7 research outputs found
An event detection framework for the representation of the AGGIR variables
International audienceIn this paper, we propose a framework to study the AGGIR (Autonomy Gerontology Iso-Resources Groups) grid model, in order to evaluate the level of independency of elderly people, according to their capabilities of performing activities and interact with their environments over the time. To model the Activities of Daily Living (ADL), we also extend a previously proposed Domain Specific Language (DSL), in order to employ operators to deal with constraints related to time and location of activities, and event recognition. Our framework aims at providing an analysis tool regarding the performance of elder-ly/handicapped people within a home environment by means of data recovered from sensors using the iCASA simulator. To evaluate our approach, we pick three of the AGGIR variables (i.e., dressing, toileting, and transfers) and evaluate their testability in many scenarios, by means of records representing the occurrence of activities of the elderly. Results demonstrate the accuracy of our framework to manage the obtained records correctly and thus generate the appropriate event information
L'épidémiologie de la dépendance du sujet ùgé. Histoire naturelle, tendances évolutives et déterminants
The contingent of babyâboomers combined with an expansion of morbidity increasinglyobserved in some layers of older and aging populations are a major challenge for society.The aim of this thesis was to study the natural history and determinants of dependency inaging. In the first part, we showed that longevity was a multifactorial phenomenon withsimilarities and discrepancies by gender. In the second part, the study of secular trendsshowed a 10âyear gain in life expectancy and a postponement of dependency in over 75âyearâold demonstrating a compression of morbidity for men and high levels of education,but an expansion of morbidity for the subjects of low educational level. IRT models haveallowed us to more accurately describe the process of dependency. Our work confirmed thatthe ability to perform daily activities was hierarchically affected and the front door of theprocess was limitation for shopping, while the last step was for transfer limitation. Thetrajectories of functional evolution before death are more favorable to men and high levelsof education. Furthermore, the sequences are hierarchical specific to dementia, especiallyfor IADL. Demented people experienced sharper functional declines and greater levels ofdependency. Further analyzes will have to focus on exploring more widely different patternsof change in elderly population and identify the determinants underlying these profiles.Keywords:Le contingent de personnes issues de la gĂ©nĂ©ration du babyâboom conjuguĂ© Ă une expansionde la morbiditĂ© de plus en plus observĂ©e dans certaines couches des populations ĂągĂ©es etvieillissantes constitue un dĂ©fi majeur pour la sociĂ©tĂ©. Lâobjectif de cette thĂšse Ă©taitdâĂ©tudier lâhistoire naturelle et les dĂ©terminants de la dĂ©pendance dans le vieillissement.Dans une premiĂšre partie nous avons montrĂ© que la longĂ©vitĂ© Ă©tait un phĂ©nomĂšnemultifactoriel avec des similitudes et des spĂ©cificitĂ©s selon le sexe. Dans une deuxiĂšmepartie, lâĂ©tude des tendances sĂ©culaires a montrĂ© un gain dâespĂ©rance de vie en 10 ans avecun recul de lâĂąge dâentrĂ©e en dĂ©pendance chez les plus de 75 ans attestant dâunecompression de la morbiditĂ© pour les hommes et les hauts niveaux dâĂ©tudes, mais dâuneexpansion de la morbiditĂ© pour les sujets de bas niveau dâĂ©tudes. Les modĂšles IRT nous