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Practices Used in Health and Social Services for the Management of Mistreatment Situations towards Adults in a Context of Gender and Sexual Diversity: A Scoping Review 在性别和性取向多样性的背景下,卫生和社会服务机构在处理虐待成年人情况时采用的做法:范围审查
Pub Date : 2024-07-17 DOI: 10.21926/obm.geriatr.2403282
Mélanie Couture, Julien Gauthier-Mongeon, Pearce Simamonika, Rosalie Bernard, Kevin St-Martin, Rosalie Lacasse, S. Israel
Research indicates that adults in the context of gender and sexual diversity (GSD) experienced more violence and discrimination than the rest of the population. GSD refers to all the diversities of sexual characteristics, sexual orientations and gender identity of a person or a group. To encourage the use of evidence-based interventions in health and social services, it is important to extrapolate from the scientific literature how mistreatment situations are managed in this context. A scoping review was conducted using the approach of the Johanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. In total, 8 databases were searched for relevant studies published in English and in French. Screening according to inclusion criteria (titles, abstracts, and full texts) and data extraction were performed independently by two team members. Twelve studies were included in this scoping review and covered only three types of mistreatments: intimate partner violence, discrimination, and sexual assaults. Findings suggest a need for tools to better identify mistreatment situations in the context of GSD and additional studies to highlight effective interventions using adequate methodology. None of the studies reported data specifically about older adults or regarding key care events related to the management of mistreatment situations (reporting, needs assessment or investigation). Implications include addressing gaps in research and better educating care providers in health and social services in matters related to GSD, to ensure that they have a better understanding of the needs and realities of this population.
研究表明,性别和性取向多样性(GSD)背景下的成年人比其他人遭受更多的暴力和歧视。GSD 是指一个人或一个群体在性特征、性取向和性别认同方面的所有多样性。为了鼓励在卫生和社会服务中使用循证干预措施,必须从科学文献中推断在这种情况下如何处理虐待情况。我们采用约翰娜-布里格斯研究所(Johanna Briggs Institute)的方法和《系统性综述和元分析协议扩展的首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews)指南进行了范围界定综述。共检索了 8 个数据库中以英语和法语发表的相关研究。根据纳入标准(标题、摘要和全文)进行的筛选和数据提取由两名团队成员独立完成。本次范围界定审查共纳入了 12 项研究,仅涉及三种虐待类型:亲密伴侣暴力、歧视和性侵犯。研究结果表明,我们需要一些工具来更好地识别 GSD 中的虐待情况,并需要更多的研究来强调使用适当方法的有效干预措施。没有一项研究专门报告了有关老年人或与虐待情况管理(报告、需求评估或调查)相关的关键护理事件的数据。研究的意义包括弥补研究方面的不足,更好地教育卫生和社会服务部门的护理人员与 GSD 相关的问题,以确保他们更好地了解这一群体的需求和现实情况。
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引用次数: 0
Integrating Palliative Medicine into Medical Education: Creating a More Compassionate Generation of Physicians 将姑息医学融入医学教育:培养更具同情心的新一代医生
Pub Date : 2024-07-01 DOI: 10.21926/obm.geriatr.2403281
Regina M. Mackey, Macaila Eick, Sara Jacobsen, Abraham Labrada Satiago, M. Lapid
How should Palliative Medicine competencies be taught to medical students? In the United States and other countries, there is a consensus that teaching Palliative Medicine competencies to medical students is essential. Health agencies have also identified teaching Palliative Medicine competencies as crucial. According to Sanchez-Reilly and Ross, medical students reported that they feel better prepared to care for the elderly, patients with severe illness, and dying patients after completing formal training. The authors hypothesized that a one-week rotation with Palliative Medicine during the Medicine Clerkship would improve the medical students’ skills to care for these populations of patients. The one-week inpatient rotation was designed to equip all fifty medical students at Mayo Medical School with a knowledge base of Palliative Care, communication skills, care for elderly frail and dying patients, and basic pain management for patients with severe illness. Each of the fifty students rotated with a Palliative Care consulting team with patient interaction, lectures, online teaching, and interdisciplinary team activities. Hands-on learning proved more effective than using just the classroom teaching classical model, with 70% of students responding positively to the hands-on approach. Learning how to apply Palliative Care skills while visiting patients with complex diseases, showed to be better received as an education module. Out of the fifty medical students surveyed, thirty-five responded (70%), and all responses were positive. This method of teaching could be expanded to teach other advanced hospice and palliative care skills.
