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      Social exclusion of older persons: a scoping review and conceptual framework


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          As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion.

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          The online version of this article (doi: 10.1007/s10433-016-0398-8) contains supplementary material, which is available to authorized users.

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          Knowledge transfer for the management of dementia: a cluster-randomised trial of blended learning in general practice

          Background The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone. Methods In this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed. Results 166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores. Conclusion A blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge. Trial registration Current Controlled Trials ISRCTN36550981.
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            A longitudinal analysis of loneliness among older people in Great Britain.

            Longitudinal studies of loneliness among older people are comparatively rare. At 8 years after the initial survey in 1999-2000, we followed up on the 999 people aged 65+ years who were living in the community in the United Kingdom. We found that 583 participants were still alive, and 287 (58%) participated in the follow-up survey. The overall prevalence of loneliness at both time points was very similar, with 9% reporting severe loneliness; 30% reporting that they were sometimes lonely, and 61% reporting that they were never lonely. We developed a 12-category typology to describe changes in loneliness across the follow-up period and report that 60% of participants had a stable loneliness rating, with 40-50% rating themselves as never lonely, and 20-25% rating themselves as persistently lonely; 25% demonstrated decreased loneliness, and approximately 15% demonstrated worse loneliness. Changes in loneliness were linked with changes in marital status, living arrangements, social networks, and physical health. Importantly improvements in physical health and improved social relationships were linked to reduced levels of loneliness. This result suggests that strategies to combat loneliness are not confined to the arena of social interventions such as befriending services, which aim to build and support social embeddedness, but may also result from the treatment of chronic and long-term health conditions.
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              Never the Right Age? Gender and Age-Based Discrimination in Employment


                Author and article information

                Eur J Ageing
                Eur J Ageing
                European Journal of Ageing
                Springer Netherlands (Dordrecht )
                11 October 2016
                11 October 2016
                March 2017
                : 14
                : 1
                : 81-98
                [1 ]ISNI 0000 0004 0488 0789, GRID grid.6142.1, Irish Centre for Social Gerontology, , National University of Ireland Galway, ; Galway, Ireland
                [2 ]ISNI 0000 0001 0462 7212, GRID grid.1006.7, Institute of Health & Society, and Newcastle University Institute for Ageing, , Newcastle University, ; Newcastle, UK
                [3 ]ISNI 0000 0001 0658 8800, GRID grid.4827.9, Centre for Innovative Ageing, , Swansea University, ; Swansea, UK
                [4 ]ISNI 0000 0000 9769 2525, GRID grid.25881.36, Africa Unit for Transdisciplinary Health Research (AUTHeR), , North-West University, ; Potchefstroom, South Africa
                © The Author(s) 2018, corrected publication July 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2017

                Geriatric medicine
                multidimensional disadvantage,later life,knowledge synthesis,old-age exclusion


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