Startery Podlaskiej Gospodarki. Analiza Gospodarczych Obszarów Wzrostu I Innowacji Województwa Podlaskiego: Sektor Rehabilitacji Geriatrycznej (Podlasie Economy Starters. Analysis of Economic Growth and Innovation Areas of Podlaskie: Geriatric Rehabilitat Bogusław Plawgo, Magdalena Klimczuk, Mariusz Citkowski, Marta Juchnicka & Andrzej Klimczuk Wojewódzki Urz¸Ad Pracy W Białymstoku (2009) .

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a (...) series of adaptable questions for the patient–physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient’s aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values. (shrink)

Caregiving robots are often lauded for their potential to assist with geriatric care. While seniors can be wise and mature, possessing valuable life experience, they can also present a variety of ethical challenges, from prevalence of racism and sexism, to troubled relationships, histories of abusive behavior, and aggression, mood swings and impulsive behavior associated with cognitive decline. I draw on Confucian ethics, especially the concept of filial piety, to address these issues. Confucian scholars have developed a rich set of theoretical (...) resources for dealing with beloved but imperfect elders, and navigating the challenges of supporting seniors whose ethical commitments are unreliable. These resources provide a way to reconcile two important but conflicting desiderata: to value and care for seniors, but also to clear-mindedly deal with their moral shortcomings. In particular, they articulate a duty to remonstrate with our elders when they err. Confucian filial piety can helpfully inform robot design and use in geriatric care. They can be used to strengthen and protect emotional connections in important relationships, but should not be used to reinforce patient preferences when doing so damages relationships or their ability to act morally. Rather than conceive of patient wellbeing as in tension with moral behavior, and care as a burden for caregivers, not a source of value and meaning, Confucian accounts of filial piety help identify both new areas of concern and new potential in the development of caregiving technologies, ones which see these goods as complementary. (shrink)

As the world population is rapidly aging, stakeholders must address the care of the elderly with great concern. Also, loss of dignity is often associated with aging due to dementia, mobility problems and diminished functional autonomy. However, dignity is a polysemic term that is deemed useless by some ethicists. To counter this claim, we propose four concepts to define it better and make use accurately of this notion. These are human dignity, dignity of identity, dignities of excellence and attributed dignities. (...) Finally, we explain the importance of solicitude and human dignity in the care of the elderly. This will ensure the respect, friendship and dignity of the elderly in providing geriatric ethical care. (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Gerontologia kreatywna - dział gerontologii społecznej postulowany przez Anitȩ Stefańsk¸a} i Martȩ Szabelsk¸a}-Holeksȩ. Docelowo subdyscyplina ta ma zajmować siȩ problematyk¸a} twórczości i kreatywności osób starszych. Gerontologia kreatywna jest przede wszystkim zwi¸a}zana z psychologi¸a} twórczości, a szczególnie z akmeologi¸a} kreatywn¸a}, czyli psychologi¸a} osobowości twórczej człowieka. Gerontologia kreatywna z jednej strony korzysta z wiedzy pochodz¸a}cej z geriatrii, gerontopsychologii, gerontologii eksperymentalnej, gerontosocjologii i geragogiki. Z drugiej strony zaś podstawy gerontologii kreatywnej osadzone s¸a w działach akmeologii kreatywnej, w szczególności w: historii akmeologii kreatywnej, akmeologii (...) kreatywnej działalności zawodowej, akmeologii kreatywnej osobowości, eksperymentalnej akmeologii kreatywnej oraz stosowanej akmeologii kreatywnej. Konceptualizacja teorii gerontologii kreatywnej jest prób¸a zastosowania teorii istniej¸acych już na gruncie psychologii i gerontologii. Gerontologia kreatywna jako nauka multidyscyplinarna ma także korzystać z dorobku socjologii, filozofii, medycyny, biologii, ekonomii, demografii, antropologii społecznej i kultury, pedagogiki społecznej, kultur i twórczości oraz nauk o kulturze i sztuce. ** Creative gerontology - department of social gerontology postulated by Anita Stefańska and Marta Szabelska-Holeksa. Ultimately, this sub-discipline is to deal with the issues of creativity and creativity of older people. Creative gerontology is primarily associated with the psychology of creativity, and especially with creative acmeology, or the psychology of the creative personality of a human being. On the one hand, creative gerontology uses knowledge derived from geriatrics, gerontopsychology, experimental gerontology, gerontosociology and geragogy. On the other hand, the foundations of creative gerontology are embedded in the sections of creative acmeology, in particular in the history of creative acmeology, creative occupational acmeology, creative personality acmeology, experimental creative acmeology and applied creative acmeology. Conceptualization of the theory of creative gerontology is an attempt to apply theories already existing on the basis of psychology and gerontology. Creative gerontology as a multidisciplinary science is also to use the achievements of sociology, philosophy, medicine, biology, economics, demography, social anthropology and culture, social pedagogy, cultures and creativity as well as the sciences of culture and art. (shrink)

The questions concerning “who we are”, “where we go to”, and “where we come from”, preoccupied the humanity from immemorial times. During the last few decades, with the accelerated improvement of the investigation methods and of the advanced successful interventions allowing the life salvation, there have been reported some attempts to correlate the psychic phenomena with the body status by the recuperation, analysis and explanation of the symptoms recorded during the near-death experiences. Such special situations, in which the heart and (...) the brain, the support of mental activities, cease their activity, has become a fundamental tool to investigate the consciousness associated phenomena during the arrest status of the fundamental processes of the life. The fundamental question actually is whether consciousness really continues to exist even if the body has ceased its function by stopping the heartbeat and brain support activities [1,2]. An answer to such a question goes toward even further questions: can there be “life” beyond the death [3]? This exciting question includes also several aspects: what is consciousness and which is its nature [4]? Could consciousness exist as a disembodied entity? To answer these fundamental questions of existence, the collaboration of several disciplines such as neurology, psychology, medicine, biology, pharmacology and also physics, to call only the most important of them, is necessary, the geriatrics finding suitable responses within the multidisciplinary researches to its various questions related to the life prolongation and the improvement of the life quality. Within such a context, it was recently developed an informational model of consciousness, which can offer response to the above questions, based on the last discoveries of the quantum physics and cosmology [4,5]. (shrink)

Old age in the Indian context and facing it through Ayurveda.

As it was shown in the Part I of this work, the driving of our life is determined by series of YES/NO - type elemental decision, which is actually the information unit (Bit), so we operate actually in an informational mode. The informational analysis and modeling of consciousness reveals seven informational systems, reflected at the conscious level by the cognitive informational centers suggestively called Iknow (Ik - memory), Iwant (Iw - decision center), Iove (Il-emotions), Iam (Ia-body status), Icreate (Ic-informational genetic (...) transmitter and educator), Icreated (I-cd genetic generator inherited from the parents) and Ibelieve, (Ib - connection to the informational field of the universe). As the mind can operate in a bipolar mode, we dispose of two alternatives to use our free will: in a positive (YES) or negative (NO) mode. Such modes can be applied as a function of the personal criteria, especially that inhered from the family, which are the fundamental ones, but also from that acquired during the life. The persistence to operate in a positive or a negative mode is fundamental for the designing of our personal trajectory and therefore for our destiny. The destiny and the role of our free will in deciding the course of our own life are analyzed therefore with respect to our YES/NO attitude, which is an integrated informational output composed by the contribution of all cognition centers, showing that when this is favorable to the life rules, it is avoided its deterioration determined by a permanently negative attitude and thinking mode. It is shown that our intervention should be directed both to the operating mode but also to the decision criteria, when it is ascertained that they do not correspond to the reality, allowing a favorable adaptation. As parents and therefore as forming and educator of the next generation, an activity specific for the center Ic, it is necessary to observe, discover and encourage the talents and predispositions of their Children, to put them on a privileged way of the destiny, because they will benefit of an advanced informational “budget” with respect to their generation and a certain sort of preparation. The comparative analysis between personal operating mode and the reality for adaptation necessities should guide permanently the selected trajectory way, to include new criteria, to change the older, or to reprogramming the operation mode, with the participation of all centers. The stereotype thinking chains triggered by repetitive negative thoughts acts on the informational system as stressing agents, leading to chronic, sometime serious disorders. Such thinking operation forms should be therefore detected and substituted or eliminated without delay, according to some recommended suggestions. Furthermore, it is shown that a specific self-control of the thoughts as positive or negative information and of the lifestyle, helps the health maintenance and the life prolongation under high qualitative. (shrink)

We drive our lives permanently by decisions YES/NO, and even we no longer distinguish the elementary intermediary steps of such decisions most often, they form stereotyped chains that once triggered, they run unconsciously, daily facilitating our activities. We lead our lives actually by conscious decisions, each of such decisions establishing our future trajectory. The YES/NO dipole is actually the elemental evaluation and decisional unit in the informational transmission/reception equipment and lines and in computers, respectively. Based on a binary probabilistic system, (...) this is defined as a unit of information (Bit). We operate therefore as an informational system and we actually live in a bipolar universe, which is fundamentally informational. Indeed, the laws of nature and its equilibrium or steady state conditions are based on bipolar units with opposite characteristics, such as action/reaction, attraction/rejection, gravity/anti-gravity, matter/antimatter, entropy/anti-entropy, to enumerate just a few examples. As part of this bipolar universe, we are also bipolar entities connected to information and matter. Starting from the informational features of the human being, seven informational components are identified, forming the informational system of the human body, distinguished by their different functions, reflected at the conscious level through the center Iknow (the memory, including whole life experience), Iwant (decisions center), Iove (emotions), Iam (body status), Icreate (informational genetic transmitter), Icreated (genetic generator inherited from parents) and Ibelieve, which is the gateway to the antientropic component, favorable to maintain the life structure and functioning. Taking into account the characteristics of these centers, it is discussed the life cycle and are deduced suitable conclusions concerning an optimal, active lifestyle, that would contribute to a successful life, aging and destiny. (shrink)