应如何向医科学生传授姑息医学能力?在美国和其他国家,向医科学生传授姑息医学能力已成为共识。卫生机构也认为教授姑息医学能力至关重要。根据桑切斯-赖利和罗斯的研究,医科学生报告说,在完成正规培训后,他们觉得自己在护理老年人、重病患者和垂危病人方面准备得更好了。作者假设,在医学实习期间进行为期一周的姑息医学轮转将提高医学生护理这些病人群体的技能。为期一周的住院病人轮转旨在让梅奥医学院的所有 50 名医科学生掌握姑息治疗的知识基础、沟通技巧、老年体弱和垂死病人的护理以及重症病人的基本疼痛管理。这 50 名学生分别与一个姑息关怀咨询团队轮换,进行病人互动、讲座、在线教学和跨学科团队活动。实践证明,实践学习比单纯使用课堂教学的经典模式更有效,70% 的学生对实践方法给予了积极回应。学习如何在探望复杂疾病患者时应用姑息关怀技能,作为一个教育模块,效果更好。在接受调查的 50 名医学生中,有 35 人(70%)做出了回应,所有回应都是积极的。这种教学方法可以推广到其他高级临终关怀和姑息关怀技能的教学中。
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引用次数: 0
Exploration of Dementia Help Seeking Behaviours Amongst UK South Asian Communities: A Systematic Review 英国南亚社区痴呆症患者寻求帮助的行为探索:系统回顾
Pub Date : 2024-05-10 DOI: 10.21926/obm.geriatr.2402279
Shashya Wijesinghe, E. Mukaetova-Ladinska
In the UK, 25,000 people from ethnic minority background live with dementia. Although dementia associated risk factors are common amongst South Asians, they tend to present at services later and when in crisis. This review explores UK South Asian communities perception of dementia to understand factors impacting their decision to seek help. Search terms assisted by the PICO strategy were inputted into five databases and ten qualitative papers identified. Meta-ethnography methodological framework was implemented for analysis. Four overarching understandings were identified: unfamiliarity with dementia (related to carers initial interpretation of dementia symptoms as normal ageing), cultural expectations to provide care (influenced by communities believes), services not being able to meet cultural needs impacted carers from seeking help and protective factors (religion and community belonging appear to help carers manage their needs). Carers decisions to seek help from dementia services were often influenced by cultural norms and negative experiences of services. They, consequently, turned to alternative approaches to best suit meet their needs. Understanding South Asian’s carers dementia help seeking behaviour would help services adapt and cater appropriately for service users’ needs.
在英国,有 2.5 万名来自少数民族背景的痴呆症患者。虽然痴呆症的相关风险因素在南亚人中很常见,但他们往往较晚出现在服务机构中,而且是在危机中出现。本综述探讨了英国南亚族群对痴呆症的看法,以了解影响他们决定寻求帮助的因素。在 PICO 策略的辅助下,我们将检索词输入了五个数据库,并确定了十篇定性论文。采用元人种学方法框架进行分析。确定了四种主要的理解:对痴呆症的不熟悉(与照护者最初将痴呆症症状解释为正常衰老有关)、对提供照护的文化期望(受社区信仰的影响)、服务无法满足文化需求影响照护者寻求帮助以及保护性因素(宗教和社区归属似乎有助于照护者管理自己的需求)。照护者向痴呆症服务机构寻求帮助的决定往往受到文化规范和服务机构负面经验的影响。因此,他们转而寻求其他最能满足其需求的方法。了解南亚裔痴呆症照护者的求助行为将有助于服务机构调整并适当满足服务使用者的需求。
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引用次数: 0
Impact of Sex and Gender Differences on Heart Failure, Especially in Elderly Patients 性别差异对心力衰竭(尤其是老年患者)的影响
Pub Date : 2024-03-11 DOI: 10.21926/obm.geriatr.2401273
G. Cocco, Hans Peter Hofmann, Stefano Pandolfi
Heart failure is one of the major health threats in Western societies, and its prevalence is steadily increasing. Many data show the important impact of sex (biological) and gender (sociocultural) differences on most aspects (diagnosis, etiology, treatments, and outcomes) of heart failure. For example, compared to men, women with heart failure are older, have more co-morbidities, and develop different phenotypes of heart failure. Postpartum cardiopathy is unique in women. The iatrogenic effects of cancer therapies are more frequent among women compared to men. Currently, the integration of sex and gender differences into the therapy of heart failure is rare. Consequently, women derive disadvantages from a nonspecifically adapted therapy for heart failure, get worse outcomes, and have more iatrogenic adverse effects than men. This situation is medically unfortunate and increases medical expenditures. A sex-guided approach to the correct evaluation of patients with heart failure should become the cornerstone for the correct management of these patients.
