Dissertations / Theses: 'Older subject'

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Torres, Palma William Ignacio, and Galaz Mirta Margarita Flores. "Predictive factors of subject well-being in older people." Pontificia Universidad Católica del Perú, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/123824.

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This study assessed the effect of variables such as life satisfaction, self-rated health, social support and coping styles on subjective well-being. The level of subjective well-being was studied in a sample of Mexican elderly persons from the state of Yucatan in Merida (n = 122) with an age range of 60-93 years. The results in women show that coping styles predicts subjective well-being in negative affects. Moreover, self-perception of health, coping styles, and satisfaction with life are adequate predictors of the cognitive dimension of subjective well-being. Results in men show that satisfaction with life and coping styles predict the cognitive dimension of subjective well-being. Findings point to the importance of exploring psychosocial variables in older adults.
El presente estudio evaluó el efecto de las variables satisfacción con la vida, autopercepción de salud, apoyo social y estilos de enfrentamiento sobre el bienestar subjetivo. Se contó con una muestra de 122 adultos mayores mexicanos del Estado de Yucatán, en la ciudad de Mérida con un rango de edad de 60 a 93 años. Los resultados en mujeres muestran que los estilos de enfrentamiento son predictores del bienestar subjetivo en los afectos negativos. En cuanto a la dimensión cognitiva del bienestar subjetivo, la autopercepción de salud, los estilos de enfrentamiento y la satisfacción con la vida fueron predictores adecuados. En hombres, los resultados demuestran que la dimensión cognitiva del bienestar subjetivo fue predicha a partir de la satisfacción con la vida y los estilos de enfrentamiento. Los hallazgos muestran la importancia del profundizar y promover variables psicosociales en los adultos mayores.
Cette étude a évalué l’effet de la satisfaction de la vie, de l’auto-perception de la santé, du soutien social et des styles d’adaptation sur les variables de bien-être subjectif. Nous avons étudié le niveau de bien-être subjectif d’un échantillon de 122 Mexicains âgés de l’État du Yucatan, dans la ville de Mérida, âgés de 60 à 93 ans. Les résultats chez les femmes montrent que les styles d’adaptation sont des facteurs prédictifs du bien-être subjectif des affects négatifs, en termes de la dimension cognitive du bien-être subjectif, l’auto-perception de la santé, les styles de confrontation et de satisfaction avec la vie étaient des prédicteurs adéquats, tandis que chez les hommes, les résultats montrent que la dimension cognitive du bien-être subjectif est prévu de satisfaction de la vie et les styles d’adaptation. Les résultats montrent l’importance d’approfondir et de promouvoir les variables psychosociales chez les personnes âgées.
Este estudo avaliou o efeito de variáveis, satisfação com a vida, autopercepção de saúde, apoio social e estilos de coping no bem-estar subjetivo. o nível de bem-estar subjetivo foi estudado no estado de uma amostra de adultos mexicanos mais antiga do Yucatan em Merida (n = 122) com uma faixa etária de 60-93 anos. Os resultados em mulheres mais antiga mostram que os estilos de enfrentamento são preditores de bem-estar subjetivo em efeito negativo em termos da dimensão cognitiva do bem-estar de saúde subjetiva auto-avaliação, estilos e satisfação com a vida de enfrentamento foram preditores adequados em homens mais antiga resultados mostram que a dimensão cognitiva do bem-estar subjetivo está previsto a partir de satisfação com a vida e estilos de enfrentamento.

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Moody, Michelle Reid. "Final boundaries : a design for the fully-constructed body-subject." Thesis, Georgia Institute of Technology, 2002. http://hdl.handle.net/1853/23316.

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Zizzi, Pasquale. "Sexuality among older adults : a taboo subject in CLSC's? = la sexualité auprès des aînés : un subject tabou en CLSC?" Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81466.