The rapid increase of the old age people imposes the reconsideration of the rehabilitation techniques and procedures and/or the development of the existing ones, at least from two points of view: the limitation use of the pharmaceutical drugs because of their secondary effects in the debilitated organisms and their avoidance; the high risk of the induced anxiety states, depression or other symptoms as a consequence of the main disease, i.e. the neuro-degenerative or mobility dysfunctions, limiting again the use of such (...) excessive drug medication. Moreover, Alzheimer’s or Parknson’s diseases are otherwise incurable, so the application of rehabilitating procedures like music-based therapy becomes preferential. The advances both in the identification of the specific auditory musical-sensitive circuits and of the non- musical neuro-connections but activated indirectly by music, otherwise inaccessible by other techniques, and in the understanding of consciousness, which can be described by seven cognitive centers, allows to improve and develop the music based therapy. A multitask procedure based on the activation of these cognition centers is presented, allowing to increase the personal psychical engagement of the patient in the recommended music based therapeutic program, addressed both to the rehabilitation of the main degenerative disease and to the secondary induced dysfunctions. This procedure combines the evidence based medicine assisted by laboratory expertise for the determination of a correct diagnostic, and narrative based medicine allowing to quantify the personal engaging qualities of the patient with respect to the proposed music based program, reducing in this way the gap between these two basic procedures and bringing in a first plane the patient care, not only the disease, with beneficial consequence for the therapy efficiency and for the patient-medical care relations. (shrink)

The “nature or nurture” problem concerning the debate on the innate features with respect to the acquired ones is approached in terms of information, from the perspective of the Informational Model of Consciousness. This model reveals seven distinct informational systems reflected in consciousness as informational centers, i.e. memory (Iknow-Ik), decisional info-operational center (Iwant-Iw), emotions (Ilove-Il), metabolic operations (Iam-Ia), genetic transmission (Icreate-Ic), genetic info-generation (Icreated-Icd) and the anti-entropic center (Ibelieve-Ib). Ib is a life-assisting beneficial center, because it is opposed to the (...) entropic action of matter, eliminating or reducing the uncertainty characteristic of unknown possibilities to certainty, and inducing in this way the trust and confidence in own actions. The pro and contra arguments of the “nature or nurture” are shortly presented, noting the large range of divergent opinions and concepts on the approached problem. It is shown that the information concept acting both as informal and matter-related information, specifically referred to the embodiment/ disembodiment mechanisms for the transmission of information during the epigenetic processes, can coherently approach and explain the transgenerational transmission of the traits acquired during the life span of the predecessors. The concepts of tendency, affinity, propensity, predisposition, aptitude, vocation and talent, specific for inheritable properties described by Icd are discussed, pointing out the large pallet and variety of such concepts describing the evidences detected by external observers on the inherited behaviors, and that of self-perceived by the implicated individual, as a silent voice of whose are no longer. The external manifestation of such inherited features and traits depends on practice, because the characteristic operation of the nervous system and of epigenetic processes is based on repetition and/or intensive practice, but these are permanently guided by the silent voice of those who are no longer, with various signal intensities. (shrink)

Suicide is a major public health issue in many industrialized countries. It is one of the top ten causes of death and older age is a significant risk factor for suicide. For example, in Japan older adults (age ≥ 65) shared about 18.5% of total population but account for 24% of all suicide, in Taiwan, older adults representing 12.4% of the total population and account for 28.9% of suicide death. Dementia is a broad term for a progressive deterioration in memory (...) ability and dementia patients ran higher risk for suicide. (shrink)

The fourth amendment to the German Medicinal Products Act (Arzneimittelgesetz) states that nontherapeutic research in incompetent populations is permissible under the condition that potential research participants expressly declare their wish to participate in scientific research in an advance research directive. This article explores the implementation of advance research directives in Germany against the background of the international legal and ethical framework for biomedical research. In particular, it addresses a practical problem that arises from the disclosure requirement for advance research directives. (...) We show that, if the disclosure standard for advance research directives is set at a token level, nontherapeutic research in incompetent populations becomes practically impossible. To resolve this issue, we suggest the disclosure standard be set at a type level. (shrink)