心力衰竭是西方社会的主要健康威胁之一,其发病率正在稳步上升。许多数据显示,性(生物学)和性别(社会文化)差异对心力衰竭的大多数方面(诊断、病因、治疗和结果)都有重要影响。例如,与男性相比,女性心力衰竭患者的年龄更大,合并疾病更多,心力衰竭的表型也不同。产后心脏病在女性中是独一无二的。与男性相比,女性更容易受到癌症疗法的先天性影响。目前,将性和性别差异纳入心力衰竭治疗的情况还很少见。因此,与男性相比,女性在心力衰竭治疗中处于不利地位,治疗效果更差,先天性不良反应更多。这种情况在医学上是不幸的,也增加了医疗支出。对心力衰竭患者进行正确评估的性别指导方法应成为正确管理这些患者的基石。
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引用次数: 0
Mental Health among the Elderly in Nepal: Special Emphasis on Depression 尼泊尔老年人的心理健康:特别关注抑郁症
Pub Date : 2024-02-08 DOI: 10.21926/obm.geriatr.2401268
A. Risal, D. Kunwar, Barsha Shrestha
This paper discusses the impact of Depression on the aging population. It also tries to explore the psychosocial risk factors and burden associated with geriatric depression in low-and-middle-income (LAMI) countries. Nepal, a South Asian developing country, is resource-poor and research-naïve. Research, in general, and mental health studies, in particular, are the least prioritized in this country. The lack of culturally adapted psychiatric inventories is one of the possible reasons for the low number of mental health research in Nepal. However, recent studies done at the local and regional levels show a significant load of depressive symptoms among the elderly in Nepal.
本文讨论了抑郁症对老龄人口的影响。本文还试图探讨中低收入国家与老年抑郁症相关的社会心理风险因素和负担。尼泊尔是一个南亚发展中国家,资源匮乏且缺乏研究。研究,尤其是心理健康研究,在这个国家是最不被优先考虑的。缺乏适合本国文化的精神病学清单可能是尼泊尔心理健康研究数量较少的原因之一。不过,最近在地方和区域一级进行的研究表明,尼泊尔老年人的抑郁症状很严重。
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引用次数: 0
Mental Health among the Elderly in Nepal: Special Emphasis on Depression 尼泊尔老年人的心理健康:特别关注抑郁症
Pub Date : 2024-02-08 DOI: 10.21926/obm.geriatr.2401268
A. Risal, D. Kunwar, Barsha Shrestha
This paper discusses the impact of Depression on the aging population. It also tries to explore the psychosocial risk factors and burden associated with geriatric depression in low-and-middle-income (LAMI) countries. Nepal, a South Asian developing country, is resource-poor and research-naïve. Research, in general, and mental health studies, in particular, are the least prioritized in this country. The lack of culturally adapted psychiatric inventories is one of the possible reasons for the low number of mental health research in Nepal. However, recent studies done at the local and regional levels show a significant load of depressive symptoms among the elderly in Nepal.
本文讨论了抑郁症对老龄人口的影响。本文还试图探讨中低收入国家与老年抑郁症相关的社会心理风险因素和负担。尼泊尔是一个南亚发展中国家,资源匮乏且缺乏研究。研究,尤其是心理健康研究,在这个国家是最不被优先考虑的。缺乏适合本国文化的精神病学清单可能是尼泊尔心理健康研究数量较少的原因之一。不过,最近在地方和区域一级进行的研究表明,尼泊尔老年人的抑郁症状很严重。
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引用次数: 0
Using Elder Abuse Case Studies to Develop LGBTQ+ Cultural Competency 利用虐待老人案例研究培养 LGBTQ+ 文化胜任能力
Pub Date : 2024-01-15 DOI: 10.21926/obm.geriatr.2401266
Loree Cook-Daniels
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) elders are vulnerable to both the “usual” types of elder abuse (physical, sexual, emotional, and financial abuse, along with neglect), and with abuse that is specific to the context and history of LGBTQ+ elders. Training for adult protective services, long-term care ombudsmen, and other professionals who work with abused elders therefore should include information and skill-building in responding to this population. Research into effective training about LGBTQ+ elders indicates that interactive training activities such as case studies are critical components. This paper presents six case studies of LGBTQ+ elder abuse, representing financial and physical abuse, intimate partner violence, sexual abuse, neglect, and abandonment. Victims are transgender, lesbian, and gay. Each case study is accompanied by a discussion of key elements in the case, and includes discussion questions and developer comments to help integrate the cases into a comprehensive curricula.
