Perancangan Dog Furniture Untuk Rumah Tinggal

The interaction of humans and pets, especially dogs has become a very important need both inside and outside the room. To accommodate the interaction of the joint activity between human and dog within the main room of the living room, it is necessary to identify what activities can be performed together and the type of furniture required. How to design the necessary furniture and flexibility to be used in the living room, dining room, and bedroom is also a problem that has been solved.This design method was adopted from Sarah Gibbons, the first step is to observe the activities of human and dog in the family room, dining room, and bedroom. On the results of observations made, determined design limitations for designing dog furniture. In addition to observation of the activity, observations were also conducted on dog characters. The results of this observation will have an impact on the shape and material of dog furniture design.The result of designing dog furniture is to accommodate human activities with dogs. The types of furniture that are accommodated are the facilities of work areas, seating facilities, and storage facilities. Design of this dog furniture, each furniture item accommodates two needs of activity as well as flexible design to be moved in three rooms by recomposing based on the needs of each room

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Hippocampal atrophy in people with memory deficits: results from the population-based IPREA study.

Background:Clinical studies have shown that hippocampal atrophy is present before dementia in people withmemory deficits and can predict dementia development. The question remains whether this association holdsin the general population. This is of interest for the possible use of hippocampal atrophy to screen populationfor preventive interventions. The aim of this study was to assess hippocampal volume and shape abnormalitiesin elderly adults with memory deficits in a cross-sectional population-based study.Methods:We included individuals participating in the Italian Project on the Epidemiology of AlzheimerDisease (IPREA) study: 75 cognitively normal individuals (HC), 31 individuals with memory deficits (MEM),and 31 individuals with memory deficits not otherwise specified (MEMnos). Hippocampal volumes and shapewere extracted through manual tracing and the growing and adaptive meshes (GAMEs) shape-modelingalgorithm. We investigated between-group differences in hippocampal volume and shape, and correlationswith memory deficits.Results:In MEM participants, hippocampal volumes were significantly smaller than in HC and weremildly associated with worse memory scores. Memory-associated shape changes mapped to the anteriorhippocampus. Shape-based analysis detected no significant difference between MEM and HC, while MEMnosshowed shape changes in the posterior hippocampus compared with HC and MEM groups.Conclusions:These findings support the discriminant validity of hippocampal volumetry as a biomarker ofmemory impairment in the general population. The detection of shape changes in MEMnos but not in MEMparticipants suggests that shape-based biomarkers might lack sensitivity to detect Alzheimer’s-like pathologyin the general population

Comparison of disease clusters in two elderly populations hospitalized in 2008 and 2010.

BACKGROUND: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. OBJECTIVES: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. METHODS: Data were obtained from the multicenter 'Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. RESULTS: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. CONCLUSION: These findings strengthened the idea of an association other than by chance of diseases in the elderly population

The stigma of low opioid prescription in the hospitalized multimorbid elderly in Italy

The primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa` Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65+ years old, were enrolled in the first registry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was assessed by means of a numerical scale. The prevalence of patients prescribed with opioids at admission was 3.8\ua0% in the first run, 3.6\ua0% in the second and 4.1\ua0% in the third, whereas at discharge rates were slightly higher (5.8, 5.3, and 6.6\ua0%). The most frequently prescribed agents were mild opioids such as codeine and tramadol. The number of total prescribed drugs was positively associated with opioid prescription in the three runs; in the third, dementia and a better functional status were inversely associated with opioid prescription. Finally, as many as 58\ua0% of patients with significant pain at discharge were prescribed no analgesic at all. The conservative attitude of Italian physicians to prescribe opioids in elderly patients changed very little between hospital admission and discharge through a period of 5\ua0years. Reasons for such a low opioid prescription should be sought in physicians\u2019 and patients\u2019 concerns and prejudices