Search results

1 – 10 of 23
Per page
102050
Citations:
Loading...
Access Restricted. View access options
Article
Publication date: 24 March 2011

Antony Bayer

Geriatric medicine is the branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness in older people. Rather than being defined by…

828

Abstract

Geriatric medicine is the branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness in older people. Rather than being defined by some arbitrary cut‐off in chronological age, it recognises that most older people, especially the ‘young‐old’, are in good health for most of the time. They are likely to benefit from standard medical management by generalists. Geriatricians focus on the more challenging patients ‐ those older people who are physically and cognitively frail, many of whom will be among the growing numbers of the ‘old‐old’. This population is characterised by non‐specific presentation of illness, functional dependency and a need for a multidisciplinary approach to care and judicious use of drug therapy. Drawing on publications from the department of geriatric medicine in Cardiff, this article illustrates important aspects of clinical care of older people and highlight the need for better recognition and prevention, better assessment and diagnosis and better therapeutic tools to manage acute and chronic illness in old age.

Details

Quality in Ageing and Older Adults, vol. 12 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

Access Restricted. View access options
Article
Publication date: 7 September 2012

Antony Bayer

Knowledge of Alzheimer's disease (AD), timely recognition and good management should be the norm in all health and social care settings. This paper seeks to focus on developments…

386

Abstract

Purpose

Knowledge of Alzheimer's disease (AD), timely recognition and good management should be the norm in all health and social care settings. This paper seeks to focus on developments in diagnosis and treatment.

Design/methodology/approach

Key research papers and policy documents published in the last few years are reviewed, with an emphasis on those most relevant to Wales.

Findings

The number of people with AD is predicted to steadily increase over the next 40 years. Recent policy developments have recognised the importance of better identification and management of dementia and have proposed memory clinics as the core of new services for early diagnosis and identification. Newer biomarkers of AD enable diagnosis to be made more reliably and at a stage before the patient is demented (prodromal AD). Latest guidance from the National Institute for Health and Clinical Excellence (NICE) now recommends that the use of anticholinesterase inhibitor drugs or memantine is considered in all patients with AD. There is active research into newer treatment approaches, notably the role of cognitive rehabilitation in early dementia and the use of potentially disease‐modifying drugs such as anti‐amyloid antibodies. Unfortunately, current research funding is inadequate and only a small minority of people with AD become involved with research.

Originality/value

The paper shows that, given the growing importance of AD, there is an urgent need to boost recruitment of people with dementia into research trials. There is also a need to address ethical considerations of diagnosing prodromal AD – this is important for both the person undergoing assessment and for society as a whole.

Details

Quality in Ageing and Older Adults, vol. 13 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Access Restricted. View access options
Article
Publication date: 24 March 2011

Peter Elwood

86

Abstract

Details

Quality in Ageing and Older Adults, vol. 12 no. 1
Type: Research Article
ISSN: 1471-7794

Available. Content available
Article
Publication date: 7 September 2012

Peter Elwood

231

Abstract

Details

Quality in Ageing and Older Adults, vol. 13 no. 3
Type: Research Article
ISSN: 1471-7794

Access Restricted. View access options
Article
Publication date: 24 March 2011

Win Tadd, Alex Hillman, Sian Calnan, Mike Calnan, Tony Bayer and Simon Read

This paper reports on an ethnographic study to explore the experience of dignity in the acute care of older people in four acute NHS trusts. It explores the prevalent view that…

1178

Abstract

This paper reports on an ethnographic study to explore the experience of dignity in the acute care of older people in four acute NHS trusts. It explores the prevalent view that acute care is not the right place for older people and the failure to acknowledge that the largest group of users are the very old, the frail and the dependent, which results in environments that are not friendly to older people generally, and are especially hostile to those with cognitive impairments. Added to this, a culture that is risk averse and defensive, where care is undervalued and where professional accountability and discretion are replaced by standardised checklists, pathways and audits, cultivates the attitude that if an aspect of care can't be measured it doesn't matter. Overall, getting the job done appears to matter more than how the job is done, so that the focus is primarily on the task rather than seeing the person. It describes how the failure of acute trusts to respond to the needs of the majority of their users ‐ older people ‐ results in the failure to provide dignified care and the impact of this on both the quality of care and patient outcomes.

Details

Quality in Ageing and Older Adults, vol. 12 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

Access Restricted. View access options
Article
Publication date: 12 October 2022

Ali Ahmed, John Olsen and John Page

The overarching objective of this research is to integrate the Lean Six Sigma (LSS) framework with computer simulation to improve the production efficiency of a light-emitting…

917

Abstract

Purpose

The overarching objective of this research is to integrate the Lean Six Sigma (LSS) framework with computer simulation to improve the production efficiency of a light-emitting diode (LED) manufacturing factory.

Design/methodology/approach

Recently, the idea of taking advantage of the benefits of Six Sigma and simulation models together has led both industry and the academy towards further investigation and implementation of these methodologies. From this perspective, the present research will illustrate the effectiveness of using LSS methodology in a real factory environment by using the combination of three simulation methods which are system dynamics (SD), discrete-event simulation (DES) and agent-based (AB) modelling.