女同性恋、男同性恋、双性恋、变性人和同性恋(LGBTQ+)老人既容易受到 "通常 "类型的虐待(身体虐待、性虐待、情感虐待、经济虐待以及忽视),也容易受到 LGBTQ+ 老人的背景和历史所特有的虐待。因此,对成人保护服务机构、长期护理监察员以及其他与受虐老年人打交道的专业人员的培训应包括应对这一群体的信息和技能建设。对 LGBTQ+ 老年人进行有效培训的研究表明,案例研究等互动培训活动是关键的组成部分。本文介绍了六个 LGBTQ+ 虐待老人的案例研究,分别涉及经济和身体虐待、亲密伴侣暴力、性虐待、忽视和遗弃。受害者为变性人、女同性恋和男同性恋。每个案例研究都附有对案例中关键因素的讨论,还包括讨论问题和开发人员的评论,以帮助将案例整合到综合课程中。
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引用次数: 0
Acknowledgement to Reviewers of OBM Geriatrics in 2023 向《2023 年老年医学》审稿人致谢
Pub Date : 2024-01-04 DOI: 10.21926/obm.geriatr.2401265
Obm Geriatrics Editorial Office
The editors of OBM Geriatrics would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2023. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal’s editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to the service Publons (https://publons.com) to receive recognition. Of course, in these initiatives we are careful not to compromise reviewer confidentiality. Many reviewers see their work as a voluntary and often unseen part of their role as researchers. We are grateful to the time reviewers donate to our journals and the contribution they make.
OBM Geriatrics》编辑衷心感谢以下审稿人对 2023 年的稿件进行了评估。我们非常感谢专家审稿人的贡献,这对期刊的编辑过程至关重要。我们旨在通过多种机制表彰审稿人的贡献,每年公布审稿人姓名就是其中之一。审稿人会收到一张优惠券,让他们在下一期《LIDSEN》出版物上享受折扣,并可直接从我们的投稿系统下载认可证书。此外,审稿人还可以注册使用 Publons (https://publons.com) 服务,以获得表彰。当然,在这些举措中,我们注意不损害审稿人的保密性。许多审稿人认为他们的工作是自愿的,而且往往是他们作为研究人员的职责中不为人知的一部分。我们非常感谢审稿人为我们的期刊付出的时间和做出的贡献。
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引用次数: 0
Active Aging for L.I.F.E.: An Intergenerational Program for Addressing and Changing Attitudes Toward Longevity 积极老龄化促进 L.I.F.E.:解决和改变对长寿态度的代际计划
Pub Date : 2023-12-27 DOI: 10.21926/obm.geriatr.2304264
Emily Roberts, Greg Clare, Mahendran Balasubramanian, Quinn Button
The global population of adults 65 years of age and older will increase dramatically over the next several decades, presenting economic and social challenges requiring sustainable solutions. Aging is a process in which everyone is already involved, it is a lifelong experience not just a later life occurrence. Changing world demographics illustrate that people are living longer, among the world’s young people, survival to age 80 is expected to be commonplace. This new found “longevity dividend” needs to be maximized and enjoyed. Increased longevity and worldwide aging are constantly in the public view, yet preparing people for this long life has received little attention. People need to be prepared to live a long life in an aging world and one way to achieve this is through aging education. Aging education across the lifespan can prepare people for the long life ahead of them, promote aging with optimism, and combat ageism. This paper reports on the Active Aging for L.I.F.E. four-part education program which was shared with 91 high school students. The program brought the domains of Longevity, Independence, Fitness and Engagement to the high school students through an intergenerational team of older adults and college age students, using an experimental design to test the outcomes in student perceptions of their own longevity in the context of the L.I.F.E. programming. The treatment group findings showed that the students perceptions about aging and longevity were impacted. In addition, written responses reflected the value of the programming through participant understanding of the impact of lifestyle, diet and social interaction on successful aging through the lifespan.
