Sensory Impairments among Canadians 55 years and Older: An Analysis of 1986 and 1991 Health and Activity Limitation Survey

It has been well established that increasing age is associated with worsening health and decreasing functional ability among seniors, including conditions that lead to hearing and seeing impairments. The development of such sensory impairments can lead to a reduced quality of life by interfering with the ability to carry out activities of daily living and engaging in social activities. The review, which precedes the findings of this report, highlights the impact of sensory impairments on seniors (65 years and older) by first describing the prevalence of hearing and seeing impairments in this population and then examining the association between sensory impairment and physical, cognitive, and social functioning.HALS; aging

Describing Disability among High and Low Income Status Older Adults in Canada

The purpose of this study was to determine the prevalence, types, and severity of disabilities, as well as the medical conditions that may have caused disabilities among non-institutionalized older adults by high and low income. Disabled individuals aged 55 years and older were identified from the 1986 and 1991 Health and Activity Limitation Surveys. The overall unweighted sample sizes for each survey were 132,337 in 1986 and 91,355 in 1991. Approximately 40% of senior men and women reported having at least one disability, with women just slightly more likely than men to report being disabled. Almost twice as many senior women had low income compared with senior men. Mobility and agility disabilities were the most common types of disabilities reported by older adults. Arthritis/rheumatism was the medical condition most often reported as the primary cause of a disability among women. Men most often reported diseases of the ear and mastoid processes, with differences reported by low and high income respondents. Among 55-64 year olds, low income respondents were generally less likely to be categorized as mildly disabled and more likely to be categorized as severely disabled compared with high income respondents. In an effort to postpone or prevent disabilities in an ever-growing older population, public health initiatives are required to educate older adults about medical conditions and impairments that often lead to disability, particularly among low income seniors.disability; income; seniors

Describing Disability among High and Low Income Status Older Adults in Canada

The purpose of this study was to determine the prevalence, types, and severity of disabilities, as well as the medical conditions that may have caused disabilities among non-institutionalized older adults by high and low income. Disabled individuals aged 55 years and older were identified from the 1986 and 1991 Health and Activity Limitation Surveys. The overall unweighted sample sizes for each survey were 132,337 in 1986 and 91,355 in 1991. Approximately 40% of senior men and women reported having at least one disability, with women just slightly more likely than men to report being disabled. Almost twice as many senior women had low income compared with senior men. Mobility and agility disabilities were the most common types of disabilities reported by older adults. Arthritis/rheumatism was the medical condition most often reported as the primary cause of a disability among women. Men most often reported diseases of the ear and mastoid processes, with differences reported by low and high income respondents. Among 55-64 year olds, low income respondents were generally less likely to be categorized as mildly disabled and more likely to be categorized as severely disabled compared with high income respondents. In an effort to postpone or prevent disabilities in an ever-growing older population, public health initiatives are required to educate older adults about medical conditions and impairments that often lead to disability, particularly among low income seniors.disability; income; seniors

Is Dementia Screening of Apparently Healthy Individuals Justified?

Despite efforts to raise awareness and develop guidelines for care of individuals with dementia, reports of poor detection and inadequate management persist. This has led to a call for more identification of people with dementia, that is, screening individuals who may or may not complain of symptoms of dementia in both acute settings and primary care. The following should be considered before recommending screening for dementia among individuals in the general population. Dementia Tests. Low prevalence reduces positive predictive value of tests and screening tests will miss people who have dementia and identify people who do not have dementia in substantial numbers. Clinical Issues. The clinical course of dementia has not yet been shown to be amenable to intervention. Misdiagnosis and overdiagnosis can have significant long-term effects including stigmatization, loss of employment, and autonomy. Economic Issues. Health systems do not have the capacity to respond to increased demand resulting from screening. In conclusion, at present attention to life-course risk reduction and support in the community for frail and cognitively impaired older adults is a better use of limited healthcare resources than introduction of unevaluated dementia screening programs.Peer Reviewe

Integration of service, education, and research in local official public health agencies

Chambers et al discuss improved education for future public health practitioners. continuing education of existing staff, and research and evaluations activities in local official public health agencies in Ontario Canada

Knowledge Translation of Interprofessional Collaborative Patient-Centred Practice: The Working Together Project Experience

