Pain characteristics of older residents in Iranian nursing homes Caractéristiques des douleurs ressenties par les résidents âgés dans les maisons de retraite iraniennes

Background: Pain is a common complaint among the aging population, particularly among the older residents of nursing homes. Aims: The main aim of the study was to examine the pain characteristics among older residents of nursing homes in Tehran, Islamic Republic of Iran. Methods: This was a cross-sectional study. The sample consisted of 394 older adults admitted to Tehran nursing homes. To gather the required data, Brief Pain Inventory and Abbreviated Mental Test score were used. Results: 51 of the female and 26 of the male participants suffered from pain. Lower extremity and lower part of back were the most frequently affected. Pain interfered with general activity (P < 0.001), mood (P = 0.016), walking (P < 0.001), normal work (P < 0.001), relations with others (P = 0.043), sleeping (P = 0.002) and enjoyment of life (P = 0.019) of the older residents and these effects were more prominent in female sex. Factors such as age, gender and schooling were of significant relationships with pain (P < 0.001) and its intensity (P <0.001). Conclusions: Chronic pain is common among older residents of nursing homes and deteriorates their quality of life. This study reconfirms the previously mentioned importance of using effective pain evaluation and pain management strategies in nursing homes. © World Health Organization (WHO) 2019. Some rights reserved

Effect of point-contact transparency on coherent mixing of Josephson and transport supercurrents

The influence of electron reflection on dc Josephson effect in a ballistic point contact with transport current in the banks is considered theoretically. The effect of finite transparency on the vortex-like currents near the contact and at the phase difference $\phi =\pi ,$ which has been predicted recently \cite{KOSh}, is investigated. We show that at low temperatures even a small reflection on the contact destroys the mentioned vortex-like current states, which can be restored by increasing of the temperature.Comment: 6 pages, 8 Figures, Latex Fil

Relationship between oral health and demographic characteristics in retired elderly people in Iran بررس� ارتباط س�ا٠ت د�ا� با ٠شخصات ج٠ع� تش�اخت� سا�٠�دا� باز�شست�

Objectives The current study aimed to determine the relationship between oral health and demographic characteristics of retired elderly people. Methods & Materials This cross-sectional study was conducted on 158 older adults aged � 60 years. The subjects were selected using random sampling method and personnel codes. All the elderly participants were retired members of the Tehran Municipality Administration. The study data were collected by direct visit to the subjects' place of residence and conducting interviews. The data collection tool was a questionnaire that included 2 sections. The first section consisted of demographic, socioeconomic, and health profiles, while the second section consisted of Geriatric Oral Health Assessment Index (GOHAI). Results We collected data from 158 participants (90 men, 68 women). The mean age of the participants was 68.78 years. The obtained data suggested that 38 (24.05) participants had a poor state of oral health. About 50 of the participants mentioned high dental care costs as a reason for not referring to the dentist. According to the findings of this study, there is a direct relationship between educational level and oral health status in the elderly (P < 0.05). Conclusion Oral and dental health increase the quality of life in the elderly and reduce the high prevalence of dental problems among them. Therefore, designing and implementing practical policies to reduce oral and dental infections in the elderly and promote their health is necessary. © 2019. ا�دا� �د� از ا�� ٠طا�ع�� تع��� ارتباط س�ا٠ت د�ا� با ٠شخصات ج٠ع� تش�اخت� سا�٠�دا� باز�شست� ب�د. ٠�اد � ر�ش �ا ا�� پ���ش ب� ر�ش ت�ص�� �تح���� بر ر�� 158 ��ر سا�٠�د با�ا� 60 سا� تحت پ�شش ساز٠ا� باز�شستگ� ش�ردار� ت�را� ب� ر�ش �٠�� �گ�ر� تصاد�� ا�جا٠شد. داد ��ا ب� ص�رت ٠ست��٠� با ٠صاحب� ٠ست��٠گردآ�ر� شد. ابزار گردآ�ر� داد ��ا شا٠� پرس ش�ا٠� ٠شخصات ج٠ع� تش�اخت� � پرس ش�ا٠� شاخص س�جش س�ا٠ت د�ا� سا�٠�دا� ب�د. �ا�ت� �ا 90 ��ر ) 57 درصد( از پاسخگ��ا� سا�٠�دا� ٠رد � 68 ��ر ) 43 درصد( سا�٠�دا� ز� ب�د�د. ٠�ا�گ�� س� سا�٠�دا� ٠�رد ٠طا�ع� 78 / 68 سا� ب�د. س�ا٠ت د�ا� با س� ) 004 / P=0 (� ج�س ) 034 / P=0 (� � تحص��ات ) 0001 / P=0 ( رابط� ٠ع� �دار داشت. �ضع�ت س�ا٠ت د�ا� � د�دا� سا�٠�دا� ٠رد ب�تر از سا�٠�دا� ز� ب�د. �ت�ج� گ�ر� با ت�ج� ب� ا�٠�ت �را�ا� س�ا٠ت د�ا� � د�دا� در ا�زا�ش ک���ت ز�دگ� سا�٠�دا�� در ��گا٠طراح� ٠داخ�ات برا� ارت�ا� س�ا٠ت د�ا� سا�٠�دا�� ت�ج� ب� ���گ ��ا� ج٠ع� تش�اخت� آ ��ا ضر�ر� ب� �ظر ٠�رسد

