Search Results (2,481)

While South Africa’s recycling chain relies heavily on informal labour, the burden of non-fatal workplace injuries among landfill-based waste pickers remains poorly characterised. This study aimed to estimate the prevalence of self-reported non-fatal workplace injuries and identify associated factors among informal waste pickers at landfill sites in Johannesburg, South Africa. We conducted a cross-sectional study at two purposively selected landfill sites in Johannesburg. Using convenience sampling, 354 waste pickers were enrolled (median age 34 years; 73.2% male). A structured questionnaire captured worker characteristics and self-reported injuries over the preceding six months. Robust (modified) Poisson regression was utilised to determine associations with self-reported workplace injury. Overall, 86.2% of participants reported at least one injury. Lacerations caused by contact with waste materials predominated (82.7%), followed by violence (20.5%) and needle-stick injuries (19.9%). Notably, 94.1% of participants reported using personal protective equipment (PPE), yet the injury prevalence was high. In the multivariable model, each additional year of landfill work experience was associated with a 1.0% higher prevalence of reported injury (adjusted prevalence ratio [aPR] 1.01; 95% CI 1.01–1.02). Conversely, pickers aged 51 years and older had a 32% lower prevalence of injury than those aged 18–28 (aPR 0.68; 95% CI 0.51–0.90). To mitigate these risks, municipal authorities should implement mandatory safety training for site entry, provide industrial-grade, puncture-resistant PPE, and formalise the integration of landfill pickers into institutional occupational health frameworks. Full article

Background/Objectives: Adequate nutrition in older adults is essential to maintaining health, functionality, and quality of life, particularly in long-term care hospitals (HACLEs). Previous studies suggest that dissatisfaction with hospital food is linked to longer stays, more complications, and negative perceptions of care. Given these concerns, this study aimed to assess patients’ experiences with hospital food over a 15-year period in a HACLE in Spain, identify key influencing factors, and validate an updated PREM (Patient Reported Experience Measure) tool for food services. Methods: A retrospective, observational, repeated cross-sectional study was conducted using annual PREM surveys administered between 2011 and 2025 to patients on oral diets. Psychometric validation of the updated 8-item version (2024) was conducted. Results: Out of 1618 surveys, 1540 were included in the final analysis. The updated PREM showed strong internal consistency (α = 0.85, ω = 0.87), a two-factor structure (food quality and service conditions), and adequate model fit. Perceptions worsened after a catering company change in 2022 but improved following the implementation of new food distribution carts in 2025. The PREM total score showed a strong positive association with the global satisfaction item, providing supportive evidence based on a closely related anchor measure (Spearman’s rho = 0.80, 95% CI 0.77–0.82; p < 0.001). Scores differed significantly by diet type: patients receiving a pureed diet reported the highest average satisfaction score, followed by those on a soft diet and a regular diet. The group on a soft diet excluding foods that pose a choking hazard had the lowest mean score. Conclusions: The validated PREM scale is a reliable tool to monitor patient experience with hospital food. It enables early detection of quality issues and supports targeted improvements. Routine use in long-term care settings may foster personalized, patient-centered nutrition strategies and enhance care quality. Full article

Aging is a progressive and heterogeneous biological process influenced by multiple factors that may compromise physical and cognitive capacities and increase the risk of frailty, functional decline, and falls in older adults. Falls represent a major public health concern due to their impact on independence and long-term care demand. Immersive virtual reality (IVR) delivered through active video games (exergames) has emerged as a preventive strategy that integrates sensory, motor, and cognitive stimulation within controlled and engaging environments, particularly where traditional programs face challenges related to adherence and individual adaptation. This study aims to determine the feasibility and implementation of an IVR-based program for falls prevention in older adults at risk of frailty in primary health care (PHC). A quasi-experimental pre–post design will be conducted with an intervention group (IVR/exergames) and a conventional control group, including a total sample of 40 participants (20 per group). The protocol comprises three phases: baseline assessment and IVR familiarization; a 12-week intervention delivered twice weekly; and post-intervention assessment. The primary outcome will be fall risk assessed using the Timed Up and Go (TUG) test. Secondary outcomes include physical performance (Short Physical Performance Battery, SPPB, and handgrip dynamometry) and psychological aspects related to falls (Falls Efficacy Scale International, FES-I, and Activities-specific Balance Confidence Scale, ABC). Feasibility indicators will include recruitment, adherence, retention, and cybersickness. A reduction in TUG time is expected, providing preliminary evidence on the feasibility of integrating IVR-based programs for falls prevention within PHC systems. Full article