ontpermis de dĂ©crire plus finement le processus de dĂ©pendance. Nos travaux ont confirmĂ© quela capacitĂ© Ă effectuer les activitĂ©s quotidiennes Ă©tait hiĂ©rarchiquement affectĂ©e et que laporte dâentrĂ©e dans le processus Ă©tait la limitation pour les courses, alors que la derniĂšreĂ©tape Ă©tait la limitation au transfert. Les trajectoires dâĂ©volution fonctionnelle avant le dĂ©cĂšssont plus favorables aux hommes et aux hauts niveaux dâĂ©tudes. Par ailleurs, les sĂ©quenceshiĂ©rarchiques sont spĂ©cifiques Ă la dĂ©mence, notamment pour les IADL. Les dĂ©mentsconnaissent un dĂ©clin fonctionnel plus marquĂ© et des niveaux de dĂ©pendance supĂ©rieurs.Des analyses ultĂ©rieures devront sâattacher Ă explorer plus largement les diffĂ©rents profilsdâĂ©volution en population ĂągĂ©e et identifier les dĂ©terminants sousâjacents Ă ces profils
The social and interpersonal dimensions of measuring loss of autonomy : expectations among family caregivers and home care social workers in Québec
ProblĂ©matique: Le nombre croissant de personnes ĂągĂ©es, confrontĂ©es Ă des changements de santĂ© physiques et cognitifs entraĂźnant une perte d'autonomie, nĂ©cessite de la part des professionnels de la santĂ©, un processus d'Ă©valuation inclusif et efficace afin de s'assurer que ces personnes en perte dâautonomie reçoivent un soutien et des services appropriĂ©s. Pendant lâĂ©valuation, la prĂ©sence du proche aidant est un Ă©lĂ©ment important qui pourrait influencer ses rĂ©sultats. On sait peu de choses sur la maniĂšre dont les attentes, dans les services de santĂ© publics du QuĂ©bec, peuvent influencer le processus d'Ă©valuation et les rĂ©sultats. L'objectif de cette Ă©tude est donc d'explorer le concept des attentes tant du point des proches aidants, des travailleurs sociaux Ă domicile que de lâĂ©tablissement de santĂ©. Sous ce triple perspectif et dans le contexte de lâĂ©valuation de la perte dâautonomie, lâexploration des attentes de chacun des acteurs est rĂ©alisĂ©e par lâentremise de services de soins Ă domicile (OEMC) du QuĂ©bec.
MĂ©thodologie: Afin dâĂ©tudier et dâexplorer le phĂ©nomĂšne de la perte dâautonomie des personnes ĂągĂ©es dans une perspective Ă la fois micro et macro, une mĂ©thodologie ethnographique ciblĂ©e a Ă©tĂ© utilisĂ©e afin de collecter les donnĂ©es. Ensuite, la notion dâautonomie a fait lâobjet dâune analyse approfondie en vue dâune comprĂ©hension interdisciplinaire affinĂ©e. Pour ce faire, des entretiens individuels ont Ă©tĂ© menĂ©s avec des travailleurs sociaux dâun CIUSSS de MontrĂ©al, des aidants familiaux ainsi qu'un collectif de discussion composĂ© de plusieurs soignants. En dernier lieu, afin de reflĂ©ter les attentes des diffĂ©rents acteurs en prĂ©sence, dans le contexte du systĂšme de santĂ© actuel, articles et publications sur les rĂ©organisations systĂ©miques (selon les protocoles New Public Management et LEAN) ainsi que sur lâimpact de lâenvironnement de travail des travailleurs sociaux professionnels, ont Ă©tĂ© consultĂ©s.
RĂ©sultats: Les rĂ©sultats ont montrĂ© que les attentes des aidants familiaux, en matiĂšre de services et de soutien pour les bĂ©nĂ©ficiaires de soins, sont influencĂ©es par le processus dâĂ©valuation proprement dit. De mĂȘme, les rĂ©sultats montrent quâil existe des frontiĂšres floues entre leurs attentes concernant le service et les besoins des membres ĂągĂ©s de leur famille. En outre, les travailleurs sociaux se trouvent parfois piĂ©gĂ©s entre les pressions et les attentes quâexigent le rendement et la productivitĂ© de lâorganisation tout autant que leurs propres attentes Ă lâĂ©gard des membres aidants de la famille, qui deviendront eux-mĂȘmes de futurs clients.
