Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 134-140). Also available on the Internet.

Background: The worldwide ageing demographic trend has resulted in a growing number of frail elderly who are in the last stages of autonomous living. Oral nutritional interventions for the frail elderly address the body’s natural weight loss, sometimes reversing weight loss, though the literature is not of one accord. No review of nutritional interventions has been conducted for community-dwelling frail elderly, who are most likely to benefit from these interventions and delay adverse outcomes. Objective: (i) This systematic review analyzes results from randomized controlled trials of oral nutrition interventions for the community-dwelling frail elderly to determine their efficacy in making gains in nutritional and functional status. (ii) The secondary objective is to analyze the quality of the studies in this review and draw conclusions for further areas of development in the field of nutrition in elderly care. Methods: Randomized controlled trials of oral nutritional supplements were searched in The Cochrane Library and PubMed, and hand searched in reference lists of systematic reviews. These interventions targeted protein-energy deficiency and included oral supplementation or supplementation paired with exercise compared to a placebo or usual practice. Community-dwelling frail elderly not institutionalized or hospitalized were eligible. Studies targeting disease-specific elderly were excluded. Results: Out of 120 search results, six trials were included in this review. A small weight gain from oral nutritional interventions among frail community-dwelling elderly was reported in five out of six studies. Functional status did not improve significantly with the interventions. Studies used unstandardized definitions and different ways to measure outcomes, resulting in heterogeneity. Conclusions: The few and poor quality of studies demonstrates the need for more studies of better quality and homogeneity assessing oral nutritional interventions for nutritional and functional gain in frail elderly who are not yet suffering from adverse outcomes. / published_or_final_version / Public Health / Master / Master of Public Health

This study explores women's narratives from within and outside of the frail/non-frail binary of public home care services. It focuses on the stories that are commonly told about older women's needs and bodies and the regulatory potential of these accounts. Considering power, language, diversity and change, this study focuses on the way that twelve diverse older women at various social locations (e.g., ability, age, culture, ethnicity, 'race', sexual orientation, and socio-economic status) understand, make meaning, and negotiate the concept of frailty in relation to their everyday lives. The sample includes six women considered 'frail' in relation to service (i.e., according to clinical judgement & home care eligibility guidelines), as well as women not considered 'frail' (i.e., non-service recipients). / The twelve older women's storied responses, illustrations and experiences challenge the various stories that are told about them. Their complex accounts both reflect and reject dominant notions, blur the boundary between the frail and non-frail classifications, expose frailty as contextual, temporal and relative, as well as illustrate the connections between medical and social needs. Their individual accounts highlight how they make meaning of their life events in relation to their diverse experiences and identities, as well as how these identities and interpretations are key to their negotiations of life and needs. The variations between the imposed stories about frailty and women's self-perceptions highlight the research, policy and practice relevance of a narrative approach focused on in-depth local accounts, raise questions about the current priorities within home care services, as well as the future of social work practice with older women considered frail.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 134-140). Also available on the Internet.

No description available.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2006.

Thesis (M.S.W.)--University of Hong Kong, 1994. / Includes bibliographical references (leaves 105-110).