The Working Together (WT) project involved the design and delivery of an online learning resource for healthcare teams in long-term care (LTC) so that knowledge regarding interprofessional collaborative patient-centred practice (ICPCP) could be readily accessed and then transferred to the workplace. The purpose of this paper is to better understand the process of knowledge translation in continuing education for healthcare professionals by documenting our experiences using Lavis et al.’s (2003) organizing framework for knowledge transfer, and highlighting the impact this approach had on the design, development, delivery, and evaluation of the WT program. Fifty-nine pharmacists, physicians, nurses, and nurse practitioners from 17 LTC homes across Ontario, Canada participated in this project. The effectiveness of the knowledge translation of ICPCP through the WT project was evaluated using the Demand-Driven Learning Model (DDLM) evaluation tool (MacDonald, Breithaupt, Stodel, Farres, & Gabriel, 2002) to assess learners’ reactions to the learning resource. Data from quantitative pre-post surveys and qualitative interviews revealed that learners found using the WT online resource to be a satisfactory learning experience, obtained new knowledge and skills regarding ICPCP, transferred knowledge to the workplace, and reported that learning had a positive effect on the residents they cared for.Le projet Working Together (WT) comprend la conception et la production d’une ressource d’apprentissage en ligne pour les équipes de professionnels prodiguant des soins de santé de longue durée (SLD) afin que les connaissances relatives à la pratique interprofessionnelle en collaboration axée sur le patient (PICAP) puissent être facilement accessibles, puis transférées dans le milieu de travail. L’objectif de cet article est de mieux comprendre le processus d’application des connaissances dans la formation continue des professionnels de la santé en documentant notre expérience à l’aide de Lavis et coll. (2003), en établissant un cadre théorique pour le transfert des connaissances et en mettant en évidence l’incidence de cette approche sur la conception, le développement, la réalisation et l’évaluation du programme WT. Cinquante-neuf pharmaciens, médecins, infirmiers et infirmières, infirmiers et infirmières praticiens de 17 centres de SLD en Ontario, au Canada, ont participé à ce projet. L’efficacité de l’application des connaissances de la PICAP à l’échelle du projet WT a été évaluée à l’aide du modèle d’apprentissage axé sur la demande (DDLM) (MacDonald, Breithaupt, Stodel, Farres et Gabriel, 2002) afin de déterminer les réactions des apprenants à la ressource d’apprentissage. Des données tirées de prétest et de postest quantitatifs ainsi que d’entrevues qualitatives ont révélé que les apprenants étaient satisfaisants de l’expérience d’apprentissage que procure la ressource en ligne WT, qu’ils ont acquis de nouvelles connaissances et aptitudes concernant la PICAP et mis en application ces connaissances dans leur milieu de travail, et que l’apprentissage a eu un effet positif sur les pensionnaires dont ils prennent soin

Disability Related Sources of Income and Expenses: An Examination Among the Elderly in Canada

The primary purpose of this paper is to examine disability-related sources of income and expenses among high and low income older Canadians. Specifically, the paper attempts to answer three questions: Do low and high income seniors experience disability equally? Do low and high income seniors incur equal disability- related non-reimbursed expenses? And, Do low and high income seniors receive equal disability-related pensions and tax credits? The analysis is based on the Health and Activity Limitation Surveys of 1986 and 1991. Both surveys were cross-sectional, designed to gather information on disabilities and their impact on daily living. Among the seniors (those 65 and over), between 10.3% (men in 1986) and 23.2% (women in 1991) were classified as low income and about 40% reporting having at least one disability, compared to one-quarter of women and men of all ages. The analysis indicates that low income seniors are disadvantaged in that they experience more disability, incur more non-reimbursed expenses, and receive less in terms of disability- related pensions and credits than do high income seniors. It thus appears that interventions should be policy based rather than individual based.elderly; disability; income

Observational Constraints on the Catastrophic Disruption Rate of Small Main Belt Asteroids

We have calculated 90% confidence limits on the steady-state rate of catastrophic disruptions of main belt asteroids in terms of the absolute magnitude at which one catastrophic disruption occurs per year (HCL) as a function of the post-disruption increase in brightness (delta m) and subsequent brightness decay rate (tau). The confidence limits were calculated using the brightest unknown main belt asteroid (V = 18.5) detected with the Pan-STARRS1 (Pan-STARRS1) telescope. We measured the Pan-STARRS1's catastrophic disruption detection efficiency over a 453-day interval using the Pan-STARRS moving object processing system (MOPS) and a simple model for the catastrophic disruption event's photometric behavior in a small aperture centered on the catastrophic disruption event. Our simplistic catastrophic disruption model suggests that delta m = 20 mag and 0.01 mag d-1 < tau < 0.1 mag d-1 which would imply that H0 = 28 -- strongly inconsistent with H0,B2005 = 23.26 +/- 0.02 predicted by Bottke et al. (2005) using purely collisional models. We postulate that the solution to the discrepancy is that > 99% of main belt catastrophic disruptions in the size range to which this study was sensitive (100 m) are not impact-generated, but are instead due to fainter rotational breakups, of which the recent discoveries of disrupted asteroids P/2013 P5 and P/2013 R3 are probable examples. We estimate that current and upcoming asteroid surveys may discover up to 10 catastrophic disruptions/year brighter than V = 18.5.Comment: 61 Pages, 10 Figures, 3 Table

The Pan-STARRS Moving Object Processing System

We describe the Pan-STARRS Moving Object Processing System (MOPS), a modern software package that produces automatic asteroid discoveries and identifications from catalogs of transient detections from next-generation astronomical survey telescopes. MOPS achieves > 99.5% efficiency in producing orbits from a synthetic but realistic population of asteroids whose measurements were simulated for a Pan-STARRS4-class telescope. Additionally, using a non-physical grid population, we demonstrate that MOPS can detect populations of currently unknown objects such as interstellar asteroids. MOPS has been adapted successfully to the prototype Pan-STARRS1 telescope despite differences in expected false detection rates, fill-factor loss and relatively sparse observing cadence compared to a hypothetical Pan-STARRS4 telescope and survey. MOPS remains >99.5% efficient at detecting objects on a single night but drops to 80% efficiency at producing orbits for objects detected on multiple nights. This loss is primarily due to configurable MOPS processing limits that are not yet tuned for the Pan-STARRS1 mission. The core MOPS software package is the product of more than 15 person-years of software development and incorporates countless additional years of effort in third-party software to perform lower-level functions such as spatial searching or orbit determination. We describe the high-level design of MOPS and essential subcomponents, the suitability of MOPS for other survey programs, and suggest a road map for future MOPS development.Comment: 57 Pages, 26 Figures, 13 Table