Elderly Demographics Research Study

Elderly Demographics Research Study Topic Background Health seeking behaviour is becoming more popular in the field of research study at present time. The use of this, somehow, became the window of opportunity to policymakers in delivering a better health system especially in developing countries1. (Shaik, 2015). This is true among the elderly population since a shift in the pattern of morbidity and mortality was observed in recent years. Non-communicable diseases have become the top leading cause of morbidity. Furthermore, the emergence of lifestyle diseases in urban areas also adds up to the list of morbidity causes. This change contributes to the reluctance of elderly in seeking wellness therefore an obstacle to achieving good health. Health seeking behaviour plays a major role in the effect of their health status and not solely attributed to advancing age 2 (Sangmee Ahn Jo, 2007). A review literature 3(Grundy, 2010) indicated contributing factors that affect decisions of elderly on health. An identified hindrance is the preference of alternative or traditional therapies over formal health care which reportedly delay consultations, and in effect, cause delay of treatment accordingly 4-14. Grundy (2010) further emphasized that despite the variation in health seeking behaviour across regions, continuing studies of this aspect in health care is essential to provide a better picture of the disease process outcome. In this study health-seeking behaviour is defined as the following: the use of alternative or traditional therapies, reported delays in consultation and compliance of prescribed medicine among elderly population. Review of Related Literature Even though the growing population in the Philippines was dominated by the young we cannot ignore the needs of the increasing population of the elderly. The elderly were not given as much attention in the government health programs but the incidence of health problems play a part to the economic burden of households15. (Cecilia Santos-Acuin, 2013). In the 2010 national census it was stated that there were about 92.34 million Filipinos and approximately 5.8M (6.8%) of these belongs to the elderly population. Philippine population projected to increase to 142 million by 2045 and a span of 35 years around 50million people will be added16. (PSA:Population Projection Statistics, 2014)World Health Organization defined elderly according to the three main categories namely chronology, change in social role and change in capabilities .To standardized UN agreed a cutoff of 60 years old and above17. (World Health Organization:Health Statistics and information system, 2015). Health-seeking behaviour among elderly patients varies from each country. In the event of non-consultation or delay consultation among elderly it is obvious that the outcome was associated with adverse medical consequences. In one of the study conducted about managing nutrition among the elderly they pointed out the importance of prevention and early intervention because of the difficulty in treating an individual once the disease was already established4. (Damian Flanagan, 2012). This was also supported by cross-sectional study done in Namibia which the outcome resulted in higher treatment delays. In the study they determined the cause and categorized delay in the treatment as longer delay based on older age, urban residence, and longer walking distance to the nearest public facility, and doing a chest x-ray while having HIV seropositive and formal education determined the shorter delays5. (Kingsley Ukwaja, 2013). One significant Malaysian study focusing among elderly which utilized CAM for natural and safer use found out that non-consultation would contribute to the increasing undiagnosed cases of chronic diseases6.(Shahid Mitha, 2013). Further studies for different ways of treatment were done to substitute for complementary and alternative medicine especially common amongst Asians with elderly multiple co morbidities6 (Shahid Mitha, 2013).A study on DM conducted in Uganda showed that the unavailability of medicines prompted the people to use CAM for treatment and consulted a faith healer especially to those failures to manage DM causing an increase in DM related complications7. (Katarina Hjelm, 2011). Moreover, the elderly in the Philippines use medicinal plants before consulting to health professionals because of its availability, cheaper price than Western drugs, and usefulness in the treatment of various illnesses and to alleviate milder form of illnesses8. People who had chronic multiple morbidity took their medicines in a daily basis to survive, to work normally and to fulfil social work or obligations in the family. Taking multiple tablets in a day is a burden to them9. (Anne Townsend, 2003). One of the study conducted in Malaysia showed that the presence of a particular symptom will only start the usage of prescribed medicine. However, once these symptoms are resolve, medication would also be terminated giving them reason not to take drugs religiously. This will just worsen the disease process and later will lead to multiple admittance. Other studies also pointed out that noncompliance of medicine are due to the fear of drug dependency, multiple side effects and interaction with other drugs.