The Comparative Approach on Outdoor Leisure Behavior of Urban Elderly People： A Case Study in Beijing

With the income increase of elderly people in Beijing and the improvement of leisure facilities since 2000, the quality of elderly people leisure life in Beijing has obviously increased com- pared to t...     

The development of private sheltered housing in Scotland: a changing market

The provision of sheltered housing for sale in Scotland has experienced rapid growth since the opening of the first scheme in 1982. Development has been geographically concentrated in a small number of inner city and rural (coastal) areas. The expectation of continued rapid expansion is unlikely if recent trends of slower growth continue. This paper uses evidence from interviews with developers and owners of sheltered and mainstream housing, to examine the possible future contribution of the private market. On the basis of such evidence it raises questions about the relevance of some existing planning policies.     

Identifying and mapping community vulnerability

Disaster vulnerability is socially constructed, i.e., it arises out of the social and economic circumstances of everyday living. Most often discussed from the perspective of developing nations, this article extends the argument using American demographic trends. Examples from recent disasters, Hurricane Andrew in particular, illustrate how certain categories of people, such as the poor, the elderly, women-headed households and recent residents, are at greater risk throughout the disaster response process. Knowledge of where these groups are concentrated within communities and the general nature of their circumstances is an important step towards effective emergency management. Emergency planners, policy-makers and responding organisations are encouraged to identify and locate high-risk sectors on Community Vulnerability Maps, integrating this information into GIS systems where feasible. Effective disaster management calls for aggressively involving these neighbourhoods and groups at all levels of planning and response, as well as mitigation efforts that address the root causes of vulnerability.     

The casualties from electric bike and motorized scooter road accidents

Objective: The objective of this study was to describe demographic and injury characteristics of hospitalized injured patients involved in e-bike and motorized scooter accidents at a national level in Israel divided by different road user groups: riders and pedestrians.

Methods: This was a retrospective study based on data from the National Trauma Registry, between January 1, 2013, and December 31, 2015. All hospitalized casualties due to the involvement of an e-bike or motorized scooter were included. The type of hospitalized road user was further categorized and described by different variables.

Results: During the study period, the Israel Trauma Registry identified 795 hospitalized patients due to an e-bike or motorized scooter accident, with a dramatic 6-fold increase from 2013 to 2015. Although the majority of the injured patients were riders, 8% were pedestrians. Among the total casualties, 33% were children aged 0–14 years and among pedestrians 42% were children and 33% were seniors (ages 60+). Five persons died in hospital, 3 riders and 2 pedestrians.

Conclusions: E-bike and motorized scooter riders represent the majority of patients hospitalized due to related traffic incident. This finding questions the social and economic advantages of electric-powered 2-wheeled vehicles.     

Prevalence and concentrations of drugs in older suspected drugged drivers

Objective: Older drivers are somewhat more likely to be involved in car crashes than middle-aged drivers but less likely to be involved than younger drivers. This study aimed to assess the extent of drug use in older suspected drunk and drugged drivers, with respect to which drugs were detected and at which concentrations.

Methods: Blood samples from older suspected drunk and drugged drivers taken between February 1, 2012, and May 22, 2013, were identified from the database at the Norwegian Institute of Public Health and were retrospectively analyzed for a broad repertoire of drugs relevant for impairment. The prevalence of different drugs among the suspected drunk and drugged drivers was studied. Regarding drug concentrations, the findings in older drivers (>65 years) were compared to a reference group of apprehended drivers aged 20–40 years.

Results: Four hundred and ten older suspected drunk and drugged drivers were included. Any drug (including ethanol) was detected in 92% of blood samples, and ethanol was detected in 81%. Benzodiazepines were found in 15% of the older drivers and z-hypnotics (zopiclone or zolpidem) were detected in 13%. The most frequent single legal drugs found in blood samples taken from older impaired drivers were zopiclone (9.8%) and diazepam (9.3%). Regarding drug combinations, older drivers used a mean number of 1.4 drugs, and 20% of ethanol-positive cases showed at least one other drug. High drug concentrations of clonazepam and diazepam were more frequently seen in the younger group.

Conclusions: This study showed that drugs were detected in the vast majority of older drivers suspected for drunk or drugged driving. Ethanol was the most frequent drug detected, followed by zopiclone and diazepam. Older drivers combine drugs to a lesser degree than younger drivers, but their combination of ethanol and other drugs represents a considerable traffic risk. Lower concentrations of benzodiazepines are seen in older compared to younger drivers.     

老年患者罗哌卡因与布比卡因蛛网膜下腔阻滞效果的比较

比较老年患者下肢手术罗哌卡因与布比卡因蛛网膜下腔阻滞效果．方法：择期骨科下肢手术的高龄病人80例,随机分为两组,R组（n=40）蛛网膜下腔注入5mg／ml罗哌卡因3ml,B组（n=40）蛛网膜下腔注入5mg／ml布比卡因3m1．采用针刺法评估感觉阻滞效果,记录感觉阻滞起效时间、运动阻滞起效时间、最高感觉阻滞平面、麻醉维持时间、术中麻醉质量与肌松效果及用药后的不良反应．结果：与B组比较,R组运动阻滞起效时间较长,运动阻滞和感觉阻滞维持时间较短（P〈0．05）;感觉阻滞起效时间差异无统计学意义（P〉O．05）;两组麻醉质量和肌松效果均较好,麻醉质量及肌松效果无统计学差异（P〉0．05）;两组不良反应发生率均较低,且差异无统计学意义（P〉0．05）．结论：老年病人下肢手术患者采用罗哌卡因蛛网膜下腔阻滞术中麻醉质量及肌松效果良好,且其运动阻滞维持时间较布比卡因短,有利于术后的恢复和功能锻炼．表4,参7．     

The reaction times of drivers aged 20 to 80 during a divided attention driving

Objective: Many studies addressing age-related changes in driving performance focus on comparing young vs. older drivers, which might lead to the biased conclusion that driving performance decreases only after the age of 65. The main aim of the study was to show that changes in driving performance are progressive throughout the adult years.

Methods: A sample of 351 drivers aged 20 to 80 was assessed for their reaction times while driving between road cones. The drivers were exposed to 2 conditions varying according to task complexity. In single task conditions, the drivers performed a full stopping maneuver at a given signal; in dual task conditions, the drivers were distracted before the signal for stopping maneuver was triggered. Reaction times were compared across conditions and age groups.

Results: The results showed that both reaction times and variability of driving performance increased progressively between the ages of 20 and 80. The increase in both reaction times and variability was greater in the complex task condition. The high-performing quarter of elderly drivers performed equally well or better than younger drivers did.

Conclusions: The data clearly supported the claim that driving performance changes steadily across age groups: both mean reaction time and interindividual variability progressively increase with age. In addition, a significant group of older drivers was identified who did not show the expected age-related decrease in performance. The findings have important implications, suggesting that in relation to driving, aging is a progressive phenomenon and may lead to variety of driving performance; age-related studies of driving performance should put more emphasis on investigating changes across the whole driver age range rather than only comparing younger and older drivers.     

Age-Dependent Factors Affecting Thoracic Response: A Finite Element Study Focused on Japanese Elderly Occupants

Objectives: The ultimate goal of this research is to reduce thoracic injuries due to traffic crashes, especially in the elderly. The specific objective is to develop and validate a full-body finite element model under 2 distinct settings that account for factors relevant for thoracic fragility of elderly: one setting representative of an average size male and one representative of an average size Japanese elderly male.

Methods: A new thorax finite element model was developed from medical images of a 71-year-old average Japanese male elderly size (161cm, 60 kg) postmortem human subject (PMHS). The model was validated at component and assembled levels against original series of published test data obtained from the same elderly specimen. The model was completed with extremities and head of a model previously developed. The rib cage and the thoracic flesh materials were assigned age-dependent properties and the model geometry was scaled up to simulate a 50th percentile male. Thereafter, the model was validated against existing biomechanical data for younger and elderly subjects, including hub-to-thorax impacts and frontal impact sled PMHS test data. Finally, a parametric study was conducted with the new models to understand the effect of size and aging factors on thoracic response and risk of rib fractures.

Results: The model behaved in agreement with tabletop test experiments in intact, denuded, and eviscerated tissue conditions. In frontal impact sled conditions, the model showed good 3-dimensional head and spine kinematics, as well as rib cage multipoint deflections. When properties representative of an aging person were simulated, both the rib cage deformation and the predicted number of rib fractures increased. The effects of age factors such as rib cortical thickness, mechanical properties, and failure thresholds on the model responses were consistent with the literature. Aged and thereby softened flesh reduced load transfer between ribs; the coupling of the rib cage was reduced. Aged costal cartilage increased the severity of the diagonal belt loading sustained by the lower loaded rib cage.

Conclusions: When age-specific parameters were implemented in a finite element (FE) model of the thorax, the rib cage kinematics and thorax injury risk increased. When the effect of size was isolated, 2 factors, in addition to rib material properties, were found to be important: flesh and costal cartilage properties. These 2 were identified to affect rib cage deformation mechanisms and may potentially increase the risk of rib fractures.     

空气污染对中老年人认知能力的影响

利用中国健康与养老追踪调查(CHARLS)数据,采用两阶段最小二乘法评估了空气污染对我国中老年人认知能力的影响及其传导路径,并进一步分析了不同类型污染物的影响差异性.研究发现:空气污染与中老年人的认知能力显著负相关,且通过一系列稳健性检验表明研究结果具有稳健性;机制分析与异质性分析显示,空气污染通过影响个人的情绪和状态、运动、社交活动、健康和记忆力来间接影响其认知能力,且空气污染对年长者、女性、有不良健康行为以及社会经济地位较低人群的认知能力负面影响更大;进一步研究发现,PM_2.5、PM₁₀、SO₂、CO具有显著的认知功能折旧效应.本文聚焦于我国空气污染和人口老龄化问题,识别了空气污染对我国居民认知能力的潜在健康影响,这在一定程度上为国家健康环境治理和实现健康老龄化提供了现实依据和政策借鉴.     

Epidemiology of tornado destruction in rural northern Bangladesh: risk factors for death and injury

The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors during the tornado (AOR = 10.4 (95 per cent CI: 5.5-19.9) and AOR = 6.6 (95 per cent CI: 5.8-7.5), respectively). Females were 1.24 times (95 per cent CI: 1.15-1.33) more likely to be injured than males. Elevated risk of injury was significantly associated with structural damage to the house and tin construction materials. Seeking treatment was protective against death among the injured, odds ratio = 0.08 (95 per cent CI: 0.03-0.21). Further research is needed to develop injury prevention strategies and to address disparities in risk between age groups and between men and women.