           Health Promotion for the Elderly in Peru, Bolivia and Chile SONIA VASQUEZ  THESIS FOR DEGREE OF MASTER IN HEALTH PROMOTION SPRING 2005 HANDLEDARE: PROFESSOR BO J A HAGLUND KAROLINSKA INSTITUTET Institutionen för folkhälsovetenskap Avdelningen för socialmedicin     2      Report series of Master theses in Public Health These reports come from the Board of Education in Public Health Sciences at Karolinska Institutet. The master education of Public Health at KI is a collaborative work of mainly three departments: Department of Public Health Sciences, The Department of Biosciences at Novum , Division of Preventive Nutrition, and The Institute of Environmental Medicine. These reports are presented as pdf files on the webbpages of Master of Public Health Education at Karolinska Institutet Leif Svanström Professor and Programme Director   3            ABSTRACT 5 DEFINITIONS 5 LIST OF ABBREVIATIONS 7 1. INTRODUCTION 7 2. BACKGROUND 9 2.1 GLOBAL OVERVIEW 9 2.2 GOALS FOR HEALTH PROMOTION IN OLDER PEOPLE 12 2.3 APPROACHES TO HEALTH PROMOTION FOR OLDER PEOPLE 12 2.3.1 The cultural change approach 13 2.3.2 The structural change approach 14 2.3.3 Intersectoral approaches 14 2.3.4 Community-based approaches 14 2.3.5 Family-based approaches 15 2.3.6 The individual approach 15 2.4 THEORETICAL MODELS FOR HEALTH PROMOTION IN OLDER PEOPLE 15 2.4.1 Individual-Level Models 16 2.4.2 Community-Based Models 17 2.5 METHODS OF IMPLEMENTING HEALTH-PROMOTION APPROACHES 17 2.5.1 Advocacy 18 2.5.2 Social Support 18 2.5.3 Empowerment 18 3. AIM 19 4. QUESTIONS 19 5. MATERIAL AND METHOD 19 5.1 CRITERIA FOR INCLUSION 19 5.2 SEARCH STRATEGIES 20 5.3 SELECTION OF ARTICLES IN THE DATABASE SEARCH 20 5.4 ANALYSING PROCESS 21 6. FINDINGS 22 6.1HEALTH PROMOTION PROGRAMMES IN WORLD HEALTH ORGANIZATION 23 6.1.1 Oral Health 23 6.1.2 Physical Activity 23 4 6.1.3 Non communicable Diseases 24 6.1.4 Mental health 24 6.1.5 Diet and physical activity 24 6.2 HEALTH PROMOTION PROGRAMMES IN THE PAN AMERICA HEALTH ORGANIZATION 25 6.2.1 Elderly People and Family 25 6.2.2 Promotion of Active Life 25 6.3 HEALTH PROMOTION PROGRAMMES IN CHILE 26 6.4 HEALTH PROMOTION PROGRAMMES IN BOLIVIA 28 6.5 HEALTH PROMOTION PROGRAMMES IN PERU 29 7. DISCUSSION 30 7.1 MATERIAL AND METHOD 30 7.2 FINDINGS 31 8. CONCLUSION 34 9. CHALLENGES 35 APPENDIX 1 35 REFERENCES 37  FIGUR 1: APPROACHES TO HEALTH PROMOTION FOR OLDER PEOPLE 13  TABELL 1: DEMOGRAPHIC TRANSITION AND TYPOLOGY OF THE CELADE FOR COUNTRIES OF LATIN AMERICA AND THE CARIBBEAN; 1980 9 TABELL 2: DEMOGRAPHIC INDICATORS FOR CHILE, PERU AND BOLIVIA 10 TABELL 3: SOCIOECONOMICS INDICATORS FOR CHILE, PERU AND BOLIVIA 11 TABELL 4: NUMBER OF SOURCE ARTICLES 20 TABELL 5: PROGRAMMES HEALTH PROMOTION FOR ELDERLY PEOPLE IN CHILE, PERU AND BOLIVIA 22 TABELL 6: PROGRAMMES HEALTH PROMOTION FOR ELDERLY PEOPLE IN CHILE, PERU AND BOLIVIA APPLY BY LEVELS 22      5              !! " HCMC, Vietnam, September, 2017 Study on cooperative ride system for the elderly in rural area of Japan Nagoya University Hitomi Sato HCMC, Vietnam, September, 2017 Nghiên cứu hệ thống chung xe cho người cao tuổi vùng nông thôn Nhật Bản Đại học Nagoya Hitomi Sato Background (1): General Evolving Issues Giới thiệu (1): Một số vấn đề chung có liên quan • A declining birth rate and aging population • Sự suy giảm tỷ lệ sinh dân số già • Depopulation in semi-mountainous areas • Sự suy giảm dân số vùng bán sơn địa - Degraded public transport services - Dịch vụ vận tải công cộng bị suy thoái - Decreased local facilities like gas stations and shops - Các có sở địa phương trạm xăng, cửa hàng bị suy giảm • “Inconvenient transportation” for the elderly (who have surrendered their driving license) • “Giao thông không thuận tiện” cho người già (người huỷ bỏ lái xe) • Preference of the elderly : Ageing and living in familiar surroundings • Ưu tiên của người cao tuổi: Sống lâu và sống trong môi trường quen thuộc These issues have been growing rapidly in Japan Những vấn đề phát triển nhanh chóng Nhật Background (2): Issues in Semi-Mount Areas Giới thiệu (2): Vấn đề vùng bán sơn địa Problems of Living in Semi-Mountainous Communities Các vấn đề sống vùng bán sơn địa No medical doctors in the vicinity No emergency hospital in the vicinity No daily shops