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This qualitative study investigated what factors impact Home-care professionals' ability to effectively discuss and intervene with older adults on the topic of intimacy and sexuality, and to generate a theoretical model for methods in which professionals deal with the subject matter. In depth interviews with nine Home-care professionals (social workers, occupational therapists, physiotherapists, nurses, home-care workers, team coordinators) from a Montreal CLSC who regularly intervene among older adults and utilize the Multiclientele Autonomy Assessment form, documentary evidence, and grounded theory analysis were utilized. Interviews centered on the professionals' conceptions of their roles and experiences as health and social service providers with regards to sexuality in later life. A theoretical model was developed describing (a) Home-care professionals' discomfort in inquiring and/or discussing the topic of sexuality with older adults, (b) phenomena that arose from those causal conditions, (c) strategies for facilitating intervention on the topic with older adults, (d) the consequences of those strategies. Implications for future research and practice are addressed.

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Adhikari, Bikram. "A single subject participatory action design method for powered wheelchairs providing automated back-in parking assistance to cognitively impaired older adults : a pilot study." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/51861.

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Mobility is one of the most significant factors that determines older adults’ perceived level of health and well being. Cognitively impaired older adults are deprived of using powered wheelchairs because of the operational safety risks. These users can benefit from intelligent assistance during cognitively or visually challenging tasks such as back-in parking. An intelligent powered wheelchair that assists a cognitively impaired elderly user to perform a back-in parking task is proposed. A single subject participatory action design method is used with a cognitively impaired older adult to identify design guidelines for the proposed system. Based on analysis of transcripts from semi-structured interviews with the participant, a semi-autonomous back-in parking system is designed to drive the powered wheelchair into a pre-specified back-in parking space when the user commands it to. A prototype of a non-intrusive steering guidance feature for a joystick handle is also designed to render shear force in a way that can be associated with steering behavior of a car. The performance of the proposed system is evaluated in a pilot study. Experiments with the autonomous trigger and autonomous assisted modes are conducted during a back-in parking task with real-life obstacles such as tables and chairs in a long-term care facility. A single-subject research design is used to acquire and analyze quantitative data as a pilot study. Results demonstrate an increase in the user’s perception of ease of use, effectiveness and feeling of safety with the proposed system. While the user experienced at least one minor contact in 37.5% of the trials when driving unaided, the proposed system eliminated all minor contacts. No statistically significant difference in completion time and route length is observed with the proposed system. In the future, improved back-in parking systems can use this work as a benchmark for single subject participatory action design. Future iterations could also replicate the usability study on a larger population.
Science, Faculty of
Computer Science, Department of
Graduate

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BERNARDI, STEFANO. "ROLE OF POLYPHENOLS IN THE MODULATION OF INTESTINAL PERMEABILITY AND OTHER RELATED MARKERS IN THE CONTEXT OF AGING." Doctoral thesis, Università degli Studi di Milano, 2019. http://hdl.handle.net/2434/693765.