by Yuen Yiu Keung. / Includes questionaire in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves 165-172). / "LIST OF CONTENTS, TABLES AND FIGURES" --- p.4 / ABSTRACT --- p.10 / Chapter CHAPTER 1 --- Introduction --- p.13 / Chapter CHAPTER 2 --- Method --- p.23 / Chapter I. --- Research Design --- p.23 / Chapter II. --- Sampling Procedure and Sample Size --- p.23 / Chapter 1. --- Sample Sources --- p.23 / Chapter 2. --- Sampling Procedure --- p.24 / Chapter III. --- Data Collection --- p.28 / Chapter 1. --- Questionnaire Construction --- p.28 / Chapter 2. --- Pilot Study --- p.29 / Chapter 3. --- Content of Questionnaire --- p.29 / Chapter 4. --- Training of Interviewers --- p.31 / Chapter 5. --- Collection of Data --- p.32 / Chapter 6. --- Validity and Reliability --- p.33 / Chapter IV. --- Data Analysis --- p.33 / Chapter CHAPTER 3 --- The Sociodemographic and Health Profiles of the Hong Kong Old-OLD --- p.35 / Chapter 3.1 --- Age and Sex Distribution of the Respondents --- p.35 / Chapter 3.2 --- "Marital Status, Working Status and Education" --- p.36 / Chapter 3.3 --- Income and Accommodation --- p.39 / Chapter 3.3.1. --- Sources of Income and Major Source of Income --- p.39 / Chapter 3.3.2. --- Personal Monthly Income --- p.41 / Chapter 3.3.3. --- Type of Residence --- p.42 / Chapter 3.3.4. --- Household Composition --- p.44 / Chapter 3.4 --- Mental Function --- p.45 / Chapter 3.4.1. --- Mental Status --- p.45 / Chapter 3.4.2. --- Geriatric Depression Scale --- p.47 / Chapter 3.5 --- Functional Disability --- p.49 / Chapter 3.6 --- Physical Health --- p.53 / Chapter 3.6.1. --- Self-Perceived Health --- p.53 / Chapter 3.6.2. --- Chronic Disease --- p.54 / Chapter 3.7 --- Physical Impairment --- p.57 / Chapter 3.7.1 --- Sensory Perception Problem --- p.57 / Chapter 3.7.2 --- Skeletal Problems --- p.61 / Chapter 3.8 --- Cardio-vascular Complaints --- p.65 / Chapter 3.9 --- Respiratory Problems --- p.67 / Chapter 3.10 --- Drug Taking --- p.69 / Chapter 3.11 --- Health Habits --- p.73 / Chapter 3.12 --- Use of Health Services --- p.77 / Chapter CHAPTER 4 / Chapter I.) --- Factors Associated With Functional Dependence --- p.80 / Chapter 4.1 --- Sociodemographic profile by Barthel Index --- p.80 / Chapter 4.1.1. --- "Differences in Age, Sex, Marital Status and Educational Levels" --- p.80 / Chapter 4.1.2. --- "Differences in major income, total monthly income, and household composition" --- p.82 / Chapter 4.2 --- Mental Health Status by Barthel ADL Index --- p.84 / Chapter 4.3 --- Physical Health by Barthel ADL Index --- p.85 / Chapter 4.4 --- Physical Impairment by Barthel Index --- p.87 / Chapter 4.5 --- Drugs Taking by Barthel Index --- p.89 / Chapter 4.6 --- Health Habits by Barthel Index --- p.90 / Chapter 4.7 --- Use of Health Services by Barthel Index --- p.92 / Chapter II.) --- Findings of Risk Factors for Disability --- p.94 / Chapter 4.8 --- Sociodemographic Factors --- p.94 / Chapter 4.9 --- Mental Health --- p.98 / Chapter 4.10 --- Health Status --- p.99 / Chapter 4.11 --- Physical Impairment --- p.101 / Chapter 4.12 --- Drug --- p.104 / Chapter 4.13 --- Health Service --- p.105 / Chapter 4.14 --- Final Regression Model --- p.106 / Chapter CHAPTER 5 / Chapter I.) --- Factors Associated with Institutionalization --- p.109 / Chapter 5.1 --- Sociodemographic profile by Residential Types --- p.109 / Chapter 5.1.1.) --- "Age, Sex, Marital Status and Educational Levels" --- p.109 / Chapter 5.1.2.) --- Major Income and Total Monthly Income --- p.111 / Chapter 5.2 --- Mental Health Status by Residential Types --- p.113 / Chapter 5.3 --- Severity of Functional Disability --- p.114 / Chapter 5.4 --- Physical Health --- p.116 / Chapter 5.5 --- Differences in Physical Impairment --- p.118 / Chapter 5.6 --- Drugs Taking --- p.121 / Chapter 5.7 --- Differences in Health Habits --- p.122 / Chapter 5.8 --- Difference in Use of Health Services --- p.124 / Chapter II.) --- Findings of Risk Factors for Institutionalization --- p.126 / Chapter 5.9.1 --- Sociodemographic Factors --- p.126 / Chapter 5.10 --- Mental Health --- p.128 / Chapter 5.11 --- Physical Dependence --- p.129 / Chapter 5.12 --- Health Status --- p.131 / Chapter 5.13 --- "Physical Impairment Sensory Perception, Skeletal, Cardiac and Respiratory Problems" --- p.133 / Chapter 5.14 --- Drug --- p.136 / Chapter 5.15 --- Health Service --- p.137 / Chapter 5.16 --- Final Regression Model --- p.138 / Chapter CHAPTER 6 --- Limitations of this study --- p.140 / Chapter CHAPTER 7 --- Discussion and Conclusion --- p.151 / Chapter I.) --- Discussion --- p.151 / Chapter II.) --- Conclusion --- p.164 / REFERENCE --- p.165 / LIST OF RESEARCH ASSISTANTS AND INTERVIEWERS --- p.173 / Chapter APPENDIX --- The Questionnaire Used at the Home Interviews / English Version / Chinese Version

