Elderly participation and empowerment : experiences of SAGE

The Hong Kong Society for the Age (SAGE) established in 1977 is one of the well-known Non-Government Organizations (NGOs) in responding to the rapid growing elderly population and the welfare needs of the senior in Hong Kong. Its services include Care and Attention Home, Elderly Hostels, Elderly Centres, Day Care Centres, Home Care Service. etc. The mission of SAGE is to ensure the elderly to have dignity and reasonable comfort in their old age. In 2008, SAGE aims to provide distinctive services to the elderly, i.e. elderly participation and empowerment (Homepage of Sage: http://www.sage.org.hk/eng/ideal.htm). This paper focuses how Sage as an elderly organization in Hong Kong empower older persons through active participation. In the past, the term “client” was widely used to describe those who approached SAGE for service or assistance. It was later changed to “Service User” or “Service Recipient”, a more appropriate term to describe the relationship as SAGE moves more towards the philosophy of a customer-oriented approach. However, the usage of this term implied a power relationship between the service providers, meaning those who “give”, and the service recipients, meaning those who “receive”. Therefore, the situation has been changed in order to emphasize “partnership” instead – a term that is devoid of status hierarchy with a fair chance of participation for both parties, which could result in a win-win situation. It is anticipated that there will be an even more progressive approach to include service users as “decision-makers”, so that they can have more say in deciding the type and mode of service provision, as well as in allocating resources. These changes not only denote the significance of enhancing the customers’ dual roles of being “partners” and “decision-makers” in the process of service provision, but also emphasis the importance of encouraging their participation through empowerment. With rapid development in information and technology, distinguish to before, the participations of the Hong Kong elderly are no longer conservative and invisible nowadays, this development promotes and enhances the active role and self-awareness in society among the elderly. Throughout the advocacy, guidance, and support of many community services in SAGE, it helps to echo the active involvement of the elders in the community. This involvement leads the elders becoming more aware of their collective strength and the power of voicing their concerns about social issues that directly or indirectly affect their own life and well-being. From SAGE experience, Elders’ involvement can be seen from the active roles they play in the organization and operation of different committees, including “Service Users’ Councils”, “Canteen Service Management Committees”, elder learning platform, etc., all these participation definitely enhance the well-being of the elders. However, elderly participation is still relatively low as regards to the whole society, and there exists considerable room for improvements at the policy-making and decision level. For example, at present, most elders’ involvements are mainly through invitations. Their opinions are generally sought on specific issues such as elderly education and welfare. From time to time, maybe, elderly representatives from different sectors of the community are invited to participate in focus group discussions initiated by the Elderly Commission of the Hong Kong Special Administrative Region, an official agency that is responsible for advocacy and policy decision-making concerning elderly welfare. Sometimes the elders themselves run some self-organized groups at local level, such as “The Hong Kong Association of Senior Citizens”, which helps play their active roles in sensitizing the Government and the community towards elderly-related issues. With these examples, how could we identify the benefits of the elderly participation? How do the elderly being empowered? A theoretical framework of participation and empowerment with a real experience in SAGE is going to explain in the next part

Art rehabilitation in amputee women with Pandora’s myth as a self-esteem and quality of life facilitator resource

A amputação é um evento traumático que repercute intensamente na vida da pessoa acometida. A dificuldade em lidar com a nova realidade pode contribuir negativamente para a autoestima e reabilitação do indivíduo, afetando a sua qualidade de vida. A Arteterapia por meio dos recursos expressivos pode ser um canal facilitador e promotor de aspectos resilientes para a superação do trauma. Objetivo: Averiguar a influência da Arteterapia na autoestima e qualidade de vida em mulheres amputadas. Grupo formado por 8 mulheres amputadas, entre 35 a 65 anos. Método: Divididos em 2 grupos (4 indivíduos no grupo de intervenção e 4 indivíduos no grupo controle). Instrumentos de avaliação: WHOQOL- Bref (World Health Organization Quality of Life), Escala de Autoestima Rosemberg (EAR), o Desenho da Figura Humana e Relatos das Participantes. As atividades foram desenvolvidas com base no mito de Pandora, em 11 oficinas arteterapêuticas com 1 hora de duração, uma vez por semana no setor de Arte-Reabilitação, AACD – Ibirapuera, São Paulo. Resultados: Estatisticamente não foram observadas diferenças significantes entre os momentos inicial e final para os domínios de Whoqol Bref e EAR, em ambos os grupos; porém, o grupo intervenção apresenta um movimento de melhora na autoestima, especialmente no quesito autodepreciação. Qualitativamente foram observadas através do discurso das participantes melhorias de autoestima e possibilidade de melhoria na qualidade de vida das participantes. Conclusão: A arteterapia, junto com a equipe interdisciplinar, pode contribuir positivamente para o processo de reabilitação em mulheres amputadas ajudando a promover a autoestima e qualidade de vida.Amputation is a traumatic event that has serious repercussions on the amputee’s life. The difficulty in dealing with the new reality can contribute negatively to self-esteem and rehabilitation, affecting the patient’s quality of life. The Art therapy, through its expressive resources, can be a facilitator and provide resilience to overcoming the trauma. Objective: The objective of this study is to investigate the influence of art therapy in self-esteem and quality of life in amputee women. Methods: A group of 8 amputees, aged 35-65 years were divided into 2 groups (4 in the experimental group and 4 in the control group). They were evaluated with the WHOQoL-Bref (World Health Organization Quality of Life), Rosenberg Self-Esteem Scale (RSE), Human Figure Drawing test and the participants’ own Reports. The activities, based on the Pandora myth, were developed in 11 art therapy workshops sessions of one hour that were carried out once a week in the Art-Rehabilitation sector off AACD – Ibirapuera, São Paulo. Results: There was no statistically significant differences observed between the initial and final assessments of quality of life (WHOQoL-Bref) and RSE domains of both groups, however, the experimental group evidenced a tendency towards the improvement of self-esteem, especiallyin regards of self-depreciation. Qualitatively, improvements of self-esteem and the possibility of improving the participants’ quality of life were also observed. Conclusion: Art Therapy, combined with interdisciplinary care, can contribute positively to the rehabilitation process of amputee women, by helping to promote better self-esteem and quality of life

