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Geriatric medicine is the branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness in older people. Rather than being defined by some arbitrary cut‐off in chronological age, it recognises that most older people, especially the ‘young‐old’, are in good health for most of the time. They are likely to benefit from standard medical management by generalists. Geriatricians focus on the more challenging patients ‐ those older people who are physically and cognitively frail, many of whom will be among the growing numbers of the ‘old‐old’. This population is characterised by non‐specific presentation of illness, functional dependency and a need for a multidisciplinary approach to care and judicious use of drug therapy. Drawing on publications from the department of geriatric medicine in Cardiff, this article illustrates important aspects of clinical care of older people and highlight the need for better recognition and prevention, better assessment and diagnosis and better therapeutic tools to manage acute and chronic illness in old age.

The acute geriatric community hospital (AGCH) in an intermediate care facility is an alternative to conventional hospitalization. A comprehensive geriatric assessment and rehabilitation are integrated into acute medical care for older patients. This study aims to evaluate patient experience and satisfaction with the AGCH.

This is a mixed method observational study including a satisfaction questionnaire and qualitative interviews with AGCH patients or informal caregivers.

A total of 152 participants filled in the questionnaire, and thirteen semi-structured interviews were conducted. Twelve categories and four overarching themes emerged in the analysis. In general, study participants experience the admission to the AGCH as positive and are satisfied with the care they received; there were also suggestions for improvement.

Limitations of this study include possible participation bias. The results show that patients value this type of care indicating that it should be implemented elsewhere. Further research will focus on health outcomes, readmission rates and cost effectiveness of the AGCH.

This is the first study to evaluate care satisfaction with the AGCH. It shows that hospitalized older adults positively value the AGCH as an alternative to hospitalization.

This paper aims to provide an in-depth examination of culturally and linguistically diverse older adults’ perceptions of and experiences with the Toronto Police Service to inform the development of a training curriculum for police officers working with older persons.

A qualitative descriptive study using virtual focus groups with 26 older adults from Toronto was conducted.

Three main themes emerged: understanding intersectionality; the impact of police officer attitudes and biases; and the need for age-friendly policing. Although many older adults rely on police services to keep them safe, there is dissatisfaction with some aspects of how police interact with older adults, particularly from minority groups.

Participants were older adults from culturally, ethnically and linguistically diverse backgrounds who are not usually included in studies on improving police services.

This paper outlines some of the pitfalls associated with the efficient management of beds using a case study in Preston. The value of follow‐up studies is reviewed and the importance of management drive to secure changes in practice is stressed. External factors, such as the control of overall bed numbers, appear to result in greater changes and improvements in effective use than prolonged investigation and negotiation with the consultants involved.

COVID-19 has profoundly shaped human interactions, and, within public healthcare systems, care relations. Through the lens of social suffering, this study explores how employee innovation is shaped by the pandemic crisis and different managerial approaches in the context of public geriatric care in Northeast Italy.

This study adopts a qualitative methodology. A total of 29 semi-structured, open-ended interviews were conducted with 23 healthcare professionals involved in geriatric care, with managerial and without managerial positions. Observation was integrated as auxiliary research to further capture on an operational level the interactions among the actors involved.

The COVID-19 crisis significantly shaped employee innovation for healthcare professionals, as the suffering it provoked in the system motivated and urged them to engage in innovative initiatives. Where employees’ engagement in innovation was recognized by the management, it was found that the suffering was mitigated, and creativity and solidarity emerged in the innovation process. Where top-down approaches did not recognize employees’ efforts and innovative initiatives, need-driven innovation and greater tensions came forward, enhancing the overall suffering in care relations and resulting in some employees considering leaving their profession.

This study is based on a single case study.

This study further highlights the employee participation in innovation as a crucial practical implication for sustaining the quality of public care and assistance. A practical implication emerging from this study suggests that “ordinary” healthcare professionals’ engagement in innovative initiatives and in their operationalization should be encouraged by the organization. In a system as complex as the public healthcare one, valuing the bottom-up, clinical inputs appears fundamental if innovation is to move away from mere technological adaptation to embrace a more comprehensive process, involving the professionals who are engaging in innovative endeavors. From a managerial point of view, adopting an approach that recognizes, supports and provides coordination to employee innovation seems instrumental to nurture an environment where employee voices feel heard, and creativity, solidarity and overall positive collaboration can occur. Thus, another significant practical implication includes the retention of healthcare professionals in the public sector in times of crisis.

