Lighting Effects on Older Adults’ Visual and Nonvisual Performance: A Systematic Review

Lighting plays an important role in daily life: It helps people perform daily activities independently and safely, and also benefits their health. This study assesses the research evidence of lighting’s impacts on older adults in four domains: (a) performance of activities of daily living and instrumental activities of daily living; (b) circadian rhythm; (c) fall prevention and postural stability; and (d) sleep quality. A comprehensive review of lighting studies on older adults’ visual and nonvisual performance was conducted using a modified PRISMA systematic review process. For the first domain, some older adults had difficulty in using the toilet, preparing meals, and doing laundry under lower illuminance. For the second domain, brighter and bluish lighting improved older adults’ circadian rhythm. For the third domain, low-intensity LED lighting affixed on door frames can help older adults maintain postural stability and prevent falling during nighttime movement. Finally, some studies concluded that receiving outdoor daylight during exercise was beneficial to older adults’ sleep quality. This study provides several methodological, theoretical, and collaborative suggestions for developing a more conclusive evidence base for lighting standards and strategies for older adults.     

Joint distribution of rises,falls, and number of runs in random sequences

By using the matrix formulation of the two-step approach to the distributions of runs, a recursive relation and an explicit expression are derived for the generating function of the joint distribution of rises and falls for multivariate random sequences in terms of generating functions of individual letters, from which the generating functions of the joint distribution of rises, falls, and number of runs are obtained. An explicit formula for the joint distribution of rises and falls with arbitrary specification is also obtained.     

Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses

Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fall-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.     

Diabetes mellitus in older men

Most persons with diabetes mellitus are over the age of 60 years. Males develop diabetes more commonly than females. Older diabetics tend to have both impaired insulin release as well as insulin resistance. In older persons diabetes mellitus is associated with decreased functional status and cognitive dysfunction. In general, older persons with diabetes are inclined to be underdiagnosed and undertreated. Managing diabetes in older persons requires special considerations because of their differences in pathophysiology of diabetes and strong association with functional, cognitive impairments and comorbidities. The use of strict therapeutic diets is not recommended in older persons. Treatment of hypertension and hyperglycemia can improve outcomes in older persons. The interdisciplinary team approach is important for care of older diabetic persons.     

Fall-related injuries in Amsterdam: Frail older women at risk

ABSTRACT

Unintentional falls are a common cause of injury, especially among older persons. This study evaluates risk factors such as gender and age on morbidity and mortality after unintentional falls. Data were collected retrospectively for patients with a unintentional fall who were presented to the emergency department in 2013. A total of 3,217 patients were included; the majority were female. Patients over 65 years of age had a significant higher mortality and a longer length of hospital stay. Older women are at risk for sustaining a fall-related injury. Female gender is furthermore associated with increased length of stay in the hospital. Prevention should focus especially on these frail patients.     

从《文选》看中古作家的地域分布

考察《文选》所选录的中古作家的地域分布,可以看出该时期不同发展阶段各地文学盛衰变化的情况。大致说来,从西汉中叶直到东汉前半期,关中一带的学术、文艺极为繁荣。随着东汉迁都洛阳,太学等学术中心亦随之东移,士子辐辏于洛阳,曾是全国文化中心的关中地区逐渐衰落。东汉的"羌乱"及西部人民东迁对后来的文坛格局产生了较大的影响。《文选》选录三国时代作家二十二人,大部分集中于东部地区。西晋运祚虽短,但被《文选》选录的作家却达三十二人,其地域分布似较两汉、三国有所扩大,但人数最多的仍然是今山东和河南的黄河沿岸一带及淮北地区,这些地方从战国以来,就是学术和文化最兴盛之地。《文选》选录东晋南朝作家共三十六人,绝大部分为黄河以南人氏,形成这一状况的原因是多方面的。     

A systematic review of the association between lower urinary tract symptoms and falls,injuries, and fractures in community-dwelling older men

Background: Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men.

Methods: We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men. Medline, Embase, and Cinahl were searched for any type of observational study that has been published in a peer-reviewed journal in English language. Studies were excluded if they did not report male-specific data or targeted specific patient populations. Results were summarized qualitatively.

Results: Three prospective cohort studies and six cross-sectional studies were identified. Incontinence, urgency, nocturia, and frequency were consistently shown to have weak to moderate association with falls (the point estimates of odds ratio and relative risk ranged from 1.31 to 1.67) in studies with low risk of bias for confounding. Only frequency was shown to be associated with fractures.

Conclusions: Urinary incontinence and lower urinary tract storage symptoms are associated with falls in community-dwelling older men. The circumstances of falls in men with LUTS need to be investigated to generate hypotheses about what types of interventions may be effective in reducing falls.     

Serious psychological distress,sex, and falls among the elderly

Serious psychological distress and falls are two major public health problems among the elderly. This study aims to test the hypothesis that although serious psychological distress can increase the risks of falls among the elderly, it tends to affect elderly women more than elderly men. Data of this study are from the 2011 California Health Survey Interviews (CHIS). We extracted a sample of 13,153 respondents aged 65 and older for this study, including 8,087 females and 5,066 males. We tested both unadjusted and adjusted interaction effects using bivariate and multivariate logistic regression analysis. Elderly women with serious psychological distress had the greatest likelihood of falls as compared to men with serious psychological distress and men and women without serious psychological distress. With respect to the covariates, limitations of physical activity and poor self-rated health status, Asian race, and older age were more likely to be associated with falls. This study provides further information on sex disparities of falls among the elderly such that serious psychological distress has a greater impact on falls for elderly women than elderly men. Thus, the findings of our studies suggest that mental health services and intervention can be useful to prevent falls for elderly women.     

从全台失陷后的史料再探乙未台湾抗战的动机

从全台失陷后的台民抗战史料中可以看出,乙未年台湾人民所掀起的那场轰轰烈烈的抗日反割台斗争,绝非仅如岛内某些人所说仅仅"只是一场地域乡民的保卫乡土的斗争",而且始终未曾偏离过保存中国领土台湾免遭日本割占、保护台湾之中国人免遭沦为"倭奴"的悲惨命运这一根本目的,乙未台湾抗战之所以兴起,更主要是源于广大台湾人民强烈的爱国意识与民族感情。