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The corrosion behavior of the TiTaNbZrAg alloys with different amounts of tantalum (0%, 10% and 20%) and with distinct surface topography (smooth and rough) was investigated in phosphate buffer solution (PBS) for long-time immersion (1000 h). By this approach, we expect to bring about new insights into the influence of both the amount of Ta in the alloy composition and the surface topography on the corrosion behavior of the Ti-based alloys. The corrosion resistance was studied by Open Circuit Potential (OCP), Potentiodynamic Polarization (PP), and Electrochemical Impedance Spectroscopy (EIS). From the potentiodynamic investigations, it was observed that all types of samples showed good corrosion resistance (i.e., Rcorr < 10 µm y−1) and may be used successfully for medical applications. However, the samples with smooth surfaces and with a certain amount of Ta (10% and 20%) exhibit the best corrosion performance (Rcorr < 1 µm y−1). As regards the samples with rough surfaces, the results evidenced that they showed lower corrosion resistance (1 < Rcorr < 3 µm y−1), suggesting that the Ta presence does not necessarily hinder the corrosion processes. Actually, the synergetic effect of both the presence of Ta and surface roughness plays an important role in corrosion resistance.

Adoption of digital technology by older adults has become an important topic in academia and the public sphere within the debate on digital inclusion. Likewise, this topic has gained traction in the print media also. This paper assesses the representation of older adults in print media in the past 20 years in The Netherlands and Flanders. A total of 281 articles in the Dutch language were analysed to determine the representation of older adults and their level of agency. We found that they were represented in three manners: a) ambassadors of digital skill acquisition; b) naturally lacking in digital skills; or c) not alone in being helpless. These representations clearly increased during the COVIS-19 crisis. Some representations can be problematic, as the relationship between older adults and digital inclusion is not envisioned positively. Furthermore, they receive no agency to participate actively in the discussion surrounding their own digital inclusion and are too often used as the automatic example of the digitally illiterate – which is not particularly encouraging older adults towards digital skills acquisition.

As society has become more reliant on digital technology, it has changed the perception of the ageing experience to now include a digital component. However, not every older adult perceives digital technology as essential to their way of ageing. In this article, we asked 76 older adults with different patterns of digital technology use how they experience and perceive the role of digital technology in the context of their ageing. The thematic analysis results point to a more nuanced understanding of the importance of familial support, the role of personal history or continuity in older adults’ digital inclusion, and how they see the role of age in relation to digital technology. Furthermore, our findings show that ageism is both a barrier and a motivational factor for older adults. When ageism is based on the level of digital inclusion, it can cause a different ageing experience, one that is perceived as superior by those using digital technology. This leads to a precarious situation: It becomes essential to maintain digital skills to avoid the non‐digital ageing experience even as it becomes more difficult to maintain their skills due to the evolution of technology. Prior to the study, we created a conceptual framework to understand ageing in a more digitalised world. We used the findings of this study to test the conceptual framework and we conclude that the framework can clarify the role (or lack) of digital technology in the ageing experience of older adults.

Abstract Background The Sohkitehew (Strong Heart) Research Group, which included an Elders Advisory Committee of seven Nehiyawak (Cree) women, set out to bring Maskwacîs community members together to understand Nehiyawak women’s experiences of “aging well”. The goals of this research were to generate information honouring Indigenous ways of knowing, and gather strengths-based knowledge about aging well, to help Maskwacîs, women maintain wellness as they age. Methods We facilitated qualitative Sharing Circles in three different settings in Maskwacîs. Discussions were prompted using the four aspects of the self, guided by Medicine Wheel teachings: Physical, Mental, Emotional, Spiritual. Detailed notes were recorded on flip charts during the discussions of each Sharing Circle. Data were analysed using descriptive content analysis to identify practical strategies for aging well. Results Thirty-six community members attended one or more Sharing Circle. Strategies included: Physical—keeping active to remain well; Mental—learning new skills to nourish your mind; Emotional—laughing, crying, and being happy; Spiritual—practicing Nehiyawak traditional ways. Participants commented that balancing these four aspects of the self is necessary to achieve wellness. Following the analysis of the Sharing Circle comments, three community feedback sessions were held to discuss the results in the wider community. These strategies were formatted into a draft booklet which incorporated Cree language, and archive photographs of Maskwacîs women and families. Conclusions The Nehiyawak Sharing Circles identified practical strategies that help women to remain well as they age. This positive approach to aging could be adopted in other Indigenous and non-Indigenous communities.