(10). Thus, being more cautious and elaborative in giving instructions to patients who are taking multiple drug regimens should be practiced by health practitioners11. (Isacson D, 2002). A house-hold survey done among elderly Nigerian revealed that regardless of age and sex, family consultation is their first choice of treatment for their illnesses. This somehow increases the morbidity among the elderly population since family members know little about the safety and appropriate treatment for them12. (Abdulraheem, 2007) A cohort study in South Korea using AGE found out that the increase level of awareness and concern about the health of elderly women increases health-care consultation thus, resulted to increased risk of morbidity.2 (Sangmee AhnJo, 2007). In Myanmar, a study conducted to elderly women concluded that low-level of education and income play great role in skipping treatment and self-care13. (Soe Moe, 2012). Similarly, in Bangladesh, younger adult and elderly age group were compared in terms of health seeking behaviour (self-care/self-treatment). It showed no significant difference in health-seeking pattern. Both age group opted self-care/self-treatment as the first line of prevention due to poverty which would explain the increase in morbidity pattern of both.14(Syed Masad Ahmed, 2005). The growing trend of non-communicable diseases is the common cause of morbidity in today’s modern world. This lifestyle related disease can be altered in the future by determining the source of it. Also, health seeking behaviour plays a major role in determining the outcome of health status of an individual. No study on health seeking behaviour and factors that influence the behaviour of our elderly in our locality so a research study would be beneficial in gathering new information. Added to that, our elderly may have different factors towards health seeking behaviour and different morbidity pattern than the others. Research Question This study aims to determine what are the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour? Significance of the study Since health care programs to the elderly is not yet well established in Davao Regional Hospital, the outcome of this study will be the basis of the future recommendation of programs for the elderly in the DRH outpatient department. With this study we will be able to deliver better health services to our elderly patients such as: a. Creating a geriatrics club that would exclusively cater the needs of the elderly patient so that they don’t need to line-up with other patients. This would somehow help lessen their delay in consultation at the same time will increase the need to seek consult to a physician as their first choice of health care giver. b. By incorporating a primary giver as a potential treatment partner for the elderly patients that would monitor and check the elderly patients’ compliance to medicine and assure treatment success. C.Enrolling those elderly patient’s ages 70 years and above residing within 5 km of the hospital premises to a family oriented program .This would benefit those elderly patient’s that cannot visit the hospital due to old age, too sick to move and avoiding too much crowd. A home visit from the assign physician will help lessen their delay in consultation, correct the use of alternative medicine and affect their first choice of care giver. Objective of the study This study general objective is to identify the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour. Specific Objectives To determine respondents socio-demographic and clinical profile. To determine the health seeking behaviour among elderly patients in terms of: Delay in consultation of chief complaint Use of alternative and traditional therapies Compliance of prescribed medicine First choice of health care provider To identify the socio-demographic and clinical characteristics of patient that would determine their health seeking behaviour. II. Methodology A. Research Design A cross-sectional study will be conducted among elderly patient of Davao Regional Hospital outpatient department. B. Setting This will be done at Davao Regional Hospital outpatient department of Family Medicine sometime in September 1, 2015 to October 31, 2015. The triaging system of Davao Regional Hospital outpatient department starts with a priority number to all with special considerations to the elderly population. All elderly on the senior citizen lane will be distributed to the different departments based on their chief complaint. In this study all respondents triage to the Family Medicine department will be invited to participate. C. Participants The respondents of this study include elderly patients ages 60 years and above willing to participate in this study. All those who are critically ill will be excluded from the study. D. Sampling Procedure A convenience sampling will be done. E. Interventions and Comparisons: Not applicable F. Randomization: Not applicable G. Data Gathering Approval of the CERC board will be obtained first prior to the collection of data. Data will be collected using a three-part standard questionnaire which will be administered through a one on one interview by the FAMED residents rotating at the outpatient department. Independent Variables Part 1 will consist of information about socio-demographic profile like age, sex, highest educational attainment, place of origin and source of funds. Part 2 will consist of the clinical profile of the respondents which includes presence of concomitant chronic diseases and current chief complaint. Dependent Variables Part 3 will be the information about the respondents’ health seeking behaviour and the outcome to be measured. In this study the following health seeking behaviours are explored. First health seeking behaviour is according to delay in consultation which in this study refer as the time from onset of chief complaint to first consult in Davao Regional Hospital FAMED outpatient department. For this study, a delay of 14 