Neuropathic Pain Prevalence of Older Adults in an Urban Area of Iran: A Population-Based Study

Background. Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. Objectives. This study, therefore, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. Methods. 5326 older people, aged � 60 years, were randomly chosen by a multistage, cluster sampling method. The selected people then were interviewed by using the following instruments: a standard questionnaire about pain, questions of interview part of Douleur Neuropathique 4 Questions (DN4) and its comorbidities, GHQ-28, and a sociodemographic checklist. Descriptive statistics and multiple regression analysis were conducted to analyze the gathered data. Results. The average of the participants' age was 68.92 ± 7.02 years. Of 5326 participants, 2529 (47.5) of participants were male. About one-third of this population had chronic pain. Chronic neuropathic pain prevalence was 13.7 and nociceptive in 30. Knee pain (20.6) and feet dysesthesia (7.8) were the most common sites of nociceptive and neuropathic pain, respectively. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. Neuropathic pain experiences were significantly associated with GHQ-28 scores (t=-11.42, P<0.001). Conclusions. In addition to neuropathic pain, other subtypes of pain prevalence and the comorbidities are determined in the community-dwelling elder adults. This study highlights the importance of neuropathic pain and its adverse consequences and can be used to manage this populations' needs in Iran effectively. © 2019 Reza Salman Roghani et al

Protective psychosocial factors of geriatric depression in community dwelling older adults: A review article

Context: Depression is a major health problem in geriatric population and has many adverse consequences. The aim of this study was to review the existing literature on psychosocial factors that protect against depression in later life. Evidence Acquisition: A MEDLINE systematic search was done via Pubmed and Sciencedirect web pages to gather the published articles on psychosocial factors of late life depression First, the titles and abstracts reviewed and relevant articles were selected according to the inclusion criteria. Then full texts of the selected articles obtained, read, and data were extracted and categorized. Results: There were 204 articles on psychosocial factors of late life depression in community dwelling older adults and among them 29 articles included protective factors. Reading them carefully, protective factors were extracted and organized into 5 main categories: Demographic factors, psychological factors, social factors, health related factors and also spiritual factors. Conclusion: Psychosocial factors protecting older adults against depression are diverse. Identification of the modifiable ones and provision of appropriate interventions to enhance them, can be helpful in preventing geriatric depression. ©2018, Iranian Journal of Psychiatry and Behavioral Sciences

Prevalence of Dementia Among Older Patients: A Hospital-Based Study in Iran

Background: Dementia constitutes a public health hazard in developing countries. The aim of this study was to evaluate the prevalence of dementia and its associated factors in older hospitalized patients. Methods: The participants of this cross-sectional study consisted of older patients admitted to medical wards in Rasoul-e Akram hospital in Tehran, Iran. Mini-Mental State Examination, Mini-Cog test, Geriatric Depression Scale, Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, and socioeconomic questionnaires were used. Results: A total of 205 elderly inpatients were included. The mean age was 71.33 ± 7.35 years; 63.4 of the participants had normal cognitive function, while 36.6 had some degree of cognitive impairment. There was a statistically significant relationship between gender, age, number of children, and occupation and the prevalence of dementia. Conclusion: Appropriate cognitive screening of older patients upon admission to hospitals could help identify potential adverse events and enhance the quality of care for patients with comorbid dementia. © The Author(s) 2019

Social Algorithms

This article concerns the review of a special class of swarm intelligence based algorithms for solving optimization problems and these algorithms can be referred to as social algorithms. Social algorithms use multiple agents and the social interactions to design rules for algorithms so as to mimic certain successful characteristics of the social/biological systems such as ants, bees, bats, birds and animals.Comment: Encyclopedia of Complexity and Systems Science, 201

Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study.

BACKGROUND: Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. METHODS: Using cognitive testing data and data on functional limitations from Wave A (2001-2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. RESULTS: Our algorithm had a cross-validated predictive accuracy of 88% (86-90), and an area under the curve of 0.97 (0.97-0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3-4) in individuals 70-79, 11% (9-12) in individuals 80-89 years old, and 28% (22-35) in those 90 and older. CONCLUSIONS: Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys

Global mortality from dementia : Application of a new method and results from the Global Burden of Disease Study 2019

Introduction Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods We meta-analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end-stage disease to calculate the total number of deaths that could be attributed to dementia. Results We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41-4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27-2.71]) than men (0.56 million [0.14-1.51]), largely but not entirely due to the higher life expectancy in women (age-standardized female-to-male ratio 1.19 [1.10-1.26]). Due to population aging, there was a large increase in all-age mortality rates from dementia between 1990 and 2019 (100.1% [89.1-117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally.Peer reviewe

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC