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Seasonal influenza virus epidemics have a major impact on healthcare systems. Data on population susceptibility to emerging influenza virus strains during the interepidemic period can guide planning for resource allocation of an upcoming influenza season. This study sought to assess the population susceptibility to representative emerging influenza virus strains collected during the interepidemic period. The microneutralisation antibody titers (MN titers) of a human serum panel against representative emerging influenza strains collected during the interepidemic period before the 2018/2019 winter influenza season (H1N1-inter and H3N2-inter) were compared with those against influenza strains representative of previous epidemics (H1N1-pre and H3N2-pre). A multifaceted approach, incorporating both genetic and antigenic data, was used in selecting these representative influenza virus strains for the MN assay. A significantly higher proportion of individuals had a ⩾four-fold reduction in MN titers between H1N1-inter and H1N1-pre than that between H3N2-inter and H3N2-pre (28.5% (127/445) vs. 4.9% (22/445), P < 0.001). The geometric mean titer (GMT) of H1N1-inter was significantly lower than that of H1N1-pre (381 (95% CI 339–428) vs. 713 (95% CI 641–792), P < 0.001), while there was no significant difference in the GMT between H3N2-inter and H3N2-pre. Since A(H1N1) predominated the 2018–2019 winter influenza epidemic, our results corroborated the epidemic subtype.
Anxiety disorders are prevalent yet under-recognized in late life. We examined the prevalence of anxiety disorders in a representative sample of community dwelling older adults in Hong Kong.
Data on 1,158 non-demented respondents aged 60–75 years were extracted from the Hong Kong Mental Morbidity survey (HKMMS). Anxiety was assessed with the revised Clinical Interview Schedule (CIS-R).
One hundred and thirty-seven respondents (11.9%, 95% CI = 10–13.7%) had common mental disorders with a CIS-R score of 12 or above. 8% (95% CI = 6.5–9.6%) had anxiety, 2.2% (95% CI = 1.3–3%) had an anxiety disorder comorbid with depressive disorder, and 1.7% (95% CI = 1–2.5%) had depression. Anxious individuals were more likely to be females (χ2 = 25.3, p < 0.001), had higher chronic physical burden (t = −9.3, p < 0.001), lower SF-12 physical functioning score (t = 9.2, p < 0.001), and poorer delayed recall (t = 2.3, p = 0.022). The risk of anxiety was higher for females (OR 2.8, 95% C.I. 1.7–4.6, p < 0.001) and those with physical illnesses (OR 1.4, 95% C.I. 1.3–1.6, p < 0.001). The risk of anxiety disorders increased in those with disorders of cardiovascular (OR 1.9, 95% C.I. 1.2–2.9, p = 0.003), musculoskeletal (OR 2.0, 95% C.I. 1.5–2.7, p < 0.001), and genitourinary system (OR 2.0, 95% C.I. 1.3–3.2, p = 0.002).
The prevalence of anxiety disorders in Hong Kong older population was 8%. Female gender and those with poor physical health were at a greater risk of developing anxiety disorders. Our findings also suggested potential risk for early sign of memory impairment in cognitively healthy individuals with anxiety disorders.
To study the association between gastrointestinal colonization of carbapenemase-producing Enterobacteriaceae (CPE) and proton pump inhibitors (PPIs).
We analyzed 31,526 patients with prospective collection of fecal specimens for CPE screening: upon admission (targeted screening) and during hospitalization (opportunistic screening, safety net screening, and extensive contact tracing), in our healthcare network with 3,200 beds from July 1, 2011, through December 31, 2015. Specimens were collected at least once weekly during hospitalization for CPE carriers and subjected to broth enrichment culture and multiplex polymerase chain reaction.
Of 66,672 fecal specimens collected, 345 specimens (0.5%) from 100 patients (0.3%) had CPE. The number and prevalence (per 100,000 patient-days) of CPE increased from 2 (0.3) in 2012 to 63 (8.0) in 2015 (P<.001). Male sex (odds ratio, 1.91 [95% CI, 1.15–3.18], P=.013), presence of wound or drain (3.12 [1.70–5.71], P<.001), and use of cephalosporins (3.06 [1.42–6.59], P=.004), carbapenems (2.21 [1.10–4.48], P=.027), and PPIs (2.84 [1.72–4.71], P<.001) in the preceding 6 months were significant risk factors by multivariable analysis. Of 79 patients with serial fecal specimens, spontaneous clearance of CPE was noted in 57 (72.2%), with a median (range) of 30 (3–411) days. Comparing patients without use of antibiotics and PPIs, consumption of both antibiotics and PPIs after CPE identification was associated with later clearance of CPE (hazard ratio, 0.35 [95% CI, 0.17–0.73], P=.005).