The institutional drive to deploy digital assistive technologies—from IoT monitoring to AI companions—as a solution to the aging care crisis functions as an ethical double-edged sword. This article argues that beyond isolated risks, these technologies introduce a systemic tension where gains in safety and efficiency often come at the cost of autonomy, human connection, and equity. We propose a critical framework that diagnoses four interconnected dimensions of this tension: (1) the erosion of privacy and autonomy through pervasive surveillance; (2) the risk of dehumanization in high-tech, low-touch interactions; (3) the “digital grey divide” as a social determinant of health; and (4) the perpetuation of “coded ageism” through algorithmic bias. To bridge the gap between ethical principle and practice, the framework translates this diagnosis into a practical roadmap for “Dignity-by-Design.” It operationalizes person-centered care through three actionable shifts: moving from compliance to commitment, replacing static consent with dynamic engagement, and establishing the lived experience of older adults and caregivers as a core design standard via participatory action research. Ultimately, this work provides a critical tool for researchers, developers, and policymakers to guide the ethically aligned implementation of technologies that truly enhance autonomy, foster trust, and uphold dignity in geriatric care. Full article

This paper examines how mathematics can be approached in the context of Adult Learning and education for older adults. Senior Education in university settings can become a highly motivating, engaging, and meaningful experience for senior learners. Drawing on our teaching practice at the Senior Classroom Program of Pablo de Olavide University (Spain), this study analyzes how andragogical principles such as autonomy, relevance, life experience, and intrinsic motivation can shape powerful learning environments for senior learners (i.e., over 50 years old). By focusing on real-world connections and on historical or philosophical perspectives, the teaching of mathematics may become not only more accessible but also intellectually stimulating, particularly when the classroom climate is supportive and inclusive. From this perspective, mathematical content, often perceived as abstract or disconnected from reality, can be approached as a resource for critical reflection, personal growth, and intergenerational dialog. Our analysis suggests that mathematics does not necessarily constitute a barrier for senior learners; under appropriate pedagogical conditions, it may instead function as a bridge to lifelong learning, fostering curiosity about how the surrounding world works and encouraging engagement with meaningful real-life problems. Full article

Physical activity apps offer significant potential to promote physical activity and active aging; however, their acceptance among older adults remains limited, often due to insufficient digital literacy. This study aimed to examine whether targeted, app-specific digital literacy training can improve eHealth literacy, acceptance of physical activity apps, and behavioral intentions among older women, drawing on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) extended with a personal innovativeness construct. A total of 63 older women (M = 67.0, SD = 4.6) were randomly assigned to an experimental (n = 32) or control group (n = 31). The experimental group participated in a nine-week digital literacy training focused on practical use of physical activity apps. Measures were collected before and after the intervention. Data were analyzed using repeated-measures MANOVA and ANOVAs. A significant Group × Time interaction was observed for technology acceptance (Wilks’ Λ = 0.41, F (7, 54) = 11.14, p < 0.001, η_p² = 0.59). The experimental group showed significant improvements across all measured constructs. The largest effects were found for eHealth literacy (η_p² = 0.39) and intention to use physical activity apps (η_p² = 0.24). App-specific digital literacy training can enhance technology acceptance and support physical activity–related intentions among older women, highlighting its potential to reduce digital barriers and promote active aging. The findings reflect short-term, self-reported changes in technology acceptance and behavioral intentions. Full article

Population aging has markedly increased the burden of cancer in older adults, in whom frailty, sarcopenia, and reduced physiological reserve limit tolerance to treatment and worsen clinical outcomes. Aging is accompanied by progressive functional decline and by biological processes such as cellular senescence, characterized by irreversible cell cycle arrest, chronic low-grade inflammation, and impaired immune surveillance. The accumulation of senescent cells and the persistence of a senescence-associated secretory phenotype contribute to tissue dysfunction and generate a microenvironment that favors tumor initiation and progression. Physical exercise has been associated with attenuation of inflammation, improvements in metabolic and immune function, and with lower levels of senescence-related biomarkers. Although aerobic exercise has been extensively studied in this setting, resistance training holds relevance for older adults due to its capacity to counteract sarcopenia, preserve muscle strength and power, and sustain functional independence. Structured and periodized approaches to resistance exercise may further enhance these benefits by delivering targeted stimuli aligned with age-related physiological deficits. Block strength training (BST), a periodized model that concentrates training adaptations into sequential phases of maximal strength, power, and muscular endurance, has demonstrated consistent improvements in functional performance and reductions in frailty risk in community-dwelling older adults. BST improves physical function. It may also influence biological processes related to aging and cancer; however, mechanistic evidence specific to BST remains to be established. We hypothesized that the exercise in block as a targeted, a structured and physiologically grounded resistance training intervention highlights the potential of BST to promote functional aging and healthy. In the case of cancer biology, and the environment near to tumour, the relationship between aging mechanisms in older adults and controlled exercise effects are currently in advance, but mechanistic trials are still lacking. Finally, we propose a novel training method, structured and personalized, that could impact different clinical outcomes in older patients with cancer. Full article

