Management of Volunteer Activities among Elderly Persons

Purpose: Volunteer activities in Japan may be expected to result in a variety of effects on health conditions and social contributions of the elderly depending on the degree of their activity participation. This study aims to identify differences in the health conditions and social contributions of the elderly in relation to the degree of volunteer activity participation, and determine what effective support can be provided for these elderly persons. Further, focusing on the differences in the level of activity of the elderly persons in volunteer activities, we discuss the effect of management through SWOT analysis from the perspectives suggested by the Balanced Scorecard (BSC), which is a performance management tool. Participants and Methods: The participants are elderly persons participating in volunteer activities, living in municipal housing owned by the Kumamoto prefecture in Japan. We classified the participants into an active group who contributed to the raising of funds for activities, and a non-active group. We conducted group interviews with the volunteers, organized interview data on the thoughts of the two groups according to the five perspectives of the balanced score card (BSC) management tool: (1) learning and development, (2) participants, (3) financial matters, (4) process of conducting activities, and (5) social contributions, and conducted a Strength-Weakness-OpportunityThreat (SWOT) analysis. In the SWOT analysis internal factors are distinguished into strengths and weaknesses, and external factors into opportunities and threats. Combining the internal and external factors, problems were extracted from the perspective of a positive strategy (S+O: strength + opportunity), a differentiation strategy (S+T: strength L threat), a stepwise strategy (W+O: weakness + opportunity), and a defensive strategy (W+T: weakness + threat). Then, we confirmed the main results by identifying the major factors in success to achieve salient aims, activity goals, and specific measures from the five perspectives provided by the BSC. Results: When comparing thestrengths of the two groups, the active group showed the following characteristics in the information collecting: more variety in the collected information (perspective of learning and development), ease of obtaining information of potential volunteers (perspective of participants), knowledge of how to raise funds (perspective of financial matters), and being physically more active and knowledgeable of the local community (perspective of social contributions).From the perspective of the process of conducting activities, both groups place importance on the relations among people. For weaknesses, and from the perspective of learning and development, the active group had difficulty in maintaining their motivation, and from the perspective of financial matters this group had difficulties in securing funds. From the perspective of social contributions, the non-active group depended on the active members. From the perspective of participants, both groups experienced a decline in physical function with age, and from the perspective of the process of activities there was a possibility that family or individual circumstances make it difficult to participate in all activities. In the SWOT analysis, combining the internal and external factors, we evaluated the directionality of volunteer activities from the five perspectives of the BSC. From the perspective of learning and development, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members conducted a signature-collecting campaign to call for continuing volunteer activities for residents among those in their surroundings, and this made it possible to continue volunteer activities. From the perspective of the process of conducting activities, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members became active in making remarks, and started to assume roles voluntarily. From the perspective of financial matters, the volunteer members were able to obtain donations for volunteer activities from neighboring establishments, as well as financial support from the social welfare council, by applying for subsidies for activities. From the perspective of participants, the number of new members increased through word of mouth spread by the existing membership. From the perspective of social cost, there was a remark that “I would like my schedule to be full of enjoyable events so that I become too busy to go to the hospital”, and in fact some members did reduce the frequency of hospital visitsDiscussion: Participants in this study are members of a volunteer group of elderly persons voluntarily formed in a regional city in Kumamoto prefecture where the elderly population accounts for 25.7% and is expected to increase. It appears that there is a self- and mutual- help relationship between active and non-active members where non-active members rely on the active members who assist the non-active members to be in harmony with the volunteer activities led by the active members, and that this relationship helps maintain independent lives. For the strengths, active members were able to collect more information from the perspective of learning and development, and contributed more through physical activity from the perspective of social contributions. It can be inferred that physically more active elderly persons are in a situation where they remain able to use their cognitive functions to collect information. For the weaknesses, the active members experienced loss of motivation. This may be due to the possibility that active members feel it a burden to assist non-active members. We wish to conduct further studies to understand how to maintain and improve motivation. The results of the SWOT analysis from the perspectives suggested by the BSC showed that there are differences in health conditions and social contributions of the elderly depending on the participation in volunteer activities, and what types of support from health services can be expected to be effective. This study evaluated the achievements of the volunteer activity goals of elderly persons by identifying the details of volunteer activities and quantifying the goals. The elderly members began to seek for new ideas to achieve better results when they were convinced that there were favorable results of their activities. This suggests that the PDCA cycle in volunteer activities may work by effecting empowerment in the process of BSC.