ABSTRACTIndigenous crafting practices are increasingly being recognised for their benefit to community connectedness, health, cultural identity, and individual wellbeing. This article explores published literature to determine the role of Indigenous crafting in transferring traditional and cultural teachings from female relatives and Elders to girls and younger women. We examine the effect of crafting on intergenerational cohesion and social connectedness within the Indigenous community. Does crafting serve as an effective conduit for physical, spiritual, emotional, and mental change in learners and teachers? Our review identifies 12 publications that describe Indigenous mostly girls and younger women’s experiences as they acquire female Elders’, teachers’ and older family members’ traditional and cultural teachings while participating in crafting activities. The papers identify an array of traditional and cultural activities including: basket weaving, beading, sewing, language acquisition, traditional songs, traditional dance, and storytelling. More contemporary forms of artistic expression such as photography, theatre and film production are also included. Research findings show that learning, teaching and practicing Indigenous crafting is associated with increased intergenerational cohesion, cultural connectedness, and wellbeing for both teachers and learners. Further, learning about Indigenous crafts and activities helps inspire pride in Indigenous identity and promotes healing from historical trauma.

Abstract The structural addictive characteristics of gambling products are important targets for prevention, but can be unintuitive to laypeople. In the PictoGRRed (Pictograms for Gambling Risk Reduction) study, we aimed to develop pictograms that illustrate the main addictive characteristics of gambling products and to assess their impact on identifying the addictiveness of gambling products by laypeople. We conducted a three-step study: (1) use of a Delphi consensus method among 56 experts from 13 countries to reach a consensus on the 10 structural addictive characteristics of gambling products to be illustrated by pictograms and their associated definitions, (2) development of 10 pictograms and their definitions, and (3) study in the general population to assess the impact of exposure to the pictograms and their definitions (n = 900). French-speaking experts from the panel assessed the addictiveness of gambling products (n = 25), in which the mean of expert’s ratings was considered as the true value. Participants were randomly provided with the pictograms and their definitions, or with a standard slogan, or with neither (control group). We considered the control group as representing the baseline ability of laypeople to assess the addictiveness of gambling products. Each group and the French-speaking experts rated the addictiveness of 14 gambling products. The judgment criterion was the intraclass coefficients (ICCs) between the mean ratings of each group and the experts, reflecting the level of agreement between each group and the experts. Exposure to the pictograms and their definition doubled the ability of laypeople to assess the addictiveness of gambling products compared with that of the group that read a slogan or the control group (ICC = 0.28 vs. 0.14 (Slogan) and 0.14 (Control)). Laypeople have limited awareness of the addictive characteristics of gambling products. The pictograms developed herein represent an innovative tool for universally empowering prevention and for selective prevention.

This is an edited book regarding the changing role of voluntary agencies in the United Kingdom, with papers written by directors or managers of major UK charitable organisations and by [...]

Background Achieving patient-centred care necessitates supporting individuals to have more involvement in the self-management of their care. Digital health technologies are widely recognised as a solution to empower more effective self-management. However, given the complexity of multiple chronic condition (multimorbidity) management, coupled with changes that occur as part of the normal ageing process, human support alongside digital self-management is often necessary for older people with multimorbidity (PwM) to sustain successful self-management. Methods The aim of the study was to explore the role played by a clinical, nurse-led telephone triage service in responding to alerts generated by older adults using a digital health platform, ProACT, to self-manage multiple chronic conditions over a period of 1 year. Semi-structured interviews with participants with multimorbidity were carried out across four time points during the trial, while interviews and focus groups were conducted with triage nurses at the end of the trial. Thematic analysis was conducted on the resulting transcripts. Results Themes found in the data include the work of triage nurses; the benefits of triage support; tensions such as anxiety due to patient monitoring; and the relationship between triage nurses and participants. Discussion This work contributes to an understanding of how older adults with multimorbidity and triage nurses collaborate in multiple chronic disease self-management. Findings are discussed within the context of Hudon et al.'s patient-centred care framework and indicate that patient-centred care was achieved, with both PwM and triage participants reporting positive experiences, relationships and several benefits of the triage support alongside digital self-management.