Tuberculosis (TB) remains a major public health burden in Vietnam, yet few studies have examined pulmonary TB mortality trends at sub-national levels, where local epidemiological patterns may differ substantially from national averages and reveal high-risk populations requiring targeted interventions and inform resource allocation. Lang Son, Vietnam, is a mountainous border province with many ethnic minority residents, and extensive cross-border movement creates distinct challenges for TB surveillance and treatment adherence. Although mortality has declined in line with national trends, rates in this border province remain higher than those in Vietnam’s major urban centers. This disparity suggests a hidden burden where Lang Son’s unique geographic challenges and ethnic diversity create health inequities that are often obscured by favorable national-level averages. To better understand local epidemiological patterns, this study examined temporal trends and gender differences in pulmonary TB mortality in Lang Son Province over a 12-year period (2005–2008 and 2011–2018). Using data from a population-based mortality registration system, we calculated crude and age-standardized mortality rates (ASR) per 100,000 person-years. Temporal trends were assessed using Poisson regression. The overall ASR was 7.7 per 100,000 person-years among men (95% CI: 6.5–9.0) and 1.9 among women (95% CI: 1.3–2.7), yielding a male-to-female ASR ratio of 4.1. The age-standardized pulmonary TB mortality declined by approximately 49.2% (from 6.3 (95% CI: 4.1–9.2) to 3.2 (95% CI: 1.9–4.9) per 100,000 person-years; p = 0.025). Notably, 69.9% of deaths occurred in individuals under age 70. While declines were observed in both sexes, sex-specific temporal trends were not statistically significant (p > 0.05). Despite these improvements, persistently higher mortality among men and older adults highlights ongoing inequities in TB outcomes within the province. These pre-pandemic findings provide an essential epidemiological baseline for assessing COVID-19’s impact on TB control and underscore the need for age- and gender-targeted interventions at sub-national levels to accelerate Vietnam’s progress toward TB elimination. Full article

The hemodialysis population has progressively aged over the past two decades; in several settings, adults aged ≥75 years represent one of the fastest-growing populations receiving dialysis. Frailty, characterized by reduced physiological reserve and heightened vulnerability to stressors, has emerged as a critical determinant of outcomes and is commonly assessed using validated instruments such as the Fried Frailty Phenotype or the Clinical Frailty Scale (CFS). Reported frailty prevalence in hemodialysis varies widely (approximately 20% to >80%), largely depending on the assessment instrument and the population studied, with consistently higher prevalence in older cohorts. It is consistently associated with older age, female sex, diabetes, lower serum albumin, cardiovascular disease, longer dialysis vintage, and lower physical activity. Compared with non-frail patients, frail hemodialysis patients have a substantially higher risk of death (approximately two-fold in pooled analyses). Seminal trials and large observational programs that shaped hemodialysis targets underrepresented very old, frail, and highly comorbid patients, limiting generalizability. In frail older adults with limited life expectancy and substantial comorbidity burden, standard thrice-weekly schedules, higher ultrafiltration intensity, and a uniform ‘fistula-first’ approach may increase treatment burden without clear proportional gains in patient-centered outcomes. This review examines evidence supporting individualized hemodialysis strategies in frail older adults. As the dialysis population continues to age, proficiency in goal-concordant, personalized prescribing is increasingly important for nephrologists and dialysis teams. Full article

