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Biomedical subjects

D Galinsky

Publications and source records attributed to D Galinsky.

At least 37 records · Page 2Linked to original sources
PubMed1985

Ten years' experience teaching geriatric medicine.

The Faculty of Health Sciences of the Ben-Gurion University of the Negev has developed a comprehensive curriculum in geriatric medicine for the 6 years of medical studies. Similar curricula were designed for the nursing and physiotherapy schools. The facilities of the Department of Geriatrics of the Soroka Medical Center, linked with the Home Care Unit and the Home for the Aged, are used for this purpose. The main issues taught are communication, observation, nursing, multidisciplinary teamwork, services for the elderly, biology of aging, physical examination, the most common clinical problems, and the management of homebound and bedridden patients. The program aims to alert students to the need for: 1) a comprehensive approach toward the elderly; 2) a multidisciplinary team; 3) community-oriented continuity of care; and 4) transforming geriatric medicine into an attractive field of specialization. The students' attitudes towards the elderly are very positive, especially after the first year, but seem to change toward the fourth year, which is most likely due to the negative role models to which the students are exposed, especially in the clinical years. New trends in Israel, such as the recognition of geriatrics as a specialty and the national health policy encouraging the development of new geriatrics departments, will indeed be helpful in this matter. Since the attitudes of doctors and medical students toward the elderly tend to reflect the behavior of the public at large, public educational programs should be directed towards the eradication of the stigma of old age among the population as a whole.

Aged↗
PubMed1985

Parathormone, calcitonin, and vitamin D metabolites during normal fracture healing in geriatric patients.

In order to study the role of calcium-regulating hormones during callus formation in elderly patients, serum levels of parathormone (PTH), calcitonin (CT), 25-hydroxyvitamin D [25-OH-D], 1,25-dihydroxyvitamin D [1,25(OH)2D], 24,25-dihydroxyvitamin D [24,25(OH)2D], and calcium (Ca) were determined in 41 patients with fractures of long bones, primarily hip fractures. The parameters were measured on admission and after eight weeks. There were almost no changes in hormone serum levels during bone repair, except for a decrease in serum levels of 1,25(OH)2D from 25.3 +/- 2.3 pg/ml on admission to 21.0 +/- 2.0 pg/ml eight weeks later (p less than .001). Patients with fractures compared to normal elderly humans have lower serum levels of PTH (0.99 +/- 0.06 ng/ml versus 1.88 +/- 0.34 ng/ml; p less than .001), 25-OH-D (10.7 +/- 1.0 ng/ml versus 17.1 +/- 1.8 ng/ml; p less than .001), and Ca (9.1 +/- 0.1 mg% versus 9.7 +/- 0.1 mg%; p less than .001) and higher serum levels of 1,25(OH)2D (25.3 +/- 2.3 pg/ml versus 17.1 +/- 2.3 pg/ml; p less than .001). Female patients have lower serum levels of 24,25(OH)2D compared to males (1.65 +/- 0.15 ng/ml versus 2.06 +/- 0.29 ng/ml; p less than .05). A similar trend was noted in serum CT levels during callus formation (0.12 +/- 0.02 ng/ml versus 0.16 +/- 0.02 ng/ml; p less than .05). Patients with subcapital fractures of the femur have significantly lower serum levels of all vitamin D metabolites on admission, compared with patients suffering from extracapsular fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

A programme in undergraduate geriatric education: the Beer Sheva experiment.

The Beer Sheva medical school was started in 1974 with the objective of training primary care doctors to meet the health needs of the Negev region of Israel. This paper describes a programme developed at Beer Sheva to prepare students to deal with the health-related problems of the elderly. Students begin their contact with the elderly in their first year (early clinical teaching programme) and continue this exposure in varying degrees during the 6 year curriculum. A preliminary study has shown that there is a trend for students to commence their studies with positive attitudes toward the elderly. The early clinical teaching programme which emphasizes interviewing skills, knowledge about ageing and community services that relate to the aged, reinforces the student's sensitivity to geriatric issues. In order to maintain the student's interest in working with the elderly, it is apparent that it will be necessary to educate both hospital and community-based physicians to provide positive role models for students.

Attitude of Health Personnel↗
PubMed1979

Hematologic values in healthy older people in the Negev area.

