Long Term Care Advocacy Delivery Systems: State and Local Responsibilities

This paper reports the results of a national comparative study of nursing home ombudsman programs for the institutionalized elderly. Of recent origin, patient representative programs have received little critical assessment as to their success in improving the quality of life of America\u27s most vulnerable aged. At the same time, anticipated increases in the number of institutionalized aged coupled with current austerity measures in the health and human services underscores the present and future need to design effective and efficient monitoring/advocacy mechanisms to prevent abuses in long stay institutions. The paper focuses on a description of the current configuration of state and local sector roles and responsibilities in carrying out long term care monitoring services. Based on study findings, proposals are presented for suggested program changes and innovative strategies for coordinating state and area level advocacy initiatives

The inter-relationship between formal and informal care: a study in France and Israel

ABSTRACT This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household : informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51 %, Israel 55 %), about one-tenth received care from a household member (France 8 %, Israel 10 %), and one-third were helped by informal carers from outside the household (France 34 %, Israel 33 %). More French respondents (35 %) received formal care services at home than Israelis (27 %). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care

Ageing in Europe. Supporting Policies for an Inclusive Society

SHARE is an international survey designed to answer the societal challenges that face us due to rapid population ageing. How do we Europeans age? How will we do economically, socially and healthwise? How are these domains interrelated? The authors of this multidisciplinary book have taken a further big step towards answering these questions based on the recent SHARE data in order to support policies for an inclusive society

Robot Vision Library

The JPL Robot Vision Library (JPLV) provides real-time robot vision algorithms for developers who are not vision specialists. The package includes algorithms for stereo ranging, visual odometry and unsurveyed camera calibration, and has unique support for very wideangle lense

Use of quality indicators to evaluate the care of patients with localized prostate carcinoma

BACKGROUND The goal of quality assurance in health care is to preserve and improve patient care. Recently, RAND developed a set of evidence-based candidate indicators for evaluating the quality of care for patients with localized prostate carcinoma; however, the feasibility and sensitivity of these indicators have not been tested in a clinical setting. The objectives of this study were to evaluate the feasibility of measuring these quality indicators and to determine their sensitivity to change in practice patterns over time. METHODS One hundred sixty-eight men who presented in either 1995 or in 2000 and were treated for localized prostate carcinoma were selected randomly from the University of Michigan tumor registry. A combination of electronic data base review and explicit chart review was used to assess the feasibility of measuring compliance for each indicator. For each indicator in which assessment was feasible, compliance with the RAND indicators was determined for patients in both years. Multivariate regression analysis was used to adjust for potential confounding effects of disease stage, tumor grade, prostate specific antigen (PSA) level, patient age, and therapy. RESULTS Based on review of available clinical data, measurement of compliance was feasible for 19 of 22 RAND candidate quality indicators (86%). For five indicators, significant differences in documentation (compliance) were detected between 1995 and 2000 ( P < 0.05). Treatment received and higher PSA levels were associated independently with documentation of compliance for several indicators ( P < 0.05). CONCLUSIONS Measurement of the majority of the RAND quality indicators for the treatment of patients with localized prostate carcinoma was feasible, and improvements in several indicators were observed between 1995 and 2000. Demonstration of such variation, even within a single institution, suggests that the indicators are sufficiently sensitive to detect differences in practice patterns. Cancer 2003;97:1428–35. © 2003 American Cancer Society. DOI 10.1002/cncr.11216Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34367/1/11216_ftp.pd

Ablation of PGC-1β Results in Defective Mitochondrial Activity, Thermogenesis, Hepatic Function, and Cardiac Performance

The transcriptional coactivator peroxisome proliferator-activated receptor-gamma coactivator-1β (PGC-1β) has been implicated in important metabolic processes. A mouse lacking PGC-1β (PGC1βKO) was generated and phenotyped using physiological, molecular, and bioinformatic approaches. PGC1βKO mice are generally viable and metabolically healthy. Using systems biology, we identified a general defect in the expression of genes involved in mitochondrial function and, specifically, the electron transport chain. This defect correlated with reduced mitochondrial volume fraction in soleus muscle and heart, but not brown adipose tissue (BAT). Under ambient temperature conditions, PGC-1β ablation was partially compensated by up-regulation of PGC-1α in BAT and white adipose tissue (WAT) that lead to increased thermogenesis, reduced body weight, and reduced fat mass. Despite their decreased fat mass, PGC1βKO mice had hypertrophic adipocytes in WAT. The thermogenic role of PGC-1β was identified in thermoneutral and cold-adapted conditions by inadequate responses to norepinephrine injection. Furthermore, PGC1βKO hearts showed a blunted chronotropic response to dobutamine stimulation, and isolated soleus muscle fibres from PGC1βKO mice have impaired mitochondrial function. Lack of PGC-1β also impaired hepatic lipid metabolism in response to acute high fat dietary loads, resulting in hepatic steatosis and reduced lipoprotein-associated triglyceride and cholesterol content. Altogether, our data suggest that PGC-1β plays a general role in controlling basal mitochondrial function and also participates in tissue-specific adaptive responses during metabolic stress

Action to protect the independence and integrity of global health research

Storeng KT, Abimbola S, Balabanova D, et al. Action to protect the independence and integrity of global health research. BMJ GLOBAL HEALTH. 2019;4(3): e001746

Social network type and health status in a national sample of elderly Israelis

A typology of social support networks was examined in relation to five health measures in a national probability sample of Israelis aged 60 and over, using multiple classification analysis (N = 4214). The procedure revealed that the more resourceful diversified and friend and neighbor network types were consistently associated with better scores on measures of basic and instrumental activities of daily living, incontinence, vision and self-rated health, even when controlling for respondents' age, sex and education. The religious family network type, also endowed with considerable support potential, tended to correlate with lower health scores. The narrow family focused network had average health ratings or less, and a moderate support capability. The least resourceful network type, the attenuated network, was most frequently associated with poor health.support network health status elderly Israel