GestaltMatcher Database - A global reference for facial phenotypic variability in rare human diseases

The most important factor that complicates the work of dysmorphologists is the significant phenotypic variability of the human face. Next-Generation Phenotyping (NGP) tools that assist clinicians with recognizing characteristic syndromic patterns are particularly challenged when confronted with patients from populations different from their training data. To that end, we systematically analyzed the impact of genetic ancestry on facial dysmorphism. For that purpose, we established the GestaltMatcher Database (GMDB) as a reference dataset for medical images of patients with rare genetic disorders from around the world. We collected 10,980 frontal facial images - more than a quarter previously unpublished - from 8,346 patients, representing 581 rare disorders. Although the predominant ancestry is still European (67%), data from underrepresented populations have been increased considerably via global collaborations (19% Asian and 7% African). This includes previously unpublished reports for more than 40% of the African patients. The NGP analysis on this diverse dataset revealed characteristic performance differences depending on the composition of training and test sets corresponding to genetic relatedness. For clinical use of NGP, incorporating non-European patients resulted in a profound enhancement of GestaltMatcher performance. The top-5 accuracy rate increased by +11.29%. Importantly, this improvement in delineating the correct disorder from a facial portrait was achieved without decreasing the performance on European patients. By design, GMDB complies with the FAIR principles by rendering the curated medical data findable, accessible, interoperable, and reusable. This means GMDB can also serve as data for training and benchmarking. In summary, our study on facial dysmorphism on a global sample revealed a considerable cross ancestral phenotypic variability confounding NGP that should be counteracted by international efforts for increasing data diversity. GMDB will serve as a vital reference database for clinicians and a transparent training set for advancing NGP technology.</p

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Plants in aquatic ecosystems: current trends and future directions

Aquatic plants fulfil a wide range of ecological roles, and make a substantial contribution to the structure, function and service provision of aquatic ecosystems. Given their well-documented importance in aquatic ecosystems, research into aquatic plants continues to blossom. The 14th International Symposium on Aquatic Plants, held in Edinburgh in September 2015, brought together 120 delegates from 28 countries and six continents. This special issue of Hydrobiologia includes a select number of papers on aspects of aquatic plants, covering a wide range of species, systems and issues. In this paper we present an overview of current trends and future directions in aquatic plant research in the early 21st century. Our understanding of aquatic plant biology, the range of scientific issues being addressed and the range of techniques available to researchers have all arguably never been greater; however, substantial challenges exist to the conservation and management of both aquatic plants and the ecosystems in which they are found. The range of countries and continents represented by conference delegates and authors of papers in the special issue illustrate the global relevance of aquatic plant research in the early 21st century but also the many challenges that this burgeoning scientific discipline must address

Knowledge management in a Chinese public organisation

This dissertation is a case study project to find out how people in a Chinese public organization understand Knowledge Management (KM) and how they use and implement it. It also tries to find out whether the improvement of “system” (information and communication technologies (ICTs)) affects the “people” and “culture” aspects in this Chinese public administration organization.Master of Business Administration (International Business

Oral Antineoplastic Handling at Heath Care Institutions in the United States: Survey of Nurses and Pharmacists

Purpose: To characterize and identify trends in current practices for ordering, handling, dispensing, administering, and disposing of oral antineoplastics. Methods: An electronic survey was designed and sent to pharmacists and nurses via professional society listservs. Results: One hundred and twenty-three practitioners responded to the survey. Of those responding, 76% described having an official policy regarding the handling of oral antineoplastics. Prescribing was limited to attending physicians or oncologists the majority of the time (42% and 98%, respectively), with 11% accepting telephone orders for oral antineoplastics. Personal protective equipment was required by many of the respondents; 70% required gloves be worn. Patient contact precautions were utilized by 79% of practitioners, of which 81% followed similar precautions for targeted therapies. Compounding was required to be performed in a biological safety cabinet by 88% of respondents, and 83% required decontamination of supplies and equipment after exposure to oral antineoplastics. Conclusion: Although practices varied slightly, the majority of respondents follow available guidance when handling oral antineoplastics

Úlcera genital aguda de Lipschütz: caso clínico

La úlcera genital aguda (UGA) o úlcera de Lipschütz constituye una infrecuente entidad clínica caracterizada por la aparición de úlceras genitales en niñas y adolescentes que no han iniciado su actividad sexual. El cuadro es de inicio agudo, con formación de úlceras dolorosas habitualmente precedidas en su aparición por manifestaciones sistémicas tales como fiebre, cefalea, astenia, adinamia, mialgias y adenopatías inguinales, y donde el estudio microbiológico de la lesión descarta un posible origen infeccioso. A pesar de presentar un cuadro clínico característico, esta enfermedad constituye una entidad poco conocida y por tanto subdiagnosticada, motivo por el cual presentamos el caso de una paciente de 10 años con diagnóstico de UGA realizado en el Departamento de Dermatología de la Pontificia Universidad Católica de Chile