Conclusion: Les rĂ©sultats de cette Ă©tude dĂ©montrent que l'interaction des diffĂ©rentes attentes, mises en Ă©vidence Ă travers les perspectives susmentionnĂ©es, crĂ©e un environnement de frustration et d'espĂ©rances déçues de la part des travailleurs sociaux et des aidants familiaux. Le climat de travail actuel dans le systĂšme de soins de santĂ© public du QuĂ©bec, qui se traduit par des contraintes budgĂ©taires par un manque de cohĂ©rence dans la fourniture de services et de soutiens Ă la clientĂšle ĂągĂ©e, influence considĂ©rablement cette perception dâattentes non rencontrĂ©es. De ce fait, les impĂ©ratifs administratifs influent de plus en plus sur la relation de service, contribuant Ă une certaine « clientĂ©lisation » des aidants familiaux.Problematic: The ever-increasing numbers of older people experiencing physical and cognitive health changes leading to loss of autonomy requires an inclusive and efficient assessment process from healthcare professionals to ensure they are receiving proper support and services. The presence of the family caregiver during the assessment is an important element that could influence its results. In public healthcare services, little is known about how expectations can influence the assessment process and outcome. The objective of this study is to explore the concept of expectations in the context of loss of autonomy assessment (OEMC) through QuĂ©bec homecare services from the triadic perspective of the family caregivers, homecare social workers and the institution.
Methodology: To study this phenomenon, a variety of data-gathering techniques were employed using a reflexive, focused ethnographic methodology that explored this notion from a macro and a micro perspective. An extensive literature review examined the notion of autonomy to gain an in-depth understanding of its interdisciplinary meaning, individual interviews were conducted with social workers working at a Montreal CIUSSS and family caregivers as well as a discussion group with a group of caregivers. Also, to provide the context of the current healthcare system, articles and publications on the systemic reorganizations according to New Public Management and LEAN protocols and the corresponding effect on the working environment of professional social workers are included as the third part of the triad of expectations.
Results: The results demonstrated that family caregiverâs expectations for services and support for their care recipients are influenced by the assessment process itself and there are blurred boundaries between their expectations for service and the needs of their elderly family members. As well, social workers sometimes find themselves caught between the pressures and expectations of performance and productivity of the organization and their own expectations of family members to provide care, until, the caregivers themselves become clients in their own right.
Conclusion: The results of this study demonstrates that the interaction of expectations from the three above-mentioned perspectives creates an environment of frustration and unmet expectations on the part of social workers and family caregivers. This is also influenced by the current working environment in the public health care system that is reflected in budget constraints and the inconsistency in the provision of services and supports to consumers. This phenomenon can contribute to the âclientizationâ of family caregivers wherein administrative imperatives increasingly influence the service relationship
The course of disability in the very old :drivers and trajectories
PhD ThesisIn recent decades the rapid growth in the numbers of the very old, those aged 85
years and above, has made them the fastest growing age group of most populations
worldwide. Nevertheless we know little about their health and disability, the latter
being a particularly important aspect of quality of life for individuals but also more
widely as a major determinant for residential care. This thesis uses a unique study,
the Newcastle 85+ Study, a longitudinal, population based cohort study of people
born in 1921 and aged 85 years at first interview in 2006, to explore the disablement
process in very late life through three substantive sub-studies.
In the first sub-study I explore how disability unfolds through the order of loss in basic
and instrumental activities of daily living [(I)ADLs, these being the building blocks of
disability. (I)ADLs were lost in a specific order, activities requiring long distance
mobility and balance (for example shopping) being lost first and those requiring upper
body strength (e.g. dressing, feeding) last and with little difference between men and
women.
The second sub-study examines the impact of specific diseases on disability onset
and finds that arthritis, diabetes and cognitive impairment were similarly disabling for
men and women, cardiac disease was more disabling in women, and cardiovascular
disease and respiratory disease disabling for women only.
The final sub-study uses novel statistical techniques to uncover patterns of disability
from age 85 to 90. Four distinct trajectories of disability were found for both sexes,
with a disability-free trajectory being identified in men but not women, and all other
trajectories showing increasing levels of disability.