days or more from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"longer delay† and a delay of 7 days to 14 days from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"shorter delay† 18-19(Fact sheet Diarrhoel disease, 2013) (Blanca Ochoa, 2002). The second health seeking behaviour is the use of alternative or traditional therapies which are define in this study as the use of herbal medicines, over the counter drugs, acupu ncture, reflexology, hilot and others not part of the conventional medicine before the initial consult referable to the chief complaint. Another health seeking behaviour is the compliance of prescribed medicine which in this study defines as the correct usage of drugs as to dosage, frequency, duration, and timing as prescribed by licensed physician of Davao Regional Hospital in relation to its chief complaint. Last health seeking behaviour is according to the first choice of health care providers. For this study, the first choice of health care providers in relation to its chief complaint. H. Sample size computation Sample size of this study was computed using the software StatCalc from EpiInfo 7. Calculations were based on the following assumptions: [1] 40% of patients aged 70 years (exposure) consult 2 weeks after onset of their chief complaint (outcome); and, [3] there are as many patients aged >70 years as there are patients aged 60-70 years. In a computation of odds ratios of getting the outcome, carried out at a 5% level of significance, a total sample of 194 patients will have 80% power of rejecting null hypothesis (no significant increase or decrease in odds ratio) if the alternative holds. An interim analysis will be done halfway through the recruitment (97%) in order to recompute the ideal sample size. I.Data handling and analysis Data for the study will be encoded in the Microsoft Excel and analyzed using EpiInfo 7. Categorical data will be summarized as frequencies and percentages, and compared. Continuous data will be summarized as means and standard deviations, and compared. Odds ratios of having particular health seeking behaviours will be computed. Level of significance will be set at 5%. Ethical Consideration Prior to participating in the study, the consent of the participant must be obtained. Ethics Review The proponent of the study will secure an approval from the Cluster Ethics Research Committee of Southern Philippines Medical Center prior to doing the research. Informed Consent: Form A written consent is obtained from the potential participants prior to conducting the study. Informed Consent: Signatory The signature of the participant should appear in the consent form. Informed Consent: Witness No witness will be required in order for the informed consent to be binding. Informed Consent: Proxy Consent There will be no proxy consent aside from that of the participant will be allowed. Informed Consent: Process Prior to signing the consent form, the potential participants are informed about the study rationale and objectives. Informed Consent: Timing and Venue The informed consent will be taken prior to the administration of the questionnaire. It will be done in the assigned area of the participant within DRH premises during office or duty hours. Disclosure of Study Objectives, Risks, Benefits and Procedures The participants will be informed of the study objectives, its purpose, its benefits and what is expected of them. They will also be told that there are no risks involved in the study. Remuneration, Reimbursement and Other Benefits No remuneration or reimbursement will be given to the participants. Privacy and Confidentiality The researchers will not disclose the identities of the participants at any time. Only the main proponent of the study has the personal information of the participants. The researchers will not contact the participants after this one time interview. Investigator’s Responsibility It is the investigator’s responsibility to ensure the confidentiality of any information obtained during the research. Specimen Handling N/A Voluntariness and Alternative Options The respondent’s participation in the study will be entirely voluntary. In case the participants wish to withdraw from this study the researchers will respect that decision and there will be no effect in the present and succeeding consultations. Information on Study Results The participants will have access to their data. After the data has been analysed, the overall results will also be made known to the participants. Extent of Use of Study Data At present there are no intended plans to use the data aside from the objectives stated in the protocol. Authorship and Contributorship Jacqueline N. Nuenay, M.D. is the principal investigator and the main author of the study. Dr. Chrysteler Clet is the co-author. Conflicts of Interest The principal investigator and the co-author declare no conflict of interest. Publication The research may be submitted for national and/or international presentation or publication. Funding The main proponent of the study is using personal funds to conduct the study. Duplicate Copy of the Informed Consent Form A duplicate copy of the informed consent form will be provided to the participants of the study. Additional copies can be made on request. Questions and Concerns Regarding the Study The participants will be encouraged by the principal investigator to voice out concerns about their participation in the study. Contact Details The participants of the study will be provided with the cell phone number of the principal investigator. The principal investigator is also available for questions, comments and concerns about the study.

