Abstract
Background
There are concerns that the COVID-19 pandemic could lead to a rise in mental health problems including anxiety amongst older people, especially those shielding alone during the ...pandemic.
The aim of this study therefore is to examine the prevalence of anxiety symptoms during the COVID-19 pandemic amongst older people and clarify factors associated with higher burden of symptoms.
Methods
We analysed data from the COVID-19 study of The Irish Longitudinal Study on Ageing, conducted on over 3,100 community dwelling people aged ≥60 years from July–November 2020.
Anxiety symptoms were measured with the Generalised Anxiety Disorder-7 Questionnaire with a score ≥ 10 indicating moderate–severe anxiety.
Linear regression models were used to assess the association of variables of interest with anxiety symptoms.
Results
Almost 9% of participants (n = 3,128; mean age 71 years) had moderate–severe symptoms of anxiety.
Factors independently associated with a higher burden of anxiety symptoms included female sex (β = 0.60 (0.33–0.87)); living alone (β = 0.72 (0.41–1.02)); ≥2 chronic diseases (β = 0.85 (0.41–1.30); heart disease (β = 0.95 (0.45–1.46)) and reporting frequent loneliness (β = 6.59 (6.03–7.16)). Age ≥ 80 years (β = −0.77 (−1.16—0.37)) and tertiary level education (β = −0.48 (−0.86—-0.10)) were associated with lower anxiety symptom burden.
Conclusion
Almost 1 in 10 of this population-representative sample of older people had moderate to severe anxiety symptoms during the COVID-19 pandemic.
Strategies to address loneliness, which was particularly strongly associated with anxiety symptoms during the pandemic, should be a priority.
Abstract
Background
The clinical frailty score (CFS) is a 9 point validated outcome measure used to measure function, mobility, cognition and co-morbidities in patients aged 65 or older. The ...physiotherapy department was restructured due to COVID-19 pandemic. This resulted in the formation of a mixed specialty team which consisted of Frailty Intervention Team (FIT), Medical Respiratory, Acute Medicine Service, Orthopaedics, General Rehabilitation and Care of the Older Person (COTOP). This service review aimed to identify frailty using the CFS across services and to compare CFS versus age, length of stay, falls history and discharge outcomes.
Methods
The CFS data was collected over two weeks. Inclusion criteria included patients who scored ≥4 on the CFS. Exclusion criteria included patients aged under 65. Variables such as age, history of falls, LOS and discharge destinations were compared across all services using Microsoft Excel.
Results
166 patients were included, the average CFS was 5.24 and the average age was 77.2 years. COTOP had the oldest (Av. age 85.4), frailest (Av. CFS 6.1) and longest avLOS (25.3 days) across all services. Frailty was prevalent across all services, with 81% of patients on the medical respiratory service classed as frail. Patients who scored a CFS of ≥4 had higher falls risk and greater LOS. Of the medical respiratory cohort only 12% were discharged to rehabilitation with 77% discharged home. Orthopaedics had the highest percentage of patients discharged to rehabilitation (44%), followed by the general rehabilitation (34%). Only 14% of the COTOP patients were transferred to rehabilitation.
Conclusion
A high incidence of frailty and falls history was identified across all services. Patients who scored lower on the CFS resulted in reduced LOS and were more likely to be discharged directly home. Proactive screening and detection of frailty allows for targeted interventions that may improve outcomes and inform early discharge planning.
Abstract
Background
The Sars-CoV-2 global pandemic placed an unprecedented demand on acute health services and led to significant morbidity and mortality in older populations. Nearly half of ...attendances to this ED are over the age of 65 years and there are over 80 nursing homes in the catchment area. A pilot study in January 2021 showed that nursing home attendances increased significantly during the third wave of COVID-19 with many of these attendances potentially avoidable and suitable for optimised care in the nursing home.
