais de Vida Diária (AIVD), Escala de Depressão Geriátrica (EDG), Mini Exame do Estado Mental (MEEM), Avaliação de Suporte Social do Medical Outcomes Study, Avaliação de Adesão Medicamentosa, Escala de Dependência de Nicotina, Escala de Avaliação de Problemas com Álcool (questionário CAGE) e uma Avaliação Sócio-econômica. Foram realizados cálculos da consistência interna das variáveis através do Coeficiente α de Cronbach e a técnica Split-Half nos instrumentos completos para avaliar reprodutibilidade. As escalas que podem ser utilizadas sem modificações ou ressalvas são: a AIVDs; o MEEM; o questionário CAGE e a Avaliação do Suporte Social do Medical Outcomes Study. A Escala de Atividades Básicas da Vida Diária (AVD) apresenta uma questão incoerente com o constructo. Quando esta é excluída das análises, ocorre melhora da coerência da escala. / Abstract: Feeling healthy or ill is a subjective condition. To measure the level or meaning of a disease is, therefore, a complex activity. The subjectivity inherent to the health-disease process results in a large variation in the identification of clinical diagnoses and, in this sense, the use of standardized instruments increases agreement among healthcare professionals. To analyze and validate the coherence and consistency of instruments used for clinical evaluation of elderly. This is a transversal-type epidemiological study. The database was obtained from a study conducted in 2002. Three hundred and fifty-three elderly individuals were inquired at home by trained interviewers using the following questionnaires: Daily-Life Basic Activities Scale (ADL), Daily-life Instrumental Activities (IADL), Geriatric Depression Scale, Mini Mental State Examination (MMSE), Social Support Survey from the Medical Outcomes Study (MOS), Medication adherence Evaluation, Nicotine Dependence Scale, Scale for Alcohol-Related Problems (the CAGE questionnaire) and a Socio-economic Evaluation. Calculations of the internal consistency of variables were performed by using the Cronbach's α Coefficient and the Split-Half technique for the complete instruments in order to evaluate reproducibility. The scales that can be used without modifications or restrictions are: the IADL; the MEEM; the Social Support Survey from the MOS; the CAGE questionnaire. The ADL has a question which was incoherent with the scale was observed. / Orientador: José Eduardo Corrente / Coorientador: Tania Ruiz / Banca: João de Castilho Cação / Banca: Beatriz Funayama Alvarenga Freire / Banca: Silvia Cristina Mangini Bocchi / Mestre

Les troubles du sommeil restent peu étudiés chez la personne âgée (PA). Ils sont pourtant fréquents, associés à certaines maladies et peuvent être des marqueurs de pathologies latentes. L'objectif de cette thèse est d'étudier, chez la PA, les liens entre les troubles du sommeil (insomnie et somnolence diurne excessive (SDE)) et la survenue de maladies neuropsychiatriques ou cardiovasculaires à partir d'une cohorte prospective l'étude des 3 cités (3C) (9094 personnes âgées de 65 ans et plus recrutées sur 3 centres en France et suivies tous les 2 ans pendant 12 ans). Quatre études ont été réalisées dans le cadre de cette thèse. La 1ère suggère que les facteurs associés à la nature et au nombre de plaintes d'insomnie chez la PA ne seraient pas significativement différents selon le sexe. Cependant chez les femmes, les facteurs portant sur le style de vie tels que le traitement hormonal substitutif et un indice de masse corporelle élevé pourraient avoir un «effet protecteur». La 2ème montre que l'insomnie et la SDE seraient des facteurs de risque indépendants de dépression chez la PA même après l'exclusion des participants ayant eu une histoire passée de dépression. La 3ème met en évidence que le nombre de plaintes d'insomnie et les difficultés à maintenir le sommeil seraient négativement associés au déclin cognitif et la SDE apparaîtrait comme un facteur de risque de déclin cognitif chez la PA. Enfin, la 4ème indique que les plaintes d'insomnie seraient une conséquence des maladies cardiovasculaires, alors que la SDE serait un déterminant de maladie cardiovasculaire indépendant d'une histoire passée de maladie cardiovasculaire.Cette thèse apporte donc de nouvelles connaissances sur les déterminants de l'insomnie ainsi que sur les conséquences des troubles du sommeil sur la survenue de maladies neuropsychiatriques et cardiovasculaires. Elle suggère de nouvelles approches dans la prise en charge des troubles du sommeil et de leurs conséquences chez la PA. / Sleep complaints remain poorly studied in the elderly. However, they are common and associated with a number of specific diseases. They may also be markers of latent disease. The objective of this thesis is to study the relationship between sleep disorders (insomnia and excessive daytime sleepiness (EDS)) and the occurrence of neuropsychiatric and cardiovascular disorders in the elderly from a prospective cohort study: The Three Cities (3C) (9094 subjects aged 65 years and over recruited from three centers in France and followed every 2 years, during 12 years). Four studies were performed drawing from the 3C cohort. The first study suggests that factors associated with the type and the number of insomnia complaints in the elderly do not differ significantly according to gender. However, among women, factors related to lifestyle such as hormone replacement therapy and a higher body mass index may have a "protective effect". The second study shows that insomnia and EDS are independent risk factors for depression even after excluding participants who had a past history of depression. The third study reports that the number of insomnia complaints and difficulty in maintaining sleep appear to be negatively associated with cognitive decline whereas EDS may be a risk factor for cognitive decline in the elderly. Finally, the fourth study indicates that insomnia complaints are more likely a consequence of cardiovascular disease, while EDS seems to be a determinant of future cardiovascular disease independently of a past-history of cardiovascular disease. This thesis provides new knowledge on the determinants of insomnia and on the consequences of sleep complaints for the onset of neuropsychiatric disorders and cardiovascular disease. It suggests also new approaches for the prevention of these sleep complaints and their consequences in the elderly.