Of 1,500 volunteers aged 65 or more selected at random in the Negev area, 224 were found to be healthy and available for further examination. The population represented broadly the various ethnic groups among Jews in Israel. The mean hemoglobin level, hematocrit, red and white blood cell counts and differential count showed no differences other than those due to chance when compared with the corresponding values in a younger (20 to 48 years of age) group. The differences between men and women were similar to those found in the comparison group, with men having higher mean values for hemoglobin, hematocrit, and red blood cell count; in the study group, serum iron, total iron-binding capacity and percent saturation were higher in men in all age groups. No differences were found in mean values of white blood cell count and differential count within the study population. However, mean serum iron was lower, and mean platelet count, higher than in the younger comparison group. This survey supports the use of normal standards for adults when elderly patients are examined, regardless of different ethnic origin. However, the higher than normal platelet counts in subjects from Asia, Africa and Eastern Europe should be taken into account.

Age Factors↗
PubMed1975

Health testing in the elderly by the multiphasic method.

A multiphasic screening programme was carried out on a stratified sample of the elderly population of a small town in Israel. The purpose was to gain an assessment of the health profile of the subjects and to estimate what kind of community geriatric services might be required. The performance of the programme in 3 days on 89% of the 200 subjects who were available testified to the rapidity and yield of information by this 'conveyor-belt' system of examination. The technique is described, and some criticisms and suggestions are advanced. Evaluation of the efficacy of this method of screening was judged on four types of information accruing in a survey of the elderly. Demographic and epidemiological data, together with prevalence of symptoms or clinical signs and their correlations could be rapidly ascertained; so also could specific pathologic parameters be rapidly collected, which required medical follow-up, such as blood sugar values. The method appeared less successful in assessing an individual's functional or social difficulties which would require specific community services because of the multi-facetted type of examination by different members of the team. Similarly, a screening programme which depends on its subjects being transported may miss some of the more infirm people, as was subsequently found in this survey. It is concluded that for the elderly, the multiphasic method with the expense and organisation required is appropriate for preliminary screening of a section of a population, or for the screening of selective groups at risk.

Aged↗
PubMed1975

The aetiology of senile osteoporosis: secondary hyperparathyroidism due to renal failure.

The aetiology of senile osteoporosis was investigated in a series of elderly normal persons (mean age 76.8 years) who were compared to 18-19 year old normal controls. Osteoporosis was estimated by standard radiological morphometric and densitometric techniques, in the metacarpals and thoraco-lumbar vertebrae. Serum parathyroid hormone levels were significantly higher in the elderly group, and correlated well with morphometric and densometric measurements of osteoporosis. Creatinine clearance was reduced in seven out of nine of the elderly group, and correlated well with the degree of osteoporosis. Serum thyrocalcitonin levels were reduced in the elderly. Tubular reaborption of phosphate and TmP/GFR were in the hyperparathyroid range in the elderly group and correlated well with the degree of osteoporosis. The hypothesis is advanced that the osteoporosis of old age is a result of parathyroid overactivity, caused by asymptomatic chronic renal failure. The suggestion is made that a diet low in phosphorus might reduce the incidence of osteoporosis in old age by reducing the parathyroid overactivity.

Adolescent↗
PubMedDate not supplied

A study of the psychosocial characteristics of patients in a geriatric rehabilitation unit in Israel.

This study characterizes the demographic backgrounds of patients in an Israeli geriatric rehabilitation unit, determines the factors associated with their family relationships and the instrumental support they received, and emphasizes the importance of social roles as a personal resource. The study population consisted of 336 low-income Jews, all of whom were immigrants. Virtually all of the subjects had a small, close support network composed mainly of their children and spouses. Their children were the most important source of instrumental support during their hospitalization. The subjects' sources of instrumental support prior to hospitalization varied, depending upon their age, gender, marital status, and social roles. Social exchange theory provided a framework for explaining their social roles. Factors found to be predictors of good family relationships were marital status, living arrangements, instrumental support, social roles, and educational level.

Aged↗
PubMedDate not supplied

Sociodemographic differences among members of two ethnic groups in a geriatric rehabilitation unit in Israel.

The Assessment of Dependency for Long-Term Care Benefits form was used to explore differences among 336 elderly Ashkenazi and Sephardi Jews during their first phase of recovery in a geriatric rehabilitation unit in Israel. Sephardi Jews were more likely to be younger, widowed at an earlier age, poorer, less educated, hold less prestigious jobs, and have fewer social roles. They were also more likely to be religious and to live in multigenerational households. In contrast, a higher proportion of Ashkenazi Jews owned their own houses or apartments and lived only with their spouses. No differences were observed in these two groups in terms of the number and duration of visits they received during their hospitalization; most of them had fairly extensive visits. Most of these elderly people reported having good family relationships. This perception was related to their living arrangements, number of social roles, marital situation, level of education, and identity of the main visitor during their hospitalization. Patients' social roles affected both the number of visits they received and the perceived relationships within the family.