The primary objective of this quality improvement project was to enhance the older person’s care and experience when presenting to ED or being reviewed in the community with symptoms and signs of COVID-19. Secondary aims were reduced nursing home attendances to ED and subsequent admissions from these attendances.
Methods
A guideline was constructed based on the RCEM standard for Quality Care for Older People and using the HSE guidelines for managing COVID-19 in nursing home patients. The guideline was introduced to staff and implemented in ED and via the EDITH service.
Results
Two PDSA cycles were undertaken post guideline implementation. There were substantial improvements in the frequency of discussion and documentation of advanced directives with increased numbers of patients being discharged directly back to the nursing home or treated in the nursing home using the guideline. There was a decrease in the number of nursing home attendances throughout the project.
Conclusion
This successful QIP shows the importance of manging older patients appropriately, while considering their wishes. Post-COVID work should centre on managing all older patients with optimised treatment and considering how they will benefit most from their attendance to ED.
Abstract
Background
During the early months of the COVID-19 pandemic, older adults in Ireland experienced a threefold increase in the prevalence of loneliness while the percentage experiencing ...clinically significant depressive more than doubled. While loneliness and depression are related, the nature and directionality of this association is still unclear. This study describes changes in both depression and loneliness from before to during the COVID-19 pandemic and adds to the limited literature on the potential bi-directional nature of the association between loneliness and depression.
Methods
Data are from The Irish Longitudinal Study on Ageing (TILDA), a prospective nationally representative study of community-dwelling adults recruited from community-dwelling adults aged 50+. Data from three waves of TILDA, including a COVID-19 specific sub-study (n = 3,964), were included in the analyses. An auto-regressive cross-lagged panel modelling approach was used to estimate the effect of depression on loneliness and vice versa.
Results
Neither loneliness nor depression increased between the two time points prior to the COVID-19 pandemic and increased significantly during the pandemic. There was a bi-directional association between loneliness and depression across time while the strength of the correlation between the two was stronger during the pandemic than had previously been the case.
Conclusion
The COVID-19 pandemic has resulted in significant increases in both loneliness and depression among older adults. Furthermore, the bi-directional nature of the association between the two suggests that loneliness can both be considered a symptom of depression and that depression may foment a negative evaluation of an individual's social interactions resulting in greater loneliness.
Abstract
Background
The COVID-19 pandemic has disproportionately affected older adults, both in morbidity and mortality1. The effects of the pandemic go beyond contracting the SARS-CoV-2 virus, ...leading to devastating consequences, particularly for individuals over the age of 60. In Ireland, isolation in older adults was exacerbated by cocooning measures and geographical limitations. The purpose of this study was to explore the relationship between loneliness, frailty, and the utilisation of health services in a sample of sexagenarians in Ireland.
Methods
Adults aged 60–70 attending COVID-19 vaccine appointments at a Level 3 Hospital in Ireland (n = 75) were invited to participate in a 36-item questionnaire. Participants reported demographic information and questions regarding physical well-being, healthcare utilisation, lifestyle and behaviours, and impact of vaccination. The survey also included three validated questionnaires: PRISMA-7 for frailty, SARC-F for sarcopenia, and the UCLA 3-Item Loneliness Scale (UCLA-3ILS).
Results
Of the 75 survey respondents, the mean age was 63.2. 72% (n = 54) identified as female. 28% (n = 21) reported that they had been cocooning during the past year. While 84% (n = 63) of respondents reported that they cancelled routine medical appointments during the pandemic, none reported avoiding attending hospital. Five respondents met the criteria for frailty and four were identified as probable sarcopenic. There was no significant difference (p = 0.64) in mean scores on the UCLA 3-ILS between frail and non-frail individuals. Persons identified as sarcopenic were more likely to have higher scores on the UCLA-3ILS (p = 0.0005).
Conclusion
This research highlights the multifaceted relationship between frailty, loneliness, and healthcare utilisation among Irish adults ages 60–70 during the COVID-19 pandemic. Future research in program, policy, and intervention development for at-risk older adults, particularly those who are frail, sarcopenic, and/or lonely, can work to reduce associated negative outcomes.