in the vicinity No medical doctors in the vicinity No emergency hospital in the vicinity No daily shops in the vicinity No jobs in the vicinity No jobs in the vicinity No post office in the vicinity Schools are too far No post office in the vicinity Schools are too far Source: MLIT Accessibility to medical doctors and shops is the main issue in those areas Source: MLIT Khả tiếp cận đến bác sỹ cửa hàng vấn đề vùng Objective of Community Support System/This study Mục tiêu hệ thống hỗ trợ cộng đồng/Nghiên cứu The ultimate goal of the project: Mục tiêu cuối cùng của dự án: To build a sustainable society where the elderly spend a vibrant life in semimountainous areas without being forced to move to urban areas Mobility Support Objective of this study is, Để xây dựng xã hội bền vững nơi mà người cao tuổi sống sống thoải mái vùng bán sơn địa mà chuyển đến thành phố Health Support To reach this goal, the community support system are developed Để đạt mục tiêu này, hệ thống hỗ trợ cộng đồng đợc phát triển Outing Stimulation Community Support System CSS Hỗ trợ y tế/sức khoẻ Hỗ trợ lại Mục tiêu nghiên cứu là, Khuyến khích chơi Hệ thống hỗ trợ cộng đồng CSS • To evaluate Mobility Support System with “Daily Happiness” • Để đánh giá hệ thống hỗ trợ lại với ”hạnh phúc hàng ngày” • To find factors affected to Daily Happiness of the elder • Để tìm yếu tố ảnh hưởng tới hạnh phúc hàng ngày người cao tuổi Asuke District Target Area Nagoya City Asuke District Toyota City Population 8,307 422,876 Ratio of the elderly 37% 21% Modal share 83% of trips are used by car Huyện Asuke Vùng quan tâm KS Dân số Nagoya City Asuke District Tỷ lệ người già Phương tiện TP Toyota 8,307 422,876 37% 21% 83% chuyến ô tô As of 2015 As of 2015 Central Toyota Central Area of Asuke Trung tâm Toyota Vùng trung tâm Asuke Central Asuke Central Area of Toyota Approx 1 hr by bus including one transfer 15 Km (10 Mi) Trung tâm Asuke Vùng trung tâm Toyota Khoảng 1 giờ xe buýt gồm lần chuyển tuyến 15 Km (10 Mi) Mobility Facts in the District (2) Thực tế hệ thống buýt huyện (2) • 13 Routes • Each route is served once a week • Service is twice a day (AM & PM) Routes of Community Bus in Asuke District 10 11 • 13 tuyến • Mỗi tuyến phục vụ lần/tuần • 2 lần ngày (AM & PM) Hệ thống tuyến buýt huyện Asuke 12 Outline of Community Support System Phác thảo hệ thống hỗ trợ cộng động lSocial Experiment from June, 2016 lNghiên cứu xã hội tuwf tháng 6, 2016 • Using Tablet • Motion Monitoring with sensor Daily Happiness App (5 grade evaluation) -Daily Happiness -Subjective Health -Amount of Conversation -Number of Outing • 14 Xe Asuke-ai Ø Using Tablet, Ø Register trips they need/ give a ride through web site Request Event information Request Register a trip to give a ride Offer Ø Sử dụng máy tính bảng, Ø Đăng ký chuyến họ cần/ cho chung qua website Request Event information Yêu cầu Register a trip to need ride Đăng ký chuyến No of passengers Origin Đăng ký cho chung Kết nối thành công Destination Pick them up Giám sát chuyển động với cảm biến Hạnh phúc hàng ngày App (5 mức độ đánh giá) - Hạnh phúc hàng ngày - Sức khoẻ - Lượng giao tiếp - Số lần chơi 13 Asuke-ai Car Successfully matched • Using Tablet Lời mời No of passengers Origin Destination Đón họ Dep time Get to the destination Dep time Đưa đến đích Request 15 Request 16 Participants Người tham gia As of March 2017 Target of this study Ø 51 participants Male and 44 female 68-93 y/o, ave 82.5 y/o Most of them live alone Mục tiêu nghiên cứu Ø 51 người tham gia nam 44 nữ 68-93 tuổi, trung bình 82.5 tuổi Hầu hết họ sống Ø 52 Drivers 32 Male 17 Female 28-74 y/o ave.61.9 y/o ppl ppl Female Male ...An e-Health System for the Elderly (Butler Project): A Pilot Study on Acceptance and Satisfaction Cristina Botella, Ph.D., 1,2 Ernestina Etchemendy, B.A., 2 Diana Castilla, B.A., 1–4 Rosa Marı´a Ban˜ os, Ph.D., 2–4 Azucena Garcı´a-Palacios, Ph.D., 1–4 Soledad Quero, Ph.D., 1–4 Mariano Alcan˜ iz, Ph.D., 2,4 and Jose´ Antonio Lozano, Ph.D. 2,4 Abstract The Butler Project is a technological e-health platform that uses the Internet to connect various users; it was designed to deliver health care to the elderly. The Butler platform has three levels of implementation: diagnosis (mood monitoring, alert system, management