How cell phones changed todays society Essay

How cellphones effect people everyday lives today? Cellphones play a bid role in today’s society as many would concur. From when someone wakes up in the morning they instantly checks their profile, messages, or missed calls. Cellphones make it easier to communicate with each other even if there’s a lot of distance between them. They made it to where if someone in Georgia want to talk to someone in New York anytime, then they could without haven to drive or fly to the other destination to. In order to keep the cellphones in business and effective they made different companies, that advertise, sale, keep in order, and produce the product. So to keep the business around each company tries to make the best deals for single and family purposes. They also build more signal towers all around the world to produce more signal than another company, to promise better service. They advertise the company on TV by commercials, on the internet with web site, on the streets with flyer or poster. They also advertise by saying they got the best by comparing there produce or services to others. Other ways like most of today’s phone are high quality with best games, internet, music, and communication. So when someone gets bored the first thing they do is pick up a phone. Most of some people’s day is spent on a cellphone. People now a days are on their phones extremely too much, missing the beauty of life. Not going out doing things hands on, they rather be sucked into cyber life or social media. Researchers found the radiofrequency field generated by your cell phone causes brain tissue to heat up. This proves your brain is absorbing radiation from your cell, study author David Gultekin, Ph.D., a researcher at the Memorial Sloan-Kettering Cancer Center in New York, tells MensHealth.com. Ten studies connect cell phone radiation  to diminished sperm count and sperm damage. Others raise health concerns such as altered brain metabolism, sleep disturbance and behavioral changes in children. That’s why I did research and found a case that can reduce radiation exposure. One of the greatest disadvantages of the cellular phone is the fact that we do not talk to strangers when traveling anymore. In the past, several people waiting for a bus would engage in a conversation while they were waiting. People who traveled the same routes every day might develop friendships along the way. This situation does not happen anymore. Today when people are waiting for a bus, they just pull out their cell phones and speak with old friends, missing out on the opportunity to make new ones. In large cities, many people do not know their neighbors, even though they may have lived in the same neighborhood for years. As a society, we are beginning to lose the face-to-face contact that was such an important part of our lives in the past. Cell phones are a great asset in aiding in our everyday lives. You should remember, however, to hang up every once in a while and pay attention to the world around you.

Death Penalty Abolishment Essay

In today’s world, money is a source for mostly everything. It is what keeps food on the table and what keeps most people going to work. With how hard people work to earn and maintain an income, it would be nice to know where the money taken in taxes goes. According to the Center on Budget and Policy Priorities (2014), the United States spent 50 billion dollars on the Department of Corrections. 35% of that total was used for capital punishment cases, which totals out to 17.5 billion dollars used in one year towards capital punishment in the United States. A large portion of those funds being used are coming from state and federal taxes collected from hard working U.S. citizens. That 17.5 billion dollars could be used for much better things then court cases. State legislatures still allowing the death penalty need to abolish the practice period to lower state taxes, fix prison structures, and help redirect funds to better locations. The complete abolishment of capital punishment would be a large driving force to lower state taxes. According to the Internal Revenue Service (IRS), the average state tax for middle class families or individuals is 9%. (2014). Using California as an example, out of that 9%, 3% goes to the states Department of Corrections. Out of that 3%, 2% of that is fed into public defenders, court room hearings and cases, extra security for death row inmates, as well as their food, living quarters, and special transportation. That is a lot of costly measures for a single person when you look at numbers. In regards to where the rest of those taxes goes, .5% goes to public safety, .25% goes towards state education services, and 1% goes towards public transportation (California Board of Equalization, 2014). If the state continues to use executions as a method of punishment, the percentage going towards corrections will only rise. If it continues to rise, either taxes will go up or the state will have to pull from education, emergency responders, and public transportation. If you look at the state of Michigan, who did abolish capital punishment, income tax is a little different. According to Michigan’s Department of Treasury (2014), the income tax is 7% for middle class families and individuals. Of that already lower 7%, only 1.55% goes towards the state’s Department of Corrections, with .75% going towards education and .75% going towards public safety. Taxes will always be there  and likely b e somewhat high but the states without capital punishment generally have a lower rate with better allocation of the funds. Capital punishment is creating an atmosphere of higher costs all around, which have to come from somewhere. Current prison structures are taking a large hit due to capital punishment that usually goes unseen. Unfortunately it takes a major issue such as a prison guard’s death to point out the prison structure issues. The average guard to inmate ratio varies from state to state. In the best conditions the guard to inmate ratio will be 1:5, in worse case situations, some states are currently 1:20. Whereas some states require a minimum of 1:1 guard to inmate ratio for death row inmates (Mitchell, 2012). Those guards are being paid next to nothing compared to the costs taking place around them. Taking a look at what it costs to maintain a prison can be staggering. It costs an average of about $47,000 per year to incarcerate an inmate in prison in California (Edwards, 2009). That