Abstract: The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.
Abstract: Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.
Abstract: The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.
Abstract: The rapid aging of the population is a common trend in the world. However, the progress of modern medical technology has increased the average life expectancy. The global population structure has changed dramatically, and the elderly population has risen rapidly. In the face of rapid population growth, it must be noted issues of the aging population must face up to, which are the physiological, psychological, and social problems associated with aging. This study aims to investigate how insurance agents are actively dealing with an aging society, their own aging anxiety, and their exercise habits. Purposive sampling was the sampling method of this study, a total of 204 respondents were surveyed and 204 valid surveys were returned. The returned valid ratio was 100%. Statistical method included descriptive statistics, t-test, and one-way ANOVA. The results of the study found that the insurance agent’s age, seniority, exercise habits to aging anxiety are significantly different.
Abstract: The preservation of historical Italian heritage, at the urban and architectural scale, has to consider restrictions and requirements connected with conservation issues and usability needs, which are often at odds with historical heritage preservation. Recent decades have been marked by the search for increased accessibility not only of public and private buildings, but to the whole historical city, also for people with disability. Moreover, in the last years the concepts of Smart City and Healthy City seek to improve accessibility both in terms of mobility (independent or assisted) and fruition of goods and services, also for historical cities. The principles of Inclusive Design have introduced new criteria for the improvement of public urban space, between current regulations and best practices. Moreover, they have contributed to transforming “special needs” into an opportunity of social innovation. These considerations find a field of research and analysis in the historical city of Venice, which is at the same time a site of UNESCO world heritage, a mass tourism destination bringing in visitors from all over the world and a city inhabited by an aging population. Due to its conformation, Venetian urban fabric is only partially accessible: about four thousand bridges divide thousands of islands, making it almost impossible to move independently. These urban characteristics and difficulties were the base, in the last 20 years, for several researches, experimentations and solutions with the aim of eliminating architectural barriers, in particular for the usability of bridges. The Venetian Municipality with the EBA Office and some external consultants realized several devices (e.g. the “stepped ramp” and the new accessible ramps for the Venice Marathon) that should determine an innovation for the city, passing from the use of mechanical replicable devices to specific architectural projects in order to guarantee autonomy in use. This paper intends to present the state-of-the-art in bridges accessibility, through an analysis based on Inclusive Design principles and on the current national and regional regulation. The purpose is to evaluate some possible strategies that could improve performances, between limits and possibilities of interventions. The aim of the research is to lay the foundations for the development of a strategic program for the City of Venice that could successfully bring together both conservation and improvement requirements.
Abstract: Socio-economic development, which is seen around
the world today, has contributed to the emergence of new problems
of a social nature. Different political, historical, geographical or
economic conditions cause that, in addition to global issues of social
policy such as an aging population, unemployment, migration,
countries, regions, there are also specific new problems that require
diagnosis, individualized approach and efficient, planned solutions.
These should include, among others, digital addiction, peer violence,
obesity among children, the problem of ‘legal highs’, stress,
depression, diseases associated with environmental pollution etc. The
central authorities, selected most often with the tools specific to
representative democracy, that is, the general election, for many
reasons, inter alia, organizational, communication, are not able to
effectively diagnose their intensity, territorial distribution, and thus to
effectively fight them. This article aims to show how in Poland,
citizens influence solving problems related to the broader social
policy implemented at the local government level and indicates the
possibilities of improving those solutions. The conclusions of
theoretical analysis have been supported by empirical studies, which
tested the use of instruments of participatory democracy in the
planning and creation of communal strategies for solving social
problems in one of the Polish voivodeships.