reports), therapy (training in inducing positive moods, memory work), and entertainment (e-mail, chat, video, photo albums, music, friend forums, accessibility to the Internet). The objective of this work is to describe the psychological aspects of the platform and to present data obtained from four users. Results show that after using the system, the participants increased their positive emotions and decreased their negative ones; in addition, they obtained high levels of satisfaction and experienced little difficulty in using the system. Introduction A n increase in life expectancy and a decrease in birth rates are resulting in an increasingly aging population, especially in those countries that are part of the so-called ‘‘first world.’’ In 2000, 6.9% of the world’s population (421 million) were 65 years old or more, and estimates indicate that by 2050, this percentage will be 16.1% (1465 million) 1 This demo- graphic transition is changing the concept of old age; no longer is it characterized by retirement, illness, inactivity, or isolation; rather, it is increasingly considered merely a further step in the life cycle, with its own characteristics and varia- tions. Researchers are paying increasing attention to how manipulation of environments and lifestyles can influence how we age. Another consequence of the new demographic distribution is an overload on the health care system. Ac- cording to The State of Aging and Health, 2 psychological problems in the elderly are poised to become a major public health issue because they will involve an increase in the de- mand for and costs of health services. Regarding the morbid characteristics of the elderly population, several studies in- dicate the importance of symptoms and depressive disorders. For example, Yaffe et al. 3 found that depressive symptoms in older people are associated with poor cognitive function and greater cognitive decline. Katon et al. 4 also indicated that the presence of depressive symptoms in the elderly correlates with a significant increase in health care demands, compared with people without depressive problems. In a similar vein, Ganguli et al 5 found that depression was one of the best predictors of mortality in the elderly population. Evidently, when depression is undetected or inadequately treated, it has serious consequences, which could even be fatal. Significantly, this population shift coincides with the tech- nological revolution of the 21st century, which is redefining how people communicate with and relate to each other. In- formation and communication technologies (ICTs) increase the speed of everyday life while helping satisfy myriad de- mands; while this is very rewarding to those who enjoy the benefits of ICTs, it also segregates and excludes those who cannot understand the rules of this ‘‘new world.’’ Social in- teractions are increasingly channeled through iCare: A Mobile Health Monitoring System for the Elderly Ziyu Lv, Feng Xia, Guowei Wu, Lin Yao, Zhikui Chen School of Software Dalian University of Technology Dalian 116620, China e-mail: f.xia@ieee.org Abstract—This paper describes a mobile health monitoring system called iCare for the elderly. We use wireless body sensors and smart phones to monitor the wellbeing of the elderly. It can offer remote monitoring for the elderly anytime anywhere and provide tailored services for each person based on their personal health condition. When detecting an emergency, the smart phone will automatically alert pre- assigned people who could be the old people's family and friends, and call the ambulance of the emergency centre. It also acts as the personal health information system and the medical guidance which offers one communication platform and the medical knowledge database so that the family and friends of the served people can cooperate with doctors to take care of him/her. The system also features some unique functions that cater to the living demands of the elderly, including regular reminder, quick alarm, medical guidance, etc. iCare is not only a real-time health monitoring system for the elderly, but also a living assistant which can make their lives more convenient and comfortable. Keywords-healthcare; assisted living; health monitoring; body