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In considerazione dell’aumento della popolazione anziana e delle malattie croniche generalmente associate che hanno un impatto significativo sul sistema sanitario a livello mondiale, risulta fondamentale identificare nuove strategie non invasive volte a promuovere lo stato di salute di questo target di soggetti. In particolare, il mantenimento di una "omeostasi" tra i processi infiammatori e antinfiammatori sembra essere un punto critico per migliorare il processo di invecchiamento. In questo contesto, è stato suggerito l’utilizzo di specifici modelli dietetici e/o di composti bioattivi degli alimenti, come ad esempio i polifenoli (PPs) per il loro possibile effetto nella prevenzione e gestione dei disturbi funzionali e metabolici associati all'età. Nei soggetti più anziani, queste condizioni possono anche essere messe in relazione a una aumentata permeabilità intestinale (PI), che è una caratteristica della barriera intestinale che contribuisce alla regolazione dello scambio di soluti e fluidi tra lume e tessuti. Nella presente tesi sono stati considerati 3 ambiti di lavoro principali diretti a: A - valutare criticamente strumenti e metodi per stimare l'assunzione di PPs in diversi gruppi target di popolazione; B – effettuare una revisione aggiornata della letteratura riguardante gli studi sul ruolo dei PPs sulla PI effettuati in vivo (modello animale), in vitro e sull'uomo; C- ottenere risultati mediante uno studio di intervento dietetico, sviluppato nell'ambito del progetto MaPLE, per supportare l'ipotesi che una dieta ricca di PPs possa migliorare la PI in un gruppo di soggetti anziani che vivono in un ambiente controllato. I risultati della parte A, suggeriscono che tè, caffè, vino rosso, frutta e verdura sono i principali prodotti che forniscono PPs in diversi gruppi di popolazione. Inoltre, emerge che i flavonoidi totali e alcune sottoclassi specifiche sono associate a un basso rischio di diabete, eventi cardiovascolari e mortalità per tutte le cause, anche se la grande variabilità in termini di metodi per la valutazione e la quantificazione dell'assunzione di PPs rende ancora difficile stabilire un quantitativo di riferimento per una assunzione adeguata di questi composti. I risultati della parte B hanno messo in luce la mancanza di studi di intervento effettuati sull’uomo che risultano necessari per aumentare la comprensione del ruolo effettivo dei PPs non solo dal punto di vista meccanicistico. Infine, nella parte C, i risultati ottenuti attraverso uno studio di intervento, dimostrano l'effetto di un modello dietetico ricco di PPs e, sviluppato appositamente per un target di soggetti anziani, nella modulazione della PI. In particolare, è stata osservata una riduzione significativa dei livelli sierici di zonulina. Inoltre, grazie all'accurata registrazione dell'assunzione alimentare lungo l'intero studio di intervento è stato possibile dimostrare meglio l’elevata compliance dei soggetti e il significativo aumento dell'assunzione totale di PPs, rafforzando così l'affidabilità degli effetti osservati. In conclusione, i risultati della presente tesi sembrano supportare l’efficacia e realizzabilità di un intervento dietetico non invasivo (ovvero ottenuto mediante inclusione di alimenti ricchi in PPs) per la gestione o la prevenzione della PI e delle condizioni associate presenti nei soggetti anziani e/o in altri gruppi sensibili della popolazione.
The need for the identification of new, and possibly non-invasive, strategies directed towards improving health status in the older population is increasing due to the burden of chronic degenerative diseases and the worldwide challenge associated to the consequent impact on the health care system. In particular, the maintenance of a “homeostasis” balance between inflammatory and anti-inflammatory networks seems to be fundamental to improve the aging process. In this context, the exploitation of specific dietary patterns and food bioactives such as polyphenols (PPs) have been suggested for their possible effect in the prevention and management of age-associated functional and metabolic disorders. In the older subjects, these conditions may be related to intestinal permeability (IP), that is a barrier feature which contributes to the regulation of solute and fluid exchange between the lumen and tissues. In the present thesis 3 main tasks have been considered directed to: A – critically assess tools and methods to estimate polyphenol intake in different target groups of population; B – review the last updated literature regarding in vivo (animal model), in vitro and human studies focused on polyphenol and IP; C- provide data from a dietary intervention study developed within the MaPLE project to support the hypothesis that a polyphenol-rich diet (PR-diet) can improve IP in a group of older subject living in a well-controlled setting. Results from task A suggested that tea, coffee, red wine, fruit and vegetables are the main products providing PPs in different target populations. In addition, total flavonoids and specific subclasses have been apparently associated with a low risk of diabetes, cardiovascular events and all-cause mortality even if the large variability in terms of methods for the evaluation and quantification of polyphenol intake makes still difficult to establish an evidence-based reference intake for these compounds. Task B results highlighted the lack of human intervention studies required to increase the understanding on the actual role of polyphenols not only from a mechanistic point of view. Finally, in the task C we are able to show the effect of a polyphenol-rich dietary pattern, specifically developed for a target of older subjects, in the modulation of IP. In particular, a significant reduction of zonulin serum levels have been found. In addition, thanks to the accurate registration of food intake along the whole intervention study it has been possible to better demonstrate the high compliance to the dietary instruction and the significant increase of total polyphenol intake, thus, strengthening the trustworthiness of the observed effects. In conclusion, the overall results of the present thesis seem to support the reliability of non-invasive dietary intervention (i.e. polyphenol-rich dietary pattern) for the management or prevention of IP and associated conditions in the older subjects and/or other sensitive target groups of population.

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Righi