With the outbreak of the COVID-19 pandemic, the necessity to explore the “human side” of innovation and its connection to emerging human needs during a crisis is growing. This study focuses on employee participation in innovation processes due to COVID-19, thus contributing to the employee-driven innovation (EDI) literature. Through the lens of social suffering, it scrutinizes the interactions between bottom-up perceptions and responses and top-down strategies in a public healthcare setting. Hence, this study addresses two major gaps present in EDI literature, for the most part focused on the private sector and on the managerial structures, tools and interventions.

Previous studies have reported that dietary fibers such as polydextrose and maltodextrin can reduce food intake; however, the studies on the differences of this effect are insufficient. The purpose of this paper is to compare the effects of dietary fibers maltodextrin and polydextrose on alterations of short-term satiety, energy intake and postprandial blood glucose in healthy females.

This study was designed as a randomized, crossover and double blind research. For this purpose, 21 healthy females consumed a milkshake containing 0 g (control), 15 g polydextrose (PDX) and 15 g maltodextrin (MDX), and an ad libitum lunch meal was served 150 min later. Subjective appetite scores (hunger, satiety, prospective food consumption and desire to eat) were measured using a visual analog scale. Appetite scores and blood glucose were measured before preload and once per 15 min after milkshake consumption.

Visual analog scale scores showed that PDX had an improved effect on satiety and hunger feelings. Compared to the control, dietary fiber increased the Area Under Curve (AUC) scores of satiety (p < 0.001) and decreased the AUC scores of hunger (p < 0.001), prospective food consumption (p < 0.001) and desire to eat (p < 0.001). Energy intake during ad libitum meal was significantly lower in PDX (Control: 862 (54.3) Kcal versus PDX: 679 (35.4) Kcal and MDX: 780 (49.3) Kcal. Moreover, the blood glucose levels were significantly lower in MDX.

This study conducted with healthy females demonstrated that PDX was more effective in inducing satiety during subsequent food intake, and that postprandial blood glucose were within more healthy levels in MDX.

We utilise the actor-network theory (ANT) – based especially on Latour (2005) – to examine how management accounting tools affect physicians’ representations and new managerial practices in French public hospitals currently undergoing reform.

We conducted a longitudinal case study – based on interviews and observations – in a large French public hospital in which dashboards are diffused to physicians and nurses dealing with both medical and managerial activities.

The case shows that head physicians and nurses are implicated in their new managerial tasks and spend time analysing dashboards. Management accounting tools thus play a role, as mediators, in organising new managerial practices, and dashboards are a means of materialising and giving structure to new managerial practices and enabling discussions and exchanges to take place between actors who were previously separated.

The case shows that management accounting tools are not necessarily useful because they help in decision-making or control – as in the dominant paradigm; rather, they are beneficial because they may help in changing representations and building a new collective organisation. Future research should therefore expand on the organisational and social roles of management accounting tools, especially in the healthcare field.

Most ANT-inspired studies in management accounting focus on explaining changes in accounting practices, which are perceived as a consequence of an ANT process. This chapter, however, analyses the practices by which management accounting tools act as a vehicle to organisational change.

The purpose of this paper is to investigate the influence that volunteering before medical school with older people in a care home has on the perceptions of older people.

Eight medical students answered an anonymous questionnaire relating to their experiences of volunteering in a care home before medical school. This was combined with an analysis of the relevant literature.

All the students had initially volunteered to enhance their CV for medical school. After volunteering, they had a greater realisation of the variety of older people. They also gained a number of transferable skills related to communicating with older people, especially those with cognitive impairment. The greatest learning experience was around the issues to do with dementia.

The research is based on eight students although they were from different areas.

It would be beneficial if care homes could be more proactive in encouraging prospective medical students to volunteer. Medical schools could also provide clearer advice or take a more active stance such as encouraging prospective students to volunteer with older people. Further research should be with a larger sample to gain insight into varying perspectives. It would also be useful to conduct research into older adults’ attitudes towards the contribution of potential medical students to their own lives and to the home.

Volunteering before medical school should be encouraged as it will enhance the chances of getting a place as well as being an eye opening experience and equip them with lifelong skills.

Original.