sensor; medical guidance I. INTRODUCTION The aging people in the contemporary society have brought great pressure and many seniors have been living alone without anyone accompanied because their offspring are busy with work and have to struggle with severe competition. For those seniors who live independently in their own homes, there is an increasing risk of falls and strokes which could threaten their lives. A lot of money and research effort has been spent on making people aware of the warning signs [1]. Getting the elderly to recognize the warning signs is not easy. And it indicates that people who have had a heart attack have a sudden death rate that is 4 to 6 times that of the general population [2]. The New England Journal of Medicine draws a conclusion that the chances of surviving a fall, heart attack or stroke are six times greater if the elderly get help within an hour. Therefore, the elderly with no one accompanied need real-time monitoring to reduce the anxiety of them and the risk of accidents. However, the financial and staffing cost of caring for the increasing numbers of aged persons in nursing homes or hospitals will be a huge challenge. In this background, a very worthy and challenging issue is how to provide the elderly with the real-time, long-term and nonintrusive assisted living and remote healthcare services. With the development of the technologies such as mobile computing, distributed computing and wireless sensor network, it is possible to provide the elderly with healthcare services that can monitor the elderly anytime anywhere. Various wireless communication motes cooperate with medical sensors to support healthcare and monitor people's health, especially the elderly suffering from diabetes, high blood pressure or heart disease [3]. For instance, in Australia, Pro Medicus makes a success of IT Healthcare [4]. It develops one secure intelligent system for transmitting medical results to doctors. CHAPTER 1 INTRODUCTION OF THE STUDY ON FINANCIAL INSTRUMENTS ACCOUNTING FOR NON-FINANCIAL FIRMS IN VIETNAM 1.1 Necessities Vietnam is integrating more intensively and extensively into the global economy, demonstrated by the vigorous flows of capital, technology and products in and out of the country. Numerous foreign companies are investing in Vietnamese market; they formulate financial reports in accordance to international standards. On the other hand, Vietnamese companies are promoting export and establishing their business overseas; thus, they are put under a tighter supervision and must comply with international standards in formulating financial reports. According to the international accounting standards, financial instruments accounting (FIA) must comply with requirements of IAS32 on the “presentation of financial instrument”; IAS39 on the “recognition and measurement of financial instruments” and IFRS7 on the “disclosure of financial instrument information”. Vietnam has not yet succeeded in formulating a systematic standard for FIA. Instead, the regulations on the practice of FIA are scattered in several set of standards such as VAS01, VAS10, VAS16, etc. This situation are causing several difficulties in managing and standardizing the information, as well as in implementing accounting practices in a financial market with the operation of derivatives such as forwards, futures, swaps, options. Meanwhile, the corporate accounting for non-financial firms does not address FIA, resulting in the confusion and inconsistence in the reporting of firms’ financial situation, affecting the trustworthiness and comparativeness of the indexes in the financial reports. Based on the actual demand of businesses, investors’ requirement for information disclosure and the needs of the accounting profession in the context of integration, the author choose to work on the topic “Completing the Financial instruments accounting for non-financial firms in Vietnam” for the PhD. thesis. 1.2 Overview of research context 1.2.1 International research on FIA 1.2.1.1 Identification of financial instruments Most of the studies agree on the main features of a financial instrument, which 1 is a contract binding parties; the instrument implies both right (assets) and obligation (liabilities) in accordance with the contract; depending on the contract, the payment instrument can be exchanged directly or indirectly. 