Background: Well-being in the elderly is shaped by complex emotional and social factors. Early identification of individuals at risk for reduced well-being may support timely preventive or supportive interventions. This study examined whether emotional intelligence indicators collected at baseline can predict well-being status 5 months later using explainable machine learning models. Methods: A cohort of elderly participants aged 60 to 89 years completed emotional intelligence measures at baseline, and well-being was assessed 5 months later using the POMS questionnaire. Four machine learning algorithms, Logistic Regression (LR), Support Vector Machines (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGBoost), were developed using 5-fold stratified cross-validation. Model performance was evaluated through accuracy, precision, recall, F1-score, ROC AUC, and normalized confusion matrices. SHapley Additive exPlanations (SHAP) were applied to interpret the contribution and directionality of each predictor. Results: XGBoost achieved the highest predictive performance (accuracy = 0.789; F1 = 0.778) and demonstrated balanced classification across well-being categories. SVM also performed robustly (accuracy = 0.760), while LR showed reduced sensitivity for detecting those with poorer well-being. SHAP analysis identified self-control, emotionality, sociability, self-motivation, and well-being components as the most influential predictors. Lower emotionality, higher sociability, and higher self-control scores were linked to a greater probability of favorable well-being outcomes. Conclusions: The findings demonstrate the feasibility of using explainable machine learning models to predict 5-month well-being status within this sample of older adults using emotional intelligence indicators. XGBoost provided the strongest and most balanced performance, while SHAP analysis clarified how specific emotional intelligence dimensions influenced predictions. These findings suggest that interpretable machine learning approaches may support future efforts toward early recognition of older adults who may be at risk for reduced well-being and guide personalized intervention strategies. Full article

Animal welfare in farmed animals is increasingly being identified as an integral part of ethical meat production; yet in most developing nations, including Ghana, little attention is being paid to this area of interest. The demand for chicken meat and egg products in Ghana has also increased because of rapid urbanisation and development; hence, public perception of poultry welfare is paramount in policy formulation and development in Ghana. This study investigates public perception of poultry welfare in Ghana, particularly laying hen farming. The study used a cross-sectional study and surveyed 1275 respondents aged 17 and older in Accra, Kumasi, and Tamale by collecting data in-person, and the questionnaire was administered using tablets or mobile devices. The study found that 69.1% of respondents poorly perceived farmed animal welfare, while 30.9% positively perceived farmed animal welfare in Ghana. There was a significant difference in perception levels among respondents in Accra and Kumasi, and those in Tamale, where respondents in Tamale indicated a slightly positive perception compared to those in Accra and Kumasi. Furthermore, 53.7% of respondents supported state intervention in farmed animal welfare, while 52.0% showed reluctance to pay a premium price for cage-free and free-range egg production in Ghana. Full article

Background and Objectives: We aimed to evaluate differences in PM exposure reduction behaviors among older adults and patients with chronic respiratory diseases, atrial fibrillation, and stroke and to identify associated determinants. Materials and Methods: This multicenter cross-sectional study included 717 participants from five cohorts: older adults (n = 255), chronic obstructive pulmonary disease (COPD, n = 145), asthma (n = 100), atrial fibrillation (n = 117), and stroke (n = 100). PM exposure reduction behaviors were assessed using a standardized 18-item questionnaire (total score range: 0–126) covering indoor, outdoor, and other behaviors (health-seeking actions, such as checking air quality and using purifiers). Results: In multivariable linear regression models, COPD (β = 11.09), asthma (β = 15.54), and atrial fibrillation (β = 14.29) were associated with significantly higher total behavior scores compared with the older adult cohort (adjusted mean 69.0), corresponding to an approximately 20% relative increase in the asthma cohort. The stroke cohort did not differ significantly from the primary cohort. Domain-specific analyses showed that indoor and other behavioral scores were consistently higher across all disease cohorts, whereas outdoor scores were significantly elevated only for asthma and atrial fibrillation. In a fully adjusted model that included all covariates simultaneously, the stroke cohort demonstrated a modest increase in the total score (β = 8.79). Increased age and higher educational attainment were independently associated with greater behavioral engagement. Conclusions: PM exposure reduction behavior scores differed across the clinical cohorts, and sociodemographic factors were independently associated with behavioral engagement. These findings support personalized disease-specific counseling and inform future digital health interventions for vulnerable populations. Full article