Leukocyte-depleted terminal blood cardioplegia provides superior myocardial protective effects in association with myocardium-derived nitric oxide and peroxynitrite production for patients undergoing prolonged aortic crossclamping for more than 120 minutes

AbstractObjectivesThis study was designed to examine the myocardial protective effect of leukocyte-depleted terminal blood cardioplegia in association with nitric oxide and peroxynitrite production, especially for patients undergoing prolonged aortic crossclamping.MethodsFifty-four patients (34 men, 20 women, mean age 56.7 ± 12.7 years) undergoing aortic valve replacement were randomly allocated to one of two groups; group LDTC (n = 27) received 10 minutes of leukocyte-depleted terminal blood cardioplegic solution, and group CONT (n = 27) served as controls. Each group was subdivided into 2 groups: aortic crossclamping for less than 120 minutes in groups LDTC-S (n = 13) and CONT-S (n = 14); aortic crossclamping for 120 minutes or more in groups LDTC-L (n = 14) and CONT-L (n = 13).ResultsAfter aortic unclamping, group LDTC-L showed higher incidence of spontaneous defibrillation (78.6% vs 30.8%, P = .0213), higher plasma nitrate + nitrite in the coronary sinus effluent (32.5 ± 4.1 vs 28.7 ± 3.0 μmol/L, P = .0013), lower differences between coronary sinus effluent and arterial blood in the percentage ratio of nitrotyrosine to tyrosine (myocardium-derived peroxynitrite; 2.987% ± 0.576% vs 3.951% ± 0.952%, P = .0036), and plasma polymorphonuclear-elastase (113.9 ± 21.3 vs 155.5 ± 41.6 μg/L, P = .0029) and malondialdehyde (2.75 ± 0.67 vs 4.02 ± 0.96 μmol/L, P = .0005) than group CONT did. Postoperatively, group LDTC-L showed lower human-heart fatty acid–binding protein (111.4 ± 25.2 vs 156.4 ± 38.6 IU/L, P = .0013), lower creatine kinase–muscle and brain (19.2 ± 4.7 vs 24.8 ± 6.5 IU/L, P = .0120), and smaller requirement of catecholamine (5.44 ± 2.29 vs 8.45 ± 3.42 μg · kg−1 · min−1, P = .0122). There were no significant differences in these parameters between groups LDTC-S and CONT-S.ConclusionsThis study demonstrated that leukocyte-depleted terminal blood cardioplegia provided superior myocardial protective effects and regulated myocardial-derived nitric oxide and peroxynitrite production only for patients undergoing aortic crossclamping for more than 120 minutes. The results suggest that prolonged aortic crossclamping deteriorates the tolerance to leukocyte-mediated myocardial injury accompanied by endothelial dysfunction associated with nitric oxide and peroxynitrite production

Formation and Reactions of NH4NO3 during Transient and Steady-State NH3-SCR of NOx, over H-AFX Zeolites: Spectroscopic and Theoretical Studies

Operando infrared (IR) spectroscopy and density functional theory (DFT) calculations were combined to investigate the selective catalytic reduction (SCR) of NOx by NH3 over H-AFX zeolites. The steady-state kinetics shows that SCR reactions involving NO2 proceed much more rapidly than those of NO. Data from in situ IR combined with online mass spectrometry under transient conditions demonstrate that Bronsted acid sites (BASs) promote the reaction of NO2 with NH3 to form N-2, H2O, and NH4NO3 at low temperatures (50-150 degrees C). In combination with DFT results, these data suggest that NO promotes the reduction of NH4NO3 to NRINO2, which then decomposes into N-2 and H2O. Therefore, the accumulation of NH4NO3 in the zeolite is inhibited by NO. Furthermore, when NO is absent, NH4NO3 decomposition into N2O and H2O occurs only at high temperatures (>200 degrees C). A comparison of H-AFX and Cu-AFX implies that Cu sites are not active for the reduction of NO2 by NH3 and that BASs are responsible for the NH3-SCR reactions involving NO2