Concomitant use of antibiotics and PPIs prolonged duration of gastrointestinal colonization by CPE.
This article explores conceptual and empirical aspects of the social exclusion/inclusion debate in later life, with a particular focus on issues of place and space in urban settings. Exploratory findings are reported from two empirical studies in Belgium and England, which sought to examine experiences of social exclusion and inclusion among people aged 60 and over living in deprived inner-city neighbourhoods. Semi-structured interviews were conducted with an ethnically diverse sample of 102 older people in Belgium and 124 in England. Thematic analysis of interview data identifies four issues in relation to the neighbourhood dimension of social exclusion/inclusion in later life: experiences of community change; feelings of security and safety; the management of urban space; and strategies of control. The results suggest that neighbourhoods have a significant influence on shaping the experience of exclusion and inclusion in later life, with a number of similarities identified across the different study areas. The article concludes by discussing conceptual and policy issues raised by the research.
This paper provides an introduction to a special issue focusing on diverse examples of policy practice in social inclusion and ageing across different regions of the world. These examples illustrate the multifaceted nature of the concept of social inclusion, and how it is applied in the context of global demographic ageing. The paper begins with an exploration of the history and development of the concept of social inclusion, as applied to ageing policy, and how the concept has emerged following its initial association with economic disadvantage. Now commonly defined as relating to social participation in key activities of the society in which people live, a social inclusionary approach highlights the risks of social exclusion and isolation faced by older people. Social inclusion thus incorporates core issues in ageing such as civil engagement, an ageing workforce, age-friendly communities, and civic involvement. There are some particular challenges to implementing social inclusion policies within the current environment, which are addressed within this special issue, and these include the impact of social and cultural change, particularly across some of the East Asian countries, and the impact of global financial crises on work and retirement.
China's population has been ageing rapidly since the 1980s, with 178 million older persons (60 years or over) in 2010 and 450 million expected by 2050. The sheer size of the ageing population means that there is an urgent need to tackle ageing issues and improve social policies in order to achieve intergenerational solidarity, sustainable development and a harmonious society. This paper will summarise the issues and debates in the past decade on social exclusion and discuss the progress of policies and practices with respect to social inclusion. The focus of discussion will be on (a) ways to improve the social security system so as to achieve a better balance of formal and informal supports, (b) development of community services for meeting the needs of older people living alone or having special needs in daily living, and (c) new initiatives for balancing formal support and filial piety, taking into account the younger generation's expectation that in order to maintain the important role of filial piety in modern China, the ability to fulfil filial obligations must be supported by the development of formal support beyond the family. In addition, some emerging issues and challenges will also be discussed.
Synthesising the social capital and ageing-friendly communities literature, this paper describes how efforts to make communities more ageing-friendly can promote social inclusion among older adults. Making existing communities more ageing-friendly involves physical and social infrastructure changes that enable older adults to pursue lifelong activities, meet their basic needs, maintain significant relationships, participate in the community in personally and socially meaningful ways, and develop new interests and sources of fulfilment. Such efforts can enhance bonding, bridging and linking capital, and thereby promote social inclusion. The authors discuss the link between ageing-friendly communities and social inclusion, and provide examples of programmes with potential to change existing communities into ones that promote the social inclusion of older adults.
This article reports on a recent survey of employer attitudes and policies towards older workers in Australia at a time of sustained economic growth and ongoing concerns about labour shortages. Findings from a survey of 590 employers with more than 50 employees in the State of Queensland point to an unusually strong orientation towards the recruitment of older workers among respondents, although the retraining of older workers is not prioritised by the majority. The issue of workforce ageing is viewed as being of medium-term importance by the majority of respondents, although for a substantial number the issue is of immediate concern. Both sector and organisation size are predictive of the application of a broad range of policies targeting older workers, with public-sector and larger organisations more likely to be active. Concerns about workforce ageing and labour supply are predictive of employer behaviours regarding older workers, suggesting that sustained policy making may be emerging in response to population ageing over and above more immediate concerns about labour shortages and that this broad thrust of organisational policy making may be immune to the point in the economic cycle. This study found no evidence that the flexible firm will not countenance an ageing workforce.