Older adults face unique challenges and have differing needs when navigating the urban environment. At the same time, civil servants and policymakers in cities are facing difficulties in promoting age-friendly initiatives due to the lack of knowledge, data, and tools about and for older adults. In this context, smart cities can play a key role in increasing the participation of older adults (i.e., 65 years and older) by collecting the data needed to provide knowledge of and design tools for older adults. However, using smart city data to inform policy making is made more difficult by several existing issues such as aggregated nonage-specific big data, lack of data altogether, and a disparity in access and use of digital technology. This paper endeavors to provide a methodology to ensure that the older adults are represented in the collected data and the translation of this data into automatic policy-making decisions. The Participation for Policy for Older Adults (PAR4POA) method introduces older adults' perspectives from the start of the project and its iterative approach means that older adults will share their needs and values with policymakers at different stages of a project. The use of this method enabled the co-creation of smart city solutions targeted to address the needs of older citizens in the context of 3 European regions. The PAR4POA method is specifically altered for the situation of older adults but could easily be used to include other marginalized populations. Ensuring participation in the automatic policy-making arena will empower marginalized populations and provide representation in data previously not provided.

BackgroundMultimorbidity is defined as the presence of two or more chronic diseases and associated comorbidities. There is a need to improve best practices around the provision of well-coordinated, person-centered care for persons with multimorbidities. Present health systems across the European Union (EU) focus on supporting a single-disease framework of care; the primary challenge is to create a patient-centric, integrated care ecosystem to understand and manage multimorbidity. ProACT is a large-scale project funded by the European Commission under the Horizon 2020 programme, that involved the design, development, and evaluation of a digital health platform to improve and advance home-based integrated care, and supported self-management, for older adults (aged ≥65 years) living with multimorbidity. ObjectiveThis paper describes the trial implementation protocol of a proof-of-concept digital health platform (ProACT) in 2 EU member states (Ireland and Belgium) to support older persons with multimorbidities self-managing at home, supported by their care network (CN). MethodsResearch was conducted across 2 EU member states, Ireland and Belgium. A 12-month action research trial design, divided into 3 evaluation cycles and lasting 3 months each, with a reflective redesign and development phase of 1 month after cycles 1 and 2 was conducted. Participants were 120 (60/120, 50% in Ireland and 60/120, 50% in Belgium) older persons with multimorbidities diagnosed with two or more of the following chronic conditions: diabetes, chronic obstructive pulmonary disease, chronic heart failure, and cardiovascular diseases. With permission from persons with multimorbidities, members of their CN were invited to participate in the study. Persons with multimorbidities were provided with ProACT technologies (tablet, devices, or sensors) to support them in self-managing their conditions. CN members also received access to an app to remotely support their persons with multimorbidity. Qualitative and quantitative feedback and evaluation data from persons with multimorbidity and CN participants were collected across four time points: baseline (T1), at the end of each 3-month action research cycle (T2 and T3), and in a final posttrial interview (T4). Thematic analysis was used to analyze the qualitative interview data. Quantitative data were analyzed via platform use statistics (to assess engagement) and standardized questionnaires (using descriptive and inferential statistics). This study is approved by the ethics committees of Ireland and Belgium. ResultsThe trial implementation phase for this 44-month (2016-2019) funded study was April 2018 to June 2019. The trial outcomes are at various stages of publication since 2021. ConclusionsProACT aims to co-design and develop a digital intervention with persons with multimorbidities and their CN, incorporating clinical guidelines with the state of the art in human-computer interaction, behavioral science, health psychology, and data analytic methods to deliver a digital health platform to advance self-management of multimorbidity at home, as part of a proactive, integrated model of supported person-centered care. International Registered Report Identifier (IRRID)RR1-10.2196/22125