Findings

The hybrid simulation method applied in this research was found to accurately mimic and model the existing real factory environment. The define, measure, analyse, control and improve (DMAIC)-based improvements showed that the applied method is able to improve machine utilization rates while balancing the workload. Moreover, queue lengths for several stations were shortened, and the average processing time was decreased by around 50%. Also, a weekly production increase of 25% was achieved while lowering the cost per unit by around 8%.

Research limitations/implications

While the case study used was for a LED manufacturing system, the proposed framework could be implemented for any other existing production system. The research also meticulously presents the steps carried out for the development of the multi-method simulation model to allow readers to replicate the model and tailor it for their own case studies and projects. The hybrid model enables managers to navigate the trade-off decisions they often face when choosing advanced production output ahead of continuous improvement practices. The adoption of methodologies outlined in this paper would attain improvements in terms of queue lengths, utilization, reduced costs and improved quality and efficiency of a real, small factory. The findings suggest improvements and create awareness among practitioners for the utilization of quality tools that will provide direct benefits to their companies. Although the multi-method simulation is effective, a limitation of the current study is the lack of micro details within each station. Furthermore, the results are all based on one specific case study which is not enough to suggest and generalized findings.

Originality/value

This research combines the use of the three main hybrid simulation paradigms (SD, DES and AB) in a unified framework DMAIC methodology. Choosing the right models in DMAIC is important, challenging and urgently necessary. Also, this paper shows empirical evidence on its effectiveness.

Details

International Journal of Lean Six Sigma, vol. 14 no. 2
Type: Research Article
ISSN: 2040-4166

Keywords

Access Restricted. View access options
Article
Publication date: 1 May 1971

Earliest localism was sited on a tree or hill or ford, crossroads or whenceways, where people assembled to talk, (Sax. witan), or trade, (Sax. staple), in eggs, fowl, fish or…

121

Abstract

Earliest localism was sited on a tree or hill or ford, crossroads or whenceways, where people assembled to talk, (Sax. witan), or trade, (Sax. staple), in eggs, fowl, fish or faggots. From such primitive beginnings many a great city has grown. Settlements and society brought changes; appointed headmen and officials, a cloak of legality, uplifted hands holding “men to witness”. Institutions tend to decay and many of these early forms passed away, but not the principle vital to the system. The parish an ecclesiastical institution, had no place until Saxons, originally heathens, became Christians and time came when Church, cottage and inn filled the lives of men, a state of localism in affairs which endured for centuries. The feudal system decayed and the vestry became the seat of local government. The novels of Thomas Hardy—and English literature boasts of no finer descriptions of life as it once was—depict this authority and the awe in which his smocked countrymen stood of “the vicar in his vestry”. The plague freed serfs and bondsmen, but events, such as the Poor Law of 1601, if anything, revived the parish as the organ of local government, but gradually secular and ecclesiastical aspects were divided and the great population explosion of the eighteenth century created necessity for subdivision of areas, which continued to serve the principle of localism however. The ballot box completed the eclipse of Church; it changed concepts of localism but not its importance in government.

Details

British Food Journal, vol. 73 no. 5
Type: Research Article
ISSN: 0007-070X

Access Restricted. View access options
Book part
Publication date: 9 October 2020

Nadia Smaili, Julien Le Maux and Walid Ben Amar

Abstract

Details

Corporate Fraud Exposed
Type: Book
ISBN: 978-1-78973-418-8

Access Restricted. View access options
Article
Publication date: 1 January 1979

Mary M. Nash and P.W. Williams

Lockheed to add Foreign Trade Index and The Philosophers Index; installs new computer. Lockheed Information Systems continues to announce plans for database additions at a rapid…

22

Abstract

Lockheed to add Foreign Trade Index and The Philosophers Index; installs new computer. Lockheed Information Systems continues to announce plans for database additions at a rapid rate. This time two somewhat unusual databases are being scheduled for introduction early in the spring of 1979.

Details

Online Review, vol. 3 no. 1
Type: Research Article
ISSN: 0309-314X

Access Restricted. View access options
Article
Publication date: 1 June 2005

Sergio Ariño‐Blasco, Win Tadd and Josep Boix‐Ferrer

Professionals' views concerning the importance of dignity and how this can best be maintained is important for the planning and provision of appropriate services, especially for…

348

Abstract

Professionals' views concerning the importance of dignity and how this can best be maintained is important for the planning and provision of appropriate services, especially for older people.Dignity was described as an integral part of being human and closely related to respect. Overall, participants painted a negative image of the lives of older people, although clear distinctions were drawn between fit and frail older people. Indignities associated with old age arose from ill health, dependency, vulnerability, frailty and loss of competence. It was considered that technological advances and information technology had left many older people behind. However, many described working with older people as an enjoyable experience offering variety, intellectual challenge and satisfaction, while recognising that working with older people was often given low status.Professionals identified the following factors as essential to dignified care: promotion of autonomy and independence; a person‐centred and holistic approach; maintenance of identity and encouragement of involvement, participation and empowerment; effective communication and respect. Undignified care was associated with: invisibility; de‐personalisation and treatment of the individual as an object; humiliation and abuse; narrow and mechanistic approaches to care.Policy development and professional education should give greater prominence to dignity and a greater emphasis ought to be placed on living with dignity in old age rather than solely dying with it.

Details

Quality in Ageing and Older Adults, vol. 6 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

1 – 10 of 23
Per page
102050