Aged↗
PubMedDate not supplied

The biopsychosocial adjustment of disabled elderly: a 1-year follow-up.

The objectives of this study were to identify and compare changes in the physical, social, and structural functions and in the family relationships of elderly patients upon hospitalization in a geriatric rehabilitation unit, and 1 year after discharge to the community (in the Negev region of Israel). The study was conducted on 88 elderly people with a mean age of 74 years. The Assessment of Dependency for Long-Term Care Benefits test was used twice as the study instrument for measuring the given objectives, once during the first week following admission to the unit and once 1 year later. At the end of the year there was improvement in most activities of daily living (ADL), a decrease in social roles, an increase in the number of illnesses, greater restrictions in diet, and an increase in use of social services. Changes were observed in the structure of the family social networks, the source of the primary caregiver, and living arrangements. Changes were not observed in the perceived family relationships. In both time periods, married elderly people evaluated family relations as better than did unmarried people. However, unmarried subjects demonstrated greater improvement in physical and social functions. Also, time had a significant effect on social function. Elderly people who were ill for less than 2 months prior to admission demonstrated greater social improvement than those whose illness lasted longer.

Activities of Daily Living↗
PubMedDate not supplied

Apo E and Apo CI loci are associated with dementia in younger but not older late-onset cases.

Numerous groups have confirmed that apolipoprotein E allelic variation accounts for a proportion of the genetic risk for late-onset Alzheimer's disease (AD). However, there is a paucity of data on the impact of this locus on the overall risk of dementia (as opposed to AD) in the elderly. Most studies have ascertained specifically AD cases from hospital clinics or brain banks and many demented cases have vascular dementia or mixed AD and vascular pathology. We have examined the closely linked apo E and apo CI loci in demented cases and non-demented controls from two community-based aged Cambridgeshire populations: the rural Ely population (cohort 1) comprised 60 pairs of demented and non-demented elderly individuals, with a mean age of 84.2 years (SD = 6.11); the Cambridge city population (cohort 2) comprised 81 pairs all aged over 84 with a mean age of 87.7 years (SD = 2.9). The younger Ely cohort showed significant allelic associations with dementia at the apo E and apo CI loci, which were not replicated in the older Cambridge cohort. These data suggest the possibility of age-dependent penetrance for different candidate genes in late-onset dementia. We propose a number of explanations to account for the stronger associations we observed between dementia and apo CI, compared to the neighbouring apo E locus. Our data are compatible with the possibility that specific alleles or genotypes may confer different risks for overall dementia, compared to AD.

Adolescent↗
PubMedDate not supplied

ELGAM--extra-laboratory gait assessment method: identification of risk factors for falls among the elderly at home.

Gait and balance disturbances are recognized risk factors for falls among elderly persons. The prevention of falls and their adverse complications is one of the challenges in geriatric care, requiring the early detection of risk factors. Heretofore, gait assessment procedures have required considerable investment in equipment for sophisticated biomechanical testing. This has limited the use of gait-testing procedures to the laboratory or clinic. We describe a simple and effective method for at-home or community gait testing, ELGAM (extra-laboratory gait assessment method). ELGAM was field-tested as part of a study of 36 community-dwelling elderly in Beer Sheba, Israel. The ELGAM parameters studied included step length, walking speed, initial starting style of walking, ability to turn head while walking, and static balance. Slow walking speed (less than 0.5 m/s), small steps, difficulty in turning the head, and impaired balance were significantly associated (chi-square analyses, p less than 0.01) with unstable gait. The parameters were also positively associated one with another, except for head turning. The ELGAM parameters were significantly related to self-assessed fall frequency, and reported 'near falls' among women only. In addition, among women only, slow walking speed was associated with depressive symptoms as detected by a validated screening test, the Short Geriatric Depression Scale, and with poor subjective health rating. Among 58% of this independently living elderly sample, ELGAM detected one or more risk factors. ELGAM is a 'low-tech', functionally based, effective method for direct recording of gait parameters that is applicable for community studies of the early detection of risk factors for falls and mobility problems.

Accidental Falls↗