Reference
1. Kang S-J and Jung, SI. (2020). Age-Related Morbidity and Mortality among Patients with COVID-19. Infect Chemother., 52(2): 154–164.
Abstract
Background
Whilst age and frailty are independently associated with mortality in COVID-19 illness, the underlying immunological mechanisms explaining this remain unexplored. We aimed to ...explore the impact of age and frailty on the acute immune response to COVID-19 illness.
Methods
We recruited older (aged 65+; n = 33) and younger (aged 20–50; n = 43) participants with acute COVID-19 illness for clinical assessment and detailed immunophenotyping for T-cell, neutrophil, monocyte and inflammatory markers using flow cytometry. We additionally assessed circulating levels of several important pro-inflammatory cytokines. Wilxocon rank-sum, chi-square tests and linear regression were used to examine the impact of age and frailty (Clinical Frailty Score 3–9) on the immune response in COVID-19 illness. Results were compared to age-matched pre-pandemic controls (n = 40).
Results
COVID-19 illness was associated with a marked pro-inflammatory response (raised CRP, IL-6, IL-2R), lymphopenia and emergency myelopoesis (an expansion of non-classical/intermediate monocytes and immature neutrophils) in both age groups (all P < 0.001). In comparison to younger participants (35.7 ± 8.6 years), older adults (76.7 ± 7.8 years) had a more marked reduction in naïve CD4+ and CD8+ cells and a more marked expansion of activated CD4+, CD8+ and effector CD8+ T-cells (all P < 0.001). These findings were independent of illness severity (all P < 0.001). In comparison to their younger counterparts, older adults had a reduced number of CD10+ neutrophils/non-classical monocytes and greater CRP, IL-6 and IL-2R (P < 0.05), although results were attenuated on adjusting for COVID-19 severity. Frailty was not associated with any significant difference in immune cell population or pro-inflammatory response in acute COVID-19 illness.
Conclusion
Increasing age, but not frailty status, was associated with reduced naïve T-cells and a more marked expansion of activated/effector T-cells in acute COVID-19 illness. These findings have important implications for understanding impact of age on anti-viral and pro-inflammatory immune responses.
Abstract
Background
Simulation-based medical education (SBME) is emerging as a key method of medical education, particularly in the setting of the COVID-19 pandemic. As part of a simulation ...development competition (SimStars) run by the National Doctors Training and Planning Unit and the South–South West Hospital Group, we brought together an inter-disciplinary team to develop a simulation scenario on hip fracture.
Methods
Our development team consisted of members of the Geriatric Medicine and Orthopaedic Departments. We developed a scenario that can be adapted to suit the needs of learners in orthopaedics, medicine, or nursing. We ran the simulation on a medical ward with one candidate and four facilitators from the Geriatric Medicine Department. The candidate (medical SHO) was presented with a patient (facilitator one), who had sustained a hip fracture following a fall. The candidate was directed to elicit a falls and bone health history, screen for delirium, and suggest further investigations and management. Subsequently, feedback was sought from all participants.
Results
The simulation took twenty minutes, debriefing took fifteen minutes. All considered, the simulation an enjoyable and feasible method for teaching and learning, and a novel way to promote team-building. The candidate felt competent in some areas, reporting that the scenario provided positive reinforcement. She reported feeling supported in identifying areas for further learning. The facilitators also considered this method a useful way to highlight a candidate’s learning needs and direct further teaching. The candidate requested further SBME-based sessions.
Conclusion
This SBME session in Ortho-Geriatrics was well-received by the candidate and facilitators. All participants enjoyed teaching and learning through this medium. Areas of high competency were reinforced and areas for future learning were identified. Further SBME was requested across more topics and for simulation training to be brought in as part of formal training.