1.2.1.2 Measurement of financial instruments The scientific circle highlights the advantage of the fair value accounting, which still remains a new concept to Vietnamese accounting, particularly FIA. This motivates the author to study the fair value accounting to find a solution in order to complete the FIA for non-financial firms in Vietnam. 1.2.1.3 Recognition of financial instruments The recognition of financial instruments depends on the classification of the instruments. L.EC.Wilson & Bryan (1997) asserts that it is necessary to formulate accounting principles on financial instruments based on their purposes rather than imposing each instrument with specific principles, so that new instruments can be employed to ensure the usefulness of information and, at the same time, minimize the cost of establishing new principles. 1.2.1.3 Presentation of financial instrument Financial instruments are becoming more and more complicated since instruments are hybridized, for example: convertible bond, preferred dividend (possessing the characteristics of both liabilities and equity); new types of derivatives (hybridizing the derivatives), hybrid instrument with embedded derivatives, etc. Hence, the recognition of financial instruments becomes more difficult accordingly. 1.2.1.4 Information disclosure of financial instruments Financial instruments are becoming more and more diversifying and complicated; thus, the requirement for disclosure of information is also getting harsh. Caedo and Tirado (2004) stated 1 Health Care Service for the Deaf and Communication Challenges A Descriptive Study on Health Care Service for the Deaf and Communication Challenges: The Case of Nefas Silk Lafto Wereda 03, Health Care Center, Addis Ababa Lidia Assegid Graduate School of Social work Addis Ababa University July, 2017 Health Care Service for the Deaf and Communication Challenges A Descriptive Study on Health Care Service for the Deaf and Communication Challenges: A Case Of Nefas Silk Lafto Wereda 03, Health Care Center, Addis Ababa Lidia Assegid Graduate School of Social work Addis Ababa University Presented in Partial Fulfillment of the Requirements For the Degree of Master of Social Work (MSW) Advisor: Dr Mesele Mengesteab July, 2017 Health Care Service for the Deaf and Communication Challenges Addis Ababa University School of Graduate Studies This is to certify that the thesis prepared by Lidia Assegid entitled: A Descriptive Study on Health Care Service for the Deaf and Communication Challenges: A Case of Nefas Silk Lafto Wereda 03, Health Care Center and submitted in partial fulfillment of the requirements for the degree of Masters of Social Work compiles with the regulations of the University and meets the accepted standards with respect to originality and quality Signed by the examining Committee: Advisor -Signature - Date Examiner -Signature - Date Examiner -Signature - Date - Health Care Service for the Deaf and Communication Challenges Acknowledgement First of all, I would like to praise my God for his blessing and help throughout my entire life The researcher gratefully wants to acknowledge his advisor Dr Mesele Mengesteab for his unreserved academic support His valuable comments were crucial for my thesis project from the starting up to the end His welcoming orientation of advising and his high level interactive communication skills were very helpful for me The researcher would like to gratitude all my respondents who participated ... No emergency hospital in the vicinity No daily shops in the vicinity No medical doctors in the vicinity No emergency hospital in the vicinity No daily shops in the vicinity No jobs in the vicinity No jobs in the vicinity... Amount of Conversation (AC) Increasing amount of conversation 0.316* in a day using Asukeai-car Number of going out (NG) 0.333*** Male dummy -0.635*** age/10 (e. g 60s=6,70s=7 etc.) 0.151*** Dummy of person certified as... No jobs in the vicinity No post office in the vicinity Schools are too far No post office in the vicinity Schools are too far Source: MLIT Accessibility to medical doctors and shops is the main issue in those areas