These sub-studies are discussed in the light of other literature, the extent to which
they explain the greater disability yet survival of women (the disability-survival
paradox), and the implications for the future
13th International Conference on Modeling, Optimization and Simulation - MOSIM 2020
ComitĂ© dâorganisation: UniversitĂ© Internationale dâAgadir â Agadir (Maroc) Laboratoire Conception Fabrication Commande â Metz (France)Session RS-1 âSimulation et Optimisationâ / âSimulation and Optimizationâ Session RS-2 âPlanification des Besoins MatiĂšres PilotĂ©e par la Demandeâ / âDemand-Driven Material Requirements Planningâ Session RS-3 âIngĂ©nierie de SystĂšmes BasĂ©es sur les ModĂšlesâ / âModel-Based System Engineeringâ Session RS-4 âRecherche OpĂ©rationnelle en Gestion de Productionâ / "Operations Research in Production Management" Session RS-5 "Planification des MatiĂšres et des Ressources / Planification de la Productionâ / âMaterial and Resource Planning / Production Planning" Session RS-6 âMaintenance Industrielleâ / âIndustrial Maintenanceâ Session RS-7 "Etudes de Cas Industrielsâ / âIndustrial Case Studies" Session RS-8 "DonnĂ©es de Masse / Analyse de DonnĂ©esâ / âBig Data / Data Analytics" Session RS-9 "Gestion des SystĂšmes de Transportâ / âTransportation System Management" Session RS-10 "Economie Circulaire / DĂ©veloppement Durable" / "Circular Economie / Sustainable Development" Session RS-11 "Conception et Gestion des ChaĂźnes Logistiquesâ / âSupply Chain Design and Management" Session SP-1 âIntelligence Artificielle & Analyse de DonnĂ©es pour la Production 4.0â / âArtificial Intelligence & Data Analytics in Manufacturing 4.0â Session SP-2 âGestion des Risques en Logistiqueâ / âRisk Management in Logisticsâ Session SP-3 âGestion des Risques et Evaluation de Performanceâ / âRisk Management and Performance Assessmentâ Session SP-4 "Indicateurs ClĂ©s de Performance 4.0 et Dynamique de Prise de DĂ©cisionâ / â4.0 Key Performance Indicators and Decision-Making Dynamics" Session SP-5 "Logistique Maritimeâ / âMarine Logistics" Session SP-6 âTerritoire et Logistique : Un SystĂšme Complexeâ / âTerritory and Logistics: A Complex Systemâ Session SP-7 "Nouvelles AvancĂ©es et Applications de la Logique Floue en Production Durable et en Logistiqueâ / âRecent Advances and Fuzzy-Logic Applications in Sustainable Manufacturing and Logistics" Session SP-8 âGestion des Soins de SantĂ©â / âHealth Care Managementâ Session SP-9 âIngĂ©nierie Organisationnelle et Gestion de la ContinuitĂ© de Service des SystĂšmes de SantĂ© dans lâEre de la Transformation NumĂ©rique de la SociĂ©tĂ©â / âOrganizational Engineering and Management of Business Continuity of Healthcare Systems in the Era of Numerical Society Transformationâ Session SP-10 âPlanification et Commande de la Production pour lâIndustrie 4.0â / âProduction Planning and Control for Industry 4.0â Session SP-11 âOptimisation des SystĂšmes de Production dans le Contexte 4.0 Utilisant lâAmĂ©lioration Continueâ / âProduction System Optimization in 4.0 Context Using Continuous Improvementâ Session SP-12 âDĂ©fis pour la Conception des SystĂšmes de Production Cyber-Physiquesâ / âChallenges for the Design of Cyber Physical Production Systemsâ Session SP-13 âProduction AvisĂ©e et DĂ©veloppement Durableâ / âSmart Manufacturing and Sustainable Developmentâ Session SP-14 âLâHumain dans lâUsine du Futurâ / âHuman in the Factory of the Futureâ Session SP-15 âOrdonnancement et PrĂ©vision de ChaĂźnes Logistiques RĂ©silientesâ / âScheduling and Forecasting for Resilient Supply Chains