BackgroundPopulations globally are ageing, resulting in higher incidence rates of chronic diseases. Digital health platforms, designed to support those with chronic conditions to self-manage at home, offer a promising solution to help people monitor their conditions and lifestyle, maintain good health, and reduce unscheduled clinical visits. However, despite high prevalence rates of multimorbidity or multiple chronic conditions, most platforms tend to focus on a single disease. A further challenge is that despite the importance of users actively engaging with such systems, little research has explored engagement. ObjectiveThe objectives of this study are to design and develop a digital health platform, ProACT, for facilitating older adults self-managing multimorbidity, with support from their care network, and evaluate end user engagement and experiences with this platform through a 12-month trial. MethodsThe ProACT digital health platform is presented in this paper. The platform was evaluated in a year-long proof-of-concept action research trial with 120 older persons with multimorbidity in Ireland and Belgium. Alongside the technology, participants had access to a clinical triage service responding to symptom alerts and a technical helpdesk. Interactions with the platform during the trial were logged to determine engagement. Semistructured interviews were conducted with participants and analyzed using inductive thematic analysis, whereas usability and user burden were examined using validated questionnaires. ResultsThis paper presents the ProACT platform and its components, along with findings on engagement with the platform and its usability. Of the 120 participants who participated, 24 (20%) withdrew before the end of the study, whereas 3 (2.5%) died. The remaining 93 participants actively used the platform until the end of the trial, on average, taking 2 or 3 health readings daily over the course of the trial in Ireland and Belgium, respectively. The participants reported ProACT to be usable and of low burden. Findings from interviews revealed that participants experienced multiple benefits as a result of using ProACT, including improved self-management, health, and well-being and support from the triage service. For those who withdrew, barriers to engagement were poor health and frustration when technology, in particular sensing devices, did not work as expected. ConclusionsThis is the first study to present findings from a longitudinal study of older adults using digital health technology to self-manage multimorbidity. Our findings show that older adults sustained engagement with the technology and found it usable. Potential reasons for these results include a strong focus on user-centered design and engagement throughout the project lifecycle, resulting in a platform that meets user needs, as well as the integration of behavior change techniques and personal analytics into the platform. The provision of triage and technical support services alongside the platform during the trial were also important facilitators of engagement. International Registered Report Identifier (IRRID)RR2-10.2196/22125

BackgroundModels based on the uniqueness of addiction processes between behavioral addictions are highly contentious, and the inclusion of gaming disorder in the addiction nosography remains controversial. An exploratory approach could clarify a hypothesized common and subjectively identifiable process in addictive behaviors and the necessarily different expressions of the disorder due to behavior specificities, in particular the sociocultural characteristics and profiles of users. ObjectiveThe aim of this study was to describe the nature of contacts to a help service by exploring commonality and specificities of burden and help-seeking for problem gambling or gaming. MethodsThis was an observational quantitative-qualitative study. We included all contacts (ie, online questions and contacts by phone or chat when the helper completed a summary) to a helpline for gamers, gamblers, and relatives over a 7-year period. We constituted a text corpus with online questions and summaries of contacts by phone or chat. We collected basic sociodemographic data, including the device used to contact the service (phone or internet), contacting the service for oneself (“user”) or being a relative of a user and type of relative, gambling (yes/no), gaming (yes/no), and age and sex of the gambler/gamer. We describe the corpus descriptively and report the computerized qualitative analysis of online questions, chat, and summary of phone calls. We performed a descendant hierarchical analysis on the data. ResultsA total of 14,564 contacts were made to the helpline, including 10,017 users and 4547 relatives. The corpus was composed of six classes: (1) gaming specificities, (2) shared psychological distress and negative emotions, (3) the procedure for being banned from gambling, (4) the provided help, (5) gambling specificities, and (6) financial problems. ConclusionsNegative emotions and shared distress linked to gambling and gaming support current scientific consensus that these behaviors can produce psychological distress in se; however, meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself: loss of control was elicited in the class corresponding to gambling specificities and not by gamers and their relatives.

After the Synod of Dort (1618-1619) forbade Remonstrant gatherings in the Dutch Republic, many Remonstrants secretly continued preaching or attending sermons and were consequently fined or imprisoned. Among them was the Nijmegen widow Willemken van Wanray (ca. 1573-1647), who wrote an autobiographical narrative of the religious persecution she endured. Scholars have shed light on the role of culturally existing scripts on which authors relied to present themselves as role models in their autobiographical narratives; such stories functioned in the family circle as examples of Christian behavior. This article, however, uses a linguistic approach to better understand the construction and functioning of autobiographical narratives as communicative events, by investigating the role of linguistic variation in positioning the self in interaction with an audience. It demonstrates that early modern writers could vary verb types and tenses to create multiple identities. Willemken van Wanray made strategic linguistic choices to present not only a Christian example to her descendants, but, anticipating further religious turbulence, she also created an innocent self for potential Gomarist readers, in order to avoid renewed persecution.