Abstract
Background
Nationally agreed standards improve the level of care delivered to all older, frail, multi-morbid patients presenting with hip fractures. Dedicated Orthogeriatric services allow ...for these standards to be achieved in a multi-disciplinary team (MDT) setting. As the COVID-19 pandemic reached our shores, the model of care set out by the Irish Hip Fracture Standards (IHFS) was under threat. Our dedicated Orthopaedic Trauma ward became an acute COVID ward and the Orthogeriatric service was re-deployed to acute medicine for Quarter 2.
Methods
Using the Irish Hip Fracture Database, local data was analysed and compared with national data from Quarter 1 to 4 (Q1–4) in 2020.
Results
When comparing local IHFS’s with national figures, ongoing challenges and future goals are highlighted.
In 2020, there were 222 hip fracture patients (mean age 81.8 years) in our hospital. Standard 1, time to the ward <4 hours, stands at 71% locally (national average 33%). Standard 2, time to theatre <48 hours, is an ongoing challenge and remains at 66% (national average 75%). Standard 3, pressure ulcer rate, was the same as the national average at 3%. Standards 4, 5 and 6 in our hospital stand at 87% (national averages of 82%, 91% and 85% respectively).
In Q1, 56%, or over 1 in every 2 patients with hip fractures, met all of the Irish Hip Fracture Standards in our hospital. In Q2, only 18% of patients met all of the IHFS’s. Q3 saw improvements with 47% of all hip fracture patients achieving all IHFS’s. Q4 showed maintenance with 45% of all patients achieving all IHFS’s.
Conclusion
These findings highlight the need for a dedicated Orthogeriatric Service and Orthopaedic ward at all times. Going forward with the risk of future waves and the emergence of new variants, every effort should be made to maintain a comprehensive orthogeriatric service to minimise a negative impact on patient care.
Abstract
Background
With the rapid development of smart phones, the platform for people to obtain information and resources has shifted from traditional media carriers to smart phones and smart ...devices. Short video applications are favored by all users and capital, and the number of users, industry scale and social influence are increasing. Under the background of covid-19, the application of short format video has received unprecedented attention and influence. At present, short videos have gone beyond “watching” and added links with user experience, user psychology, consumer behavior and other factors. This paper attempts to analyze the development status of China's short video industry from the perspective of user experience and user psychology, and study the types of short video under different operating conditions, the differences of user experience and user psychology, and the changes of interactive thinking., Especially in the aspect of emotional behavior, it puts forward effective design strategies for the application industry.
Research Objects and Methods
This study compares and analyzes the visual interface, gesture operation and interaction mode of typical short video applications (taking Tiktok, Kwai and wechat account as examples) from three aspects: interface visual perception, interactive behavior perception and psychological experience. Through the comparative study of three short video application products, this paper analyzes the similarities and differences, advantages and disadvantages of Tiktok, fast and wechat channel functions, and summarizes the user experience and interaction design strategies of these short video applications. The questionnaire data collected 234 short video users through the online questionnaire in January 2022. The content is the questionnaire survey of “current situation of short video application”, which mainly analyzes the zero order correlation and covariance analysis between psychological duration. Personal users accept short format video and user experience problems. The use of emotional micro behavior in various countries and regions was investigated by questionnaire. The gross John Emotion Regulation Questionnaire (ERQ), a measurement tool of this study, has 10 items, which are divided into two factors: cognitive reappraisal and expression inhibition. Each item is scored with 7 points (1 = very non-conforming; 2 = relatively non-conforming; 3 = slightly non-conforming; 4 = uncertain; 5 = slightly conforming; 6 = relatively conforming; 7 = very conforming). The higher the score, the higher the tendency.
Results
Through the comparative study of three short video application products and user questionnaire survey results, it is concluded that there are differences in user experience attention, short video duration and psychological demand motivation among different ages. Compared with ordinary users, older users have a shorter time span to buy videos. They found that they spend more time on live video formats than ordinary users.