nÃo hà / IntroduÃÃo: Sarcopenia, estado inflamaÃÃo crÃnica e diminuiÃÃo da modulaÃÃo autonÃmica cardÃaca sÃo frequentemente descritos em idosos frÃgeis. No entanto, o papel da inflamaÃÃo e diminuiÃÃo da modulaÃÃo autonÃmica em perda de massa muscular associada ao envelhecimento deve ser esclarecido. Objetivo: identificar, em idosos frÃgeis e robustos residentes na comunidade, correlaÃÃes entre alteraÃÃes autonÃmicas, nÃveis sÃricos de marcadores bioquÃmicos de inflamaÃÃo e diminuiÃÃo da forÃa e do desempenho muscular. Resultados: 98 voluntÃrios frÃgeis e robustos com idade de 60 anos ou mais foram submetidos à avaliaÃÃo clÃnica, exames laboratoriais e anÃlise da variabilidade da frequÃncia cardÃaca em decÃbito dorsal e em ortostase. O logaritmo natural do Ãndice de variabilidade da frequÃncia cardÃaca baixa frequÃncia (LF) foi inversamente relacionado com o marcador bioquÃmico da inflamaÃÃo fibrinogÃnio em idosos com fragilidade (p=0,046), mas nÃo em robustos. NÃo houve associaÃÃo entre Ãndices de variabilidade da frequÃncia cardÃaca e marcadores bioquÃmicos de inflamaÃÃo interleucina-6 e proteÃna C reativa ultrassensÃvel. Velocidade da marcha foi negativamente relacionada com o fibrinogÃnio em idosos frÃgeis (p=0,033), mas nÃo em idosos robustos. Em todos os idosos, velocidade da marcha foi negativamente relacionada com o fibrinogÃnio (p=0,017), interleucina-6 (p=0,038) e proteÃna C reativa ultrassensÃvel (p=0,010). ConclusÃo: nossos resultados sugerem que a sarcopenia relacionada inflamaÃÃo pode ser, pelo menos parcialmente, influenciada por diminuiÃÃo da modulaÃÃo autonÃmica em idosos. / Background: sarcopenia, chronic inflammation status and impairment of cardiac autonomic modulation are often described in frailty elderly. However, the role of inflammation and decreased autonomic modulation in loss of muscle mass associated with aging need to be enlightened. Aim: we aimed to identify, in community-dwelling frailty and robust elderly, correlations among autonomic changes, serum levels of biochemical markers of inflammation and decreased muscle strength and performance. Results: 98 volunteers aged 60 or older was assessed by clinical evaluation, laboratory tests and analysis of heart rate variability (HRV) in the supine and standing positions. The natural logarithm of the HRV index Low Frequency (LF) was inversely related with the biochemical marker of inflammation fibrinogen in frail elderly (p=0.049), but not in robust. There was no association between heart rate variability indices and biochemical markers of inflammation interleukin-6 and C-reactive protein high sensitivity. Gait speed was negatively correlated with fibrinogen in frail elderly (p=0.033), but not in elderly robust. In all elderly, gait speed correlated negatively with fibrinogen (p=0.017), IL-6 (p=0.038) and high-sensitivity CRP (p=0.010). Conclusion: our results suggest that inflammation-related sarcopenia can be at least partially influenced by decreased autonomic modulation in the elderly.

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references. Available also from UMI/Dissertation Abstracts International.