When firefighting, the combination of exposition to high temperatures, high physical demands and wearing (heavy and insulated) personal protective equipment lead to increased risk of heat stress and exhaustion in firefighters. Heat stress can easily evolve into a life-threatening heat stroke. Once heat stress occurred, the chance of getting another heat stroke during deployment gets higher. Moreover, intermittent exposure to heat stress over several years, is a risk factor for heart diseases. Similarly, exhausted during a deployment, a firefighter needs more time to rehabilitate before he can safely be deployed again. Heat stress and exhaustion can lead to line-of-duty cardiovascular events. Therefore preventing heat stress and exhaustion during deployment is beneficial for health, functioning and employability of firefighters. Since currently available measurement of the core temperature, such as thermometer pill or neck patch thermometer, are not reliable or practical for firefighters, an alternative approach may be used, namely, estimation of the core temperature based on non-invasive observation of the heart rate. Exhaustion is estimated using the training impulse model based on the heart rate reserve. Our achievement is a MoSeS health monitor system (as a smartphone application) that can real time analyze the health status of a firefighter and predict exhaustion and heat stress during deployment. The system is cheap (only a heart rate sensor and a smartphone application is needed), easy to use (intuitive “traffic light” signal), and objective (the health status is determined based on measurements of the heart rate). The only restriction is that the developed model is strongly dependent on personal maximum and minimum heart rate which need to be established behforehand. Moses Health Monitoring system for Firefighters CC BY-NC-ND Conference Proceedings 17th international e-SOCIETY 2019 IADIS
MULTIFILE
Objective: The aim of this cross-sectional study was to determine the associations between frailty and multimorbidity on the one hand and quality of life on the other in community-dwelling older people. Methods: A questionnaire was sent to all people aged 70 years and older belonging to a general practice in the Netherlands; 241 persons completed the questionnaire (response rate 47.5%). For determining multimorbidity, nine chronic diseases were examined by self-report. Frailty was assessed by the Tilburg Frailty Indicator, and quality of life was assessed by the World Health Organization Quality of Life Instrument—Older Adults Module. Results: Multimorbidity, physical, psychological, as well as social frailty components were negatively associated with quality of life. Multimorbidity and all 15 frailty components together explained 11.6% and 36.5% of the variance of the score on quality of life, respectively. Conclusion: Health care professionals should focus their interventions on the physical, psychological, and social domains of human functioning. Interprofessional cooperation between health care professionals and welfare professionals seems necessary to be able to meet the needs of frail older people.
DOCUMENT
Abstract: Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail patients. The risk of orthostatic hypotension is a significant issue in elderly patients. It results from an autonomic nervous system dysfunction and involves maladjustment of the cardiovascular system to sudden changes in the position of the body. Other significant issues in elderly patients include polypharmacy, increased risk of falls and cognitive impairment. Chronic diseases, including hypertension, deteriorate baroreceptor function and result in irreversible changes in cerebral and coronary circulation. Concurrent frailty or other components of geriatric syndrome in elderly patients are associated with a worse perception of health, an increased number of comorbidities and social isolation of the patient. It may also interfere with treatment adherence. Identifying causes of non-adherence to pharmaceutical treatment is a key factor in planning therapeutic interventions aimed at increasing control, preventing complications, and improving long-term outcomes and any adverse effects of treatment. Diagnosis of frailty and awareness of the associated difficulties in adhering to treatment may allow targeting of those elderly patients who have a poorer prognosis or may be at risk of complications from untreated or undertreated hypertension, and for the planning of interventions to improve hypertension control.
DOCUMENT