Objectives: The reduction in intrinsic capacity significantly impacts the functional abilities of older individuals, and is strongly linked to adverse health consequences. Safeguarding and enhancing an elderly person’s intrinsic capacity can lead to better life quality and improved social well-being. This research seeks to explore the relationships between social engagement, physical activity, and the likelihood of decline in intrinsic capacity among the elderly in China. Methods: Utilizing the CHARLS data from 2015, individuals with incomplete information were removed from our study. Our analysis included a total of 3502 samples. Social participation and physical activity were assessed through self-reported surveys. The evaluation of intrinsic capacity, based on WHO criteria, thoroughly examined participants in five areas: mobility, sensory functions, vitality, mental health and cognitive abilities. The links between social participation, physical activity and intrinsic capacity decline were revealed through logistic regression. Restricted cubic splines (RCS) were employed as a statistical model, exploring the relationships between dose and response. Interaction analysis was used to examine the interaction between social participation and physical activity. Analyses of subgroups facilitated the evaluation of variations based on factors including age, gender, duration of sleep, and chronic disease numbers. Results: In contrast to the low-level group, individuals with moderate to high degrees of social participation (OR = 0.80, p = 0.012; OR = 0.56, p < 0.001) and those with moderate to high levels physical activity (OR = 0.72, p = 0.019; OR = 0.74, p = 0.016) demonstrated a notably lower risk of decline in intrinsic capacities. A negative correlation was identified in a dose-response manner between social participation and the risk of IC decline. A U-shaped relationship was established between physical activity levels and the risk of intrinsic capacity decline. The fully adjusted interaction model showed that no significant interaction was observed between social participation and physical activity (p = 0.778). Furthermore, subgroup analyses showed that these associations remained generally consistent across older adults of different age groups, genders, sleep duration, and numbers of chronic diseases. Conclusions: In order to slow down the deterioration of intrinsic capacity in older adults in China, it may be beneficial to focus on sustaining elevated levels of social participation and engaging in moderate physical activity. Higher levels of social participation are associated with a lower risk of experiencing a decline in intrinsic capacity, whereas both insufficient and excessive physical activity are associated with an increased risk of intrinsic capacity decline. Full article

Objectives: To determine the incidence and outcomes of SARS-CoV-2 infection and to evaluate seroconversion rates and quantify antibody responses to COVID-19 vaccines in two cohorts of persons living with HIV at a possible higher risk of poor outcomes (HCV coinfection and those over the age of 65 years). Methods: We included participants from two established cohorts of persons living with HIV, those who were older than 65 years of age, and those with hepatitis C (HCV) co-infection. Four hundred and seventy-one participants completed questionnaires on SARS-CoV-2 infection and COVID-19 vaccine doses and submitted peripheral blood specimens for measuring antibody levels to COVID-19 antigens, full-length spike trimer, its receptor binding domain (RBD), and nucleocapsid protein (N) at 6-month intervals up to three visits between February 2021 and December 2024. Logistic and ordinal logistic regression models evaluated predictors of seroconversion and antibody levels. Results: Overall, 51% of participants developed a SARS-CoV-2 infection, but it was mild, with only nine requiring hospital admission and no deaths. Overall, 99% of tested specimens had antibodies above threshold to either spike or RBD proteins. Specimens that did not and those with lower antibody levels had testing earlier in the pandemic, and were from participants with fewer vaccine doses, and did not have natural infection. Age, depression, comorbidity, HCV co-infection, current substance use, CD4 count, or HIV viral load were predictive of antibody level. Those with hybrid immunity had higher antibody responses. Conclusions: In cohorts of persons with HIV-HCV coinfection and those who are ageing, we observed high rates of seroconversion to COVID-19 antigens. Antibody levels were higher among those with more vaccine doses, hybrid immunity, and later in the pandemic waves. Although 51% developed a breakthrough infection, outcomes were mild with no deaths. Full article

Background and Objectives: Lower urinary tract symptoms (LUTS) are highly prevalent among aging men and have traditionally been attributed primarily to benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO). However, growing evidence suggests that bladder-related mechanisms play a critical and often underrecognized role. This review aims to summarize current evidence on the contribution of the aging bladder to LUTS pathophysiology and to explore the therapeutic implications in men with BPH. Materials and Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science for studies published between January 2010 and April 2025. Search terms included combinations of “aging bladder”, “detrusor dysfunction”, “LUTS”, “BPH”, “bladder outlet obstruction”, “ischemia”, “overactive bladder”, and “detrusor underactivity”. Eligible studies included narrative reviews, systematic reviews, meta-analyses, clinical studies, and translational research addressing bladder aging and its clinical implications. A narrative synthesis approach was used due to heterogeneity in study design and outcomes. Results: A total of 43 studies were included in the qualitative synthesis. The evidence indicates that LUTS in older men result from multifactorial processes involving not only prostatic enlargement but also bladder dysfunction. Aging-associated changes include detrusor remodeling, impaired compliance, neural alterations, and vascular insufficiency, particularly chronic ischemia and oxidative stress. These mechanisms contribute to both detrusor overactivity and underactivity, providing a unifying framework for storage and voiding symptoms. Importantly, the severity of LUTS does not consistently correlate with prostate size or degree of obstruction. Conclusions: LUTS in aging men should be considered a complex condition involving both bladder and outlet factors. A bladder-centered perspective may improve patient stratification and therapeutic outcomes. Integrating bladder-targeted therapies with conventional BPH management supports a more personalized and effective approach to care. Full article