number skyrockets for a death row inmate. California taxpayers pay $90,000 more per death row prisoner each year than on prisoners in regular confinement (Mitchell, 2012). With just over 3,000 people on death row, that places a yearly $270,000,000 extra that has to be placed on death row inmates. That extra money is needed for the court hearings, extra security, singled out specific cells, and an entire area of a prison just for them. According to the Bureau of Justice Statistics, the average time someone spends on death row is 14 years (2011). If you take the 14 year average, each death row inmate is costing their state roughly $1,260,000 prior to execution. If the total amount of death row inmates is taken into account, it is costing the nation’s tax payers roughly 3.78 billion dollars over the course of 14 years to follow through with the â€Å"quick fix† to murderers. Those funds could help restructure the prisons, creating a safer environment for the guards to be in. According to Ron McAndrew (2014), a former state prison warden, â€Å"Guards are never in a fair game situation, they are trained to be outnumbered, which is a horrible thing to think about, we are hiring them and placing them in that kind of situation because we do not have a choice.† Removing capital punishment allows for the removal of death row. If death row is removed, it would allow all those extra security measures and guards to be used for general population and overall prison security. With all the money being spent on capital punishment related issues, the complete abolishment  of it would allow states to place that money where it would greatly help. According to the Organization for Economic Co-operation and Development (OECD), the United States ranks 33 in reading, 27 in math, and 22 in science amongst the rest of the countries in the world (2011). Imagine what some of that money being used for capital punishment could do for the United States as a whole when put into education. A portion of the extra money could potentially be put towards emergency responder services. Those funds could cause faster response times, better equipment, and better and more frequently trained personnel. As a whole that could potentially save lives. Another area that would better tremendously due to the relocation of funds is medical facilities. Most medical facilities in the United States are always understaffed, underpaid, and have issues maintaining. Lives could potentially be lost due to slow response times or understaffed hospitals (Sarat, 2009). The funds could go towards providing better public transportation or for some states, providing it p eriod. That money could also clean up streets, provide better roadways, and overall safer environments on roads. It could even be used to provide more jobs for a state or not be used at all and go back into the taxpayer’s pocket. Any of those options are far better than spending millions of dollars to â€Å"dispose† of a violent criminal. Just allow him to live his life out in prison. When you simplify all of the statistics and information, it comes down to a substantial amount of money being pushed into capital punishment that comes out of the taxpayer’s pocket and goes into an unnecessary location. Even though more and more states are slowly abolishing the death penalty it is still staggering how much it is costing the country as a whole. That money could do so much more for those affected states and the state services they provide to the public. So if state legislatures abolish the death penalty, it could lower state taxes, help correct issues in prison structures and help redirect funds to where they are needed. References Mitchell, P. (2008, June). Death Penalty Debacle. Retrieved August 15, 2014, from http://www.deathpenaltyinfo.org/documents/LoyolaCalifCosts.pdf Edwards, A. (2009, February). Annual Cost to Incarcerate. In Criminal Justice and Judiciary. Retrieved August 16, 2014, from http://www.lao.ca.gov/PolicyAreas/CJ/6_cj_inmatecost Snell, T. (2014, May). Capital Punishment Statistical Tables. In Bureau of Justice Statistics. Retrieved August 17, 2014, from http://www.deathpenaltyinfo.org/documents/cp12st.pdf Sarat, A. (2008). Is the Death Penalty Dying?. Amsterdam: Elsevier JAI. Horton, J. E. (2014, January). Detailed Description of the Sales & Use Tax Rate. In California State Board of Equalization. Retrieved September 1, 2014, from http://www.boe.ca.gov/news/sp111500att.htm White, G. (2014, January). Michigan Equalization Information 2014. In Michigan Department of Treasury. Retrieved September 2, 2014, from http://www.michigan.gov/taxes/0,4676,7-238-43535_43537-154825–,00.html McAndrew, R. (2014, October 23) From Executioner to Advocate – Ron McAndrew Retrieved from: http://www.youtube.com/watch?v=k_Ld9ffm_pY

Critical Thinking on Role of Scavenging in Waste Management Processes

The problems associated with scavenging are so vast that the position of scavengers needs to be reconsidered. As much as the importance of scavengers should not be under-looked, it is true that serious measures need to be taken. The major role that scavengers perform is, the reduction of the amount of waste, as they collect and sell some of the waste materials thereby encouraging recycling. They also provide the work force that is needed in garbage collection. This acts as the major source of their livelihood. However, when waste is managed in a proper way, there is likelihood of job creations for the scavenging class thus reduction of their need for collecting and selling the waste materials. This lowers the poverty rate and reduces the direct problems that are associated with the waste. The waste-associated problems to the scavengers include low hygiene, risks of fire outbreaks and general dangers including disease outbreaks. Sustainable Development in waste management is achieved by the direct involvement of the scavenging class in policy and decision making, and encouragement of their participation. Creation of opportunities that leads to the employment of the scavengers is the most sustainable way. When employed as part of the waste management team, their income level would rise as the poverty state falls. Their direct participation in the process of waste management would also be utilized fully as they are aware about the recycling and reuse of such waste. I strongly believe that the role of scavengers in waste management is very important that their inclusion in decision making and participation leads to Sustainable development.