Background: In 2017, the Sohkitehew Group was funded to undertake research to identify wellness strategies adopted by mature women as they age in the rural Cree community of Maskwacis, Alberta. We describe our recruitment processes and outcomes for events from July 2017 to June 2018, the first phase of this research. Methodology: Data gathered from minutes of 36 Sohkitehew Working Group and two Elders Advisory Committee meetings were used to identify recruitment strategies, event characteristics and recruitment outcomes for two large community events and three Sharing Circles. Results: 1. Recruitment strategies: Strategies were similar for community events and Sharing Circles: event posters were displayed throughout Maskwacis, and advertisements were broadcast by Hawk Radio and appeared in Band newsletters. 2. Event Characteristics: Settings included a large community gymnasium for large events, and smaller community venues in different Bands for Sharing Circles. Traditional/cultural protocols were addressed by smudging meeting spaces, inviting community Elders to attend all events, and saying prayers. Healthy lunches were provided. 3. Event attendance: The two larger community events attracted 96, and 37 participants, respectively. Sharing Circle attendance ranged from 8 to 23 participants. Conclusion: Recruitment strategies succeeded for the Sohkitehew events in Maskwacis. Prior trusting and respectful relationships with the community established over several years provided a firm basis for this research. Successful recruitment efforts required time, planning, flexibility, and careful attention to culture and tradition to meet objectives to attract participants. Similar strategies may be successful in other rural Indigenous communities if tailored for the specific needs and expectations of individual communities.

Forest landscape restoration includes both the planning and implementation of measures to restore degraded forests within the perspective of the wider landscape. Governing forest landscape restoration requires fundamental considerations about the conceptualisation of forested landscapes and the types of restoration measures to be taken, and about who should be engaged in the governance process. A variety of governance approaches to forest landscape restoration exist, differing in both the nature of the object to be governed and the mode of governance. This paper analyses the nature and governance of restoration in three cases of forest landscape restoration in Indonesia. In each of these cases, both the original aim for restoration and the initiators of the process differ. The cases also differ in how deeply embedded they are in formal spatial planning mechanisms at the various political scales. Nonetheless, the cases show similar trends. All cases show a dynamic process of mobilising the landscape’s stakeholders, plus a flexible process of crafting institutional space for conflict management, negotiation and decision making at the landscape level. As a result, the landscape focus changed over time from reserved forests to forested mosaic lands. The cases illustrate that the governance of forest landscape restoration should not be based on strict design criteria, but rather on a flexible governance approach that stimulates the creation of novel public-private institutional arrangements at the landscape level.

The corrosion resistance of the new Ti-6Al-4V-1Zr alloy in comparison with ternary Ti-6Al-4V alloy in Ringer-Brown solution and artificial Carter-Brugirard saliva of different pH values was studied. In Ringer-Brown solution, the new alloy presented an improvement of all electrochemical parameters due to the alloying with Zr; also, impedance spectra revealed better protective properties of its passive layer. In Carter-Brugirard artificial saliva, an increase of the passive film thickness was proved. Fluoride ions had a slight negative influence on the corrosion and ion release rates, without to affect the very good stability of the new Ti-6Al-4V-1Zr alloy.

Background: The Nutrition Therapeutic Programme (NTP) involves the provision of food supplements at primary health clinics (PHCs) to correct nutritional deficiencies in vulnerable groups. Although previous studies have identified problems with implementing the programme at PHCs, assessments of its efficiency have been scarce. Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy. Methods: A cross-sectional, descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data. Results: Only 2 women (10%) lived in food-secure households; the rest were either at risk of hunger (29%) or classified as hungry (61%). Most of the women knew they had to take the supplements to improve their nutritional status, but the majority only recalled receiving basic nutritional advice, and the information was mainly given verbally. Ten of the women had shared their supplements with others, mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs, causing confusion amongst the staff. Although many staff members expressed problems with the NTP, only 38% of them reported having routine evaluations regarding the programme. Conclusion: Several aspects compromised the effectiveness of the NTP, including socio- economic factors leading to clients’ non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy, and staff experienced difficulties with the logistics of the programme.