Day 2 :
The Education University of Hong Kong, Hong Kong
Keynote: Towards a cross-cultural understanding of ageing and learning by senior adults in Hong Kong and Australia
Time : 10:00-10:45
Dr Maureen Tam has extensive experience in teaching, research and management in higher education institutions, both in Hong Kong and overseas. Currently, Dr Tam is Associate Professor in Elderly Education with the Department of International Education and Lifelong Learning at the Education University of Hong Kong. Also, she is Deputy Director of Centre for Lifelong Learning Research and Development, and Head of the EdUHK Elder Academy. Dr Tam's research interests are wide-ranging which cover elderly education, lifelong learning, professional and vocational education, quality assurance, outcomes-based education, teaching, learning and assessment in higher education.
Aging and learning are value-laden concepts that are culturally relevant. Culture plays an important role in influencing what people think, resulting in different views and understandings by people from diverse cultural backgrounds. In the literature, there have been researched and discussions relating culture with aging and culture with learning to shed light on the value systems and predominant cultural values that have influenced the understanding of aging and learning by people in different cultures. The aim of this presentation is four-fold. First, it examines the concepts of aging and learning and considers the role that culture plays in the understanding of these two constructs. Second, it draws on the predominant East-West cultural debate to shed light on the cultural values and views that have influenced the understanding and conceptualization of aging and learning. Third, limitations are identified for the East-West dichotomous view of aging and learning using the Confucian perspective of learning to illustrate the inadequacies of the Eastern and Western ideas of learning, or lifelong learning, in particular. Finally, it draws on findings from a cross-cultural study to compare and contrast senior adults in Hong Kong and Australia, with regard to aging and learning.
Georgia State University, USA
Keynote: β-Hydroxybutyrate prevents vascular cell senescence through heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1)-upregulated octamer-binding transcriptional factor 4
Time : 11:00-11:45
Dr. Ping Song has a broad background in cell biology and biochemistry with specific training and expertise in both vascular biology and metabolism. By developing effective cell and mouse animal models, Dr. Song’s researches are focused on vascular biology and remodeling under aging, diabetic, or tobacco smoking/and e-cigarette condition. Recently, Dr. Song’s lab reported that activation of adenosine monophosphate-activated protein kinase (AMPK), an energy gauge and redox sensor, delays aging process by reduction of cyclin-dependent kinase (CDK) inhibitor p16 that is mediated by HMG box-containing protein 1 (HBP1). AMPKα2 isoform plays a fundamental role in anti-oxidant stress and anti-senescence. AMPKα also plays an important role in maintaining chromosome integrity and reduction of DNA damage, which is highly associated with cellular senescence. Ketone body β-hydroxybutyrate exerts anti-aging effects in both endothelial and vascular smooth muscle cells by upregulating a heterogeneous nuclear ribonucleoprotein A1-controlled Oct4-mediated Lamin B1 signaling pathway.
Statement of the Problem: Vascular aging is considered as a main risk factor for cardiovascular diseases. β-hydroxybutyrate (β-HB), one of three human ketone bodies, usually functions as an alternative source of energy during nutrient deprivation. Elevation of ketone bodies, including β-HB, during fasting or caloric restriction is believed to induce anti-inflammation effects and alleviate aging-related neurodegeneration. However, whether β-HB regulates molecular signaling in the aging process, specifically the senescence pathway in vascular cells, has not been previously studied. The objective of this study is to investigate the effect of β-HB on vascular cell senescence and the underlying molecular mechanisms. Methodology and Results: Vascular cells treated with β-HB and a ligand fishing pull-down approach were employed as an in vitro model. Mouse treated with β-HB was used as an in vivo animal model. β-HB stimulates cellular quiescence in vascular cells, which significantly inhibits both replicative senescence and stress-induced premature senescence via p53-independent mechanisms. Further, we identified heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) as a direct binding target of β-HB. The binding of β-HB with hnRNP A1 profoundly enforces hnRNP A1 binding to Octamer-binding transcriptional factor (Oct) 4 mRNA. The binding of hnRNP A1 with Oct4 mRNA stabilizes Oct 4 mRNA and Oct4 expression. Moreover, Oct4 increases Lamin B1, a key factor in maintaining chromosome stability against DNA damage-induced senescence. Finally, either fasting or intraperitoneal injection of β-HB in vivo elevates Oct4 and Lamin B1 in both endothelial and vascular smooth muscle cells in mice in vivo. Conclusions: Ketone body β-HB exerts anti-aging function in vascular cells by upregulating an hnRNP A1-controlled Oct4-mediated Lamin B1 pathway.
Methodist University, Campbell University, USA
Keynote: Suboptimal care of hospitalized older patients in the United States; it’s never too late to improve the quality of care
Time : 11:45-12:30
Dr. Kranthi Sitammagari is a board certified Internist, board certified Physician Advisor, Faculty at Campbell University School of Osteopathic Medicine and Associate Professor of Clinical Medicine at Methodist University in Fayetteville, NC, USA. He is an editorial board member of Society of Hospital Medicine's official magazine "The Hospitalist", Editor-in-Chief of Quality Assurance and Utilization at “StatPearls” online database publishing peer-reviewed, PubMed indexed articles and review books. He is also a scientific reviewer for multiple peer-reviewed journals including Annals of Internal Medicine, Journal of Hospital Medicine, and Journal of Preventive Medicine etc. and published peer reviewed articles. He is actively involved in clinical teaching and research.
The average life expectancy of individuals in the United States (US) has increased dramatically in the last century due to public health strategies and advances in medical treatment. It is expected that more than 20% of US population will be over 65 years of age by 2030. Older patients suffer from significant chronic medical problems including heart disease, cancer, stroke, dementia, and diabetes etc. requiring frequent hospitalizations. Almost half of the adults who get hospitalized are ≥ 65 yrs. and this proportion increases as the population ages. Hospital care costs Medicare about $149 billion per year in 2015, representing 25% of health care expenditures in the US. Hospitalization causes functional decline and increases mortality and morbidity due to confinement, immobility, diagnostic testing, and treatment especially changes in drug regimen, complications including delirium, falls, infections and death. Acute hospital care should only last long enough to allow successful transition to home care, a skilled nursing facility, or an outpatient rehabilitation program. The outcome of hospitalization is poorer with increasing age, although physiologic age is a more important predictor of outcome than is chronologic age. Even when a disorder is treatable or appears uncomplicated, a significant proportion of older patients may not return to prehospital functional status. The inpatient care is suboptimal leading to recurrent and frequent hospitalizations as most physicians have very little or no formal geriatric training despite the rapid increase in geriatric population. Hospital-wide strategies including multidisciplinary team approach, accurate medication reconciliation, early mobilization, frequent repositioning, avoiding high risk medications, training more hospital-based clinicians in geriatric care and to follow evidence-based interventions will improve both the quality and quantity of life for older adults. Additional research should be done on factors influencing poor outcome, strategies and systems to improve the quality of care in older hospitalized patients.