Background: The sociocultural changes associated with globalization and development have weakened the traditional values and family support systems for senior citizens (age 60 years and above). There is an increase in the prevalence of elder abuse and difficulties in getting appropriate care and support. This has mandated legal measures to protect the rights of the senior citizens and provide them care and support by the family and other stakeholders. Consequent to being the signatory for the “Madrid International Plan of Action on Ageing, 2002,” several countries, including India, have introduced legislation for the social protection of senior citizens. “The Maintenance and Welfare of Parents and Senior Citizens(MWP) Act, 2007” is an important legislation in India to safeguard the elderly from exploitation and abuse. Methods: This article critically evaluates the implementation of the MWP Act, 2007, and the related challenges in protecting senior citizens from abuse. The article will also highlight the proposed amendments in the Act to strengthen the effective implementation of legal protection for senior citizens and ensure their well-being and dignity. Conclusions: The MWP act is an important legal measure to ensure mainatinence and welfare of senior citizens and protect them from abuse and neglect. There is an immediate need to incorporate the necessary amendments so that the act gets more pragmatic value and becomes and important tool for elderly care and protection and reduce vulnerabilities and ensure holistic care with support in various bio-psycho-social domains.
Loneliness and social isolation are significant public health crises in older adults. The issues about companionship have many psychosocial and cultural dimensions, which is further compounded by the current COVID-19 pandemic. In modern-day India, there is a significant increase in the number of older adults left to live alone because of sociocultural changes in our society. Companionship in late life is known to promote the quality of life and decrease the mental health morbidity. There is an increasing role of pets as companions to the elderly. Novel technologies such as artificial intelligence in the form of robots are being explored to support the elderly. Sexuality is another complex issue related to older adults that is often ignored. The sexuality and sexual functioning in older adults largely depend on physiological, psychological, and sociocultural factors. The principles of ageism have influenced sexuality in older adults. Sociocultural issues and the aging-related pathophysiological changes can contribute to an increased risk for legal issues related to sexuality in this population. There is a need for more systematic research into the multifaceted concept of companionship and sexuality in the older adult population. This review article addresses these two distinct subjects separately.
BACKGROUND Virtual clinical interactions have increased tremendously since the onset of the pandemic. While they certainly have their advantages, there also exist potential limitations, e.g., in establishing a therapeutic alliance, discussing complex clinical scenarios, and so on. This may be due to possible disruptions in the accurate activation of the human mirror neuron system - a posited physiological template of effective social communication. OBJECTIVE To compare motor resonance - a putative marker of mirror neuron system (MNS) activity estimated using transcranial magnetic stimulation elicited while viewing virtual (video-based) and actual or real (enacted by a person) actions in healthy individuals. We hypothesized that motor resonance will be greater during real as compared to virtual action observation. METHODS Motor resonance or motor evoked potential (MEP) facilitation during action observation relative to rest states, is an indirect measurement of MNS activity in humans. We compared MEP facilitation during the observation of virtual (presented via videos) and real (enacted in person) actions, relative to static image observation in healthy individuals (N=64) using transcranial magnetic stimulation. The MEP recordings were obtained by two single-pulse (neuronal membrane excitability-driven) TMS paradigms of different intensities and two paired-pulse (cortical GABA-interneuron driven) TMS paradigms. RESULTS On RMANOVA we observed a significant time effect for MEP facilitation from static to virtual and real observation states when recorded using three of the four TMS paradigms. Post-hoc pairwise comparisons with Benjamini–Hochberg false discovery rate correction revealed a significant MEP facilitation in both virtual and real observation states relative to static image observation; however, we also observed a significant time effect between the two observation states (real > virtual) with two TMS paradigms. CONCLUSIONS Our results indicate that social cues expressed via both virtual (video) or real (in person) modes elicit physiological responses within the putative MNS, but this effect is more pronounced for actions presented in person. This has relevance to the appropriate implementation of digital health solutions, especially those pertaining to mental health. CLINICALTRIAL -
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