Abstract: We are facing serious problems related to long-term
depopulation and an aging society with a falling birth rate in Japan. In
this situation, we are suffering from a shortfall in human resources as
well as a shortage of workforce in rural regions. In addition, we are
struggling with a protracted economic slump and excess concentration
of population in the Tokyo Metropolitan area. It is an urgent national
issue to consider how to live in this country and what kind of structure
of society and administration policy is needed. It is necessary to clarify
people’s desire for their way of living and social assistance to be
provided. The aim of this study is to clarify the characteristics of
regional issues and the degree of their seriousness in local
municipalities of Japan. We conducted a questionnaire survey about
regional agenda in all local municipalities in Japan. We obtained
responses concerning the degree of seriousness of regional issues and
degree of importance of policies. Based on the data gathered from the
survey, it is apparent that many local municipalities are facing an
aging population and declining population. We constructed a model to
analyze factors for declining population. Using the model, it was
clarified that a population’s age structure, job opportunities and
income level affect the decline of population. In addition, we showed
the way of the evaluation of state of local municipality.
Abstract: An analysis of the Australian Diabetes Screening
Study estimated undiagnosed diabetes mellitus [DM] prevalence in a
high risk general practice based cohort. DM prevalence varied from
9.4% to 18.1% depending upon the diagnostic criteria utilised with
age being a highly significant risk factor. Utilising the gold standard
oral glucose tolerance test, the prevalence of DM was 22-23% in
those aged >= 70 years and
Abstract: Japanese society is experiencing an aging population and declining birth rate along with the popularization of higher education, spread of economic globalization, rapid progress in technical innovation, changes in employment conditions, and emergence of a knowledge-based society. Against this background, interest in career education at Japanese universities has increased in recent years. This paper describes how the government has implemented career education policies in Japan, and introduces the cases of two universities that have successfully linked career education to university education in Japan.
Abstract: Due to the rise of aging population, effective utilization
of healthcare resources has become an important issue. With the
advance of ICT technology, the application of tele-healthcare service
has received more attention than ever. The main purpose of this
research is to investigate how to conduct innovative design for
tele-healthcare service based on user-s perspectives. First, the
healthcare service blueprint was used to describe the processes
of tele-healthcare service delivery, and then construct PZB service
quality gap model based on the literature and practitioners-
interviews. Next, TRIZ theory is applied to implement service
innovation. We found the proposed service innovation procedures can
effectively improve the quality of service design.
Abstract: Environment today is featured with aging population,
increasing prevalence of chronic disease and complex of medical
treatment. Safe use of pharmaceutics relied very much on the efforts
made by both the health- related organizations and as well as the
government agencies. As far as the specialization concern in providing
health services to the patients, the government actively issued and
implemented the divisions of medical treatment and pharmaceutical to
improve the quality of care and to reduce medication errors and ensure
public health. Pharmaceutical sub-sector policy has been implemented
for 13 years. This study attempts to explore the factors that affect the
patients- behavior intention of refilling a prescription from a NHIB
pharmacy. Samples were those patients refilling their prescriptions
with the case NHIB pharmacies. A self-administered questionnaire
was used to collect respondents- information while the patients or
family members visit the pharmacy for the refilling. 1,200
questionnaires were dispatched in 37 pharmacies that randomly
selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas.
732 responses were gained with 604 valid samples for further analyses.
Results of data analyses indicated that respondents- attitude,
subjective norm, perceived behavior control and behavior intentions
toward refilling behavior varied from some demographic variables to
another. This research also suggested adding actual behavior, either by
a self-report or observed, into the research.
Abstract: Falling has been one of the major concerns and threats
to the independence of the elderly in their daily lives. With the
worldwide significant growth of the aging population, it is essential
to have a promising solution of fall detection which is able to operate
at high accuracy in real-time and supports large scale implementation
using multiple cameras. Field Programmable Gate Array (FPGA) is a
highly promising tool to be used as a hardware accelerator in many
emerging embedded vision based system. Thus, it is the main
objective of this paper to present an FPGA-based solution of visual
based fall detection to meet stringent real-time requirements with
high accuracy. The hardware architecture of visual based fall
detection which utilizes the pixel locality to reduce memory accesses
is proposed. By exploiting the parallel and pipeline architecture of
FPGA, our hardware implementation of visual based fall detection
using FGPA is able to achieve a performance of 60fps for a series of
video analytical functions at VGA resolutions (640x480). The results
of this work show that FPGA has great potentials and impacts in
enabling large scale vision system in the future healthcare industry
due to its flexibility and scalability.