Social inclusion of the older population in employment, housing, social protection and other livelihood aspects was predicted to suffer because of the financial tsunami in Hong Kong in 2008. An expected mitigating factor of the impact on social inclusion was social cohesion, which is the focus of the present study. A total of 1,352 Hong Kong Chinese adults were surveyed in 2009. The results show that social cohesion is perceived in Hong Kong to have mitigated the negative impact of the financial tsunami in terms of support for public policy relating to social inclusion of the older population. These results have implications for sustaining social cohesion as a means to promote the social inclusion of the older population.
This article examines the utility of the concept of resilience to the field of critical gerontology. Resilience is an increasingly popular concept within the social sciences. We explore some key ideas about individual and social resilience from varied fields, and propose new ways to conceptualise these in relation to resilience in later life. This article examines the history of the concept of resilience; explores some of the diverse ways that gerontologists are attempting to apply it to later life; and discusses the strengths and weaknesses of using resilience as a conceptual framework within critical ageing research. We also suggest ways of conceptualising resilience and ageing, highlighting the different scales of resilience that impact on the ability of older people to negotiate adversity, and some key areas of resilience relevant to later life. The example of mobility resilience is used to illustrate how different scales of resilience operate within an area of resilience central to the ageing experience. Finally, some key principles for the use of resilience within critical gerontology are outlined, providing guidance on how to maximise the potential of the concept whilst avoiding some of the limitations associated with its historical usage.
The aim is to analyse political participation among senior citizens in the West-Finnish region Österbotten/Pohjanmaa by using data from the 2005 GERDA (gerontological regional database) survey. The first research question related to patterns of political participation and the extent to which older people in this region engage in voting and non-institutionalised forms of participation. Secondly, the driving forces behind different dimensions of participation were assessed on an individual level by using a modified variant of the civic voluntarism model as suggested by Verba and colleagues. The results show a high propensity to vote among elders in this region, but they also suggest that so-called non-institutionalised participation is likely to become more common in the future. Moreover, even though the results support the so-called resource theory of political participation, the fit of the multivariate models were modest, which necessitates further research in order to understand fully the driving forces behind political participation of older people in this specific region.
This paper reports the results of a planarization process of polyimide which has been utilized as a passivation material in multilevel interconnection. The degree of planarization with spin-coated polyimide over metal topography is only 10–20% due to crosslinking and shrinking of the polymer during the curing process. Polystyrene used as sacrificial planarizing film can achieve <95% planarity over 100μm metal pad with 1μm height. A conformal polystyrene film can be spin-coated onto the polyimide surface without adhesion promoter. The topography of polyimide over the metal pattern can be planarized with thermal reflow of the polystyrene by baking the film below 250°C. The planarity of this sacrificial film, polystyrene, can be transferred to polyimide by etch-back without degrading the polyimide surface properties which has been examined by X-ray photoelectron spectroscopy.
Convergent electron beam diffraction (CBED) has been successfully applied to measure strain/stress in the channel area in PMOS semiconductor device with embedded SiGe (eSiGe) for 65nm technology. Reliable results of strain/stress measurements in the channel area have been achieved by good fitting of experimental CBED patterns with theoretical calculations. Stress measurements from CBED are in good agreement with simulations. A compressive stress as high as 823.9 MPa was measured in the <110> direction in the channel area of a PMOS device with eSiGe with 15% Ge and a thickness of 80nm. Stress measurements from CBED also confirm that the depth of the eSiGe and defects such as dislocation loops within the eSiGe relax strain/stress within the film and reduce strain/stress in the channel area.
Porous microspheres of poly(styrene-co-divinylbenzene) (SD) have been synthesized by suspension polymerization. They present a narrow porosity gap (21–24%) and a mean pore-radius range (106–117 Å). The mesoporous voids are then made use as the polymerization reactor for ethyl acrylate (EA), and as a result of the embedded polymerization, linear EA formed is trapped inside the individual particles (SD-EA), and its Tg is brought up to as high as the ambient temperature. Two specific loadings of EA were attained: 11% and 28% by weight. The acoustic absorption behaviors of SD-EA and SD microspheres are assessed by the attenuation coefficient (a = IAttenuated/IIncidence), in which the incident acoustic waves are two arbitrary audio frequency bands, 100–1000 Hz and 4000–5000Hz. In contrast to porous SD microspheres, SD-EA microspheres apparently relax the incident frequencies and attenuate more effectively the higher frequency sound waves. The maximum attenuation level (a) of SD-EA absorbent is about 80% (dB). It was found that the higher EA loading could improve rather slightly the attenuation level in the higher frequency range.