Conclusion
Short video application should fully integrate user experience, user psychology and interaction mode, with the goal of improving interaction experience, interface diversification and personalized design. Meet the needs of different groups of users, optimize the user experience, tap the potential needs of users, increase user stickiness, and enhance the value and competitiveness of short video applications.
Acknowledgements
Funded by College of Chinese & ASEAN Arts, Chengdu University, the major scientific research achievements.
Abstract
Background
Science Education in China is a way to improve citizens' scientific and technological literacy. It also popularized physics that promoted innovation. The deep popularization of ...physical science is an important content of science education. Therefore, it is necessary to explore the logical relationship and practical path between science education, college physics curriculum and science popularization, that is, the generalization of physics curriculum to science education and popular science from the perspective of emotional regulation.
Subjects and Methods
Apply Bruner's cognitive structure learning theory in psychology to college physics teaching, and transform the basic structure of physics into the cognitive structure of physical theories and phenomena in students' minds. In order to coordinate the development of physics courses and the popularization of science, the basic physics courses and majors of the University have been adjusted to help students understand the principles of physics and apply them to engineering. A total of 415 junior middle school students in three grades of an experimental middle school were investigated by cluster stratified sampling. The emotional regulation ability scale compiled by Lu Jiamei and Ji Jiajun (2010), the Chinese version of emotional behavior scale (PBI) revised by Yang Hongjun (2009) and the Chinese version of aggressive behavior (BWAQ) (2008) were used as research tools, and spss17 0 to analyze the data results by descriptive analysis, analysis of variance and linear regression.
Results
We found that while widely spreading science and technology, cultivating citizens' awareness of science and technology is a necessary condition for further popularizing science. We have identified four aspects of in-depth popularization of science. We have also created a four part physics course and created a teaching method that combines online and offline teaching, large and small classes, as well as theoretical and practical learning. Using various forms of science education, we have constructed three ways to provide ideological education in the curriculum. In the practice of many science education, we have not only proved that the most important part of physics education is scientific and technological literacy, but also formed the soul of basic physics curriculum: “explore laws after encountering phenomena, respond to principles creatively, and pursue loyalty and accuracy”. Based on the teaching philosophy and objectives of Xi University of technology, and taking two innovative points, three characteristic physics courses and popularization as the main line, this paper explores 30 elements of ideological education related to “physics, weapon industry and calligraphy”. These reforms were highly praised by the heads of 15 engineering majors related to the ordnance industry, and helped 13 engineering majors obtain China's higher engineering education certification.
Conclusion
After 10 years of educational practice, we have developed the physics curriculum to the stage of in-depth popularization of science. In the full combination of physics curriculum and engineering teaching, it embodies the three-stage learning process of acquisition, transformation and evaluation in Bruner's psychological theory. The scientific and technological literacy of Chinese teenagers has improved. In short, we should fully consider the important influence of emotion, actively pay attention to the changes of psychological emotion and behavior in their learning, and strive to become the manager, coordinator and collaborator of curriculum construction.
We should actively organize rich activities flexibly according to the psychological characteristics of this part of the group, strive to build a relaxed and harmonious living atmosphere, create a friendly and mutual aid relationship, encourage and guide this part of the group, adjust the psychology to the best state, and promote the healthy growth in a good learning life.
Acknowledgements
The paper was supported by the Shaanxi Social Science Foundation Project of P.R.C (Grant No.2021P022). The authors thanks for the Physical Multifunction Hall Focusing on Demonstration & Research in Xi’an Technological University (PMHFDRXATU), and the “Virtual Teaching-research Center on Cloud Teaching & Reform of Basic Physics in Universities of Midwest of China” led by Professor Shijun Xu. Further, this work was financially supported by three funding projects on the Teaching Reform in Universities of Shaanxi Province in China (Grant No. 21BY081), the 2021 Higher Education Science Research Project of Shaanxi Higher Education Society (Grant No.XGH21139), and the Soft Science Research Project of Xi'an Science and Technology Plan of P.R.C (Grant No.2021-0048).