在未来几十年里,全球 65 岁及以上的成人人口将急剧增加,带来经济和社会挑战, 需要可持续的解决方案。老龄化是一个每个人都已参与其中的过程,它是一个人一生的经历,而不仅仅是晚年的事。不断变化的世界人口结构表明,人们的寿命越来越长,预计世界上的年轻人活到 80 岁已是司空见惯的事。我们需要最大限度地利用和享受这一新发现的 "长寿红利"。寿命延长和全球老龄化问题一直是公众关注的焦点,但人们为长寿做好准备却很少受到关注。人们需要为在老龄化世界中长寿做好准备,而实现这一目标的方法之一就是开展老龄化教育。全生命周期的老龄化教育可以让人们为未来的长寿做好准备,以乐观的态度促进老龄化,并与老龄歧视作斗争。本文介绍了由四个部分组成的 "积极老龄化促进长寿教育计划",该计划由 91 名高中生参与。该计划通过一个由老年人和大学生组成的代际团队,将长寿、独立、健身和参与等领域的知识传授给高中学生,并采用实验设计来测试学生在 L.I.F.E. 计划背景下对自身长寿的看法。治疗组的研究结果表明,学生对衰老和长寿的看法受到了影响。此外,书面答复也反映了该计划的价值,因为参与者了解了生活方式、饮食和社会交往对在整个生命周期中成功老龄化的影响。
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引用次数: 0
Cell Level- Modeling of Aging and Rejuvenation 细胞水平--衰老与年轻化建模
Pub Date : 2023-12-22 DOI: 10.21926/obm.geriatr.2304263
Andrey Koptyug, Yurij Sukhovei, Elena Kostolomova, I. Unger, Vladimir Kozlov
Understanding processes related to human aging and rejuvenation relies on experimental data and advanced models operating at different levels. There are several existing conceptual and specific modeling approaches. However, one of the existing tasks is compiling generic models linking properties at cell and cell-element levels to properties at systemic levels - tissue, organ, and whole body. One of the critical issues in the relevant models is the enormity of interacting components at the cell and sub-cell levels needed to represent the properties of high-level systems properly. This paper describes a promising approach to modeling and simulation at the cell population level for studying aging and rejuvenation. It also presents initial conclusions formulated based on the results of modeling and experiments coupled to it. The model is based on the concepts of the proliferation niche and homeostatic cell number stabilization in the cell population through the associated action of proliferation and apoptosis. Importantly, we address the issue of defining “aging” and “rejuvenation” for cell populations containing large numbers of cells of different ages. It is possible to demonstrate that homeostatic regulation can be performed by maintaining the concentration of a single regulatory substance. Predictions and simulations of the proposed model are compared to data from existing publications and experiments specifically conducted to validate the model. Currently, none of the available data contradicts the modeling results at the proposed level of detail. However, an inadequate number of elements and the employed statistical approach further limit progress in such modeling. Expanding the proposed method to include a realistic number of features representing human tissues, organs, and body and to allow for proper modeling of aging and rejuvenation processes requires more advanced modeling techniques.
要了解与人类衰老和年轻化有关的过程,有赖于实验数据和在不同层面运行的先进模型。现有几种概念和具体的建模方法。然而,现有的任务之一是编制通用模型,将细胞和细胞元素层面的特性与组织、器官和全身等系统层面的特性联系起来。相关模型中的一个关键问题是细胞和亚细胞水平上的交互组件数量巨大,需要正确地表示高层次系统的属性。本文介绍了一种在细胞群体水平上进行建模和模拟以研究衰老和返老还童的可行方法。本文还介绍了根据建模和实验结果得出的初步结论。该模型基于增殖生态位和细胞群中通过增殖和凋亡的相关作用实现细胞数量稳定的概念。重要的是,我们解决了包含大量不同年龄细胞的细胞群的 "衰老 "和 "年轻化 "的定义问题。我们有可能证明,通过维持单一调节物质的浓度,就能实现平衡调节。建议模型的预测和模拟结果与现有出版物中的数据以及为验证模型而专门进行的实验进行了比较。目前,没有任何可用数据与所建议的详细程度的建模结果相矛盾。然而,元素数量不足和采用的统计方法进一步限制了此类建模的进展。要将所建议的方法扩展到包括代表人体组织、器官和身体的现实特征数量,并对衰老和年轻化过程进行适当建模,需要更先进的建模技术。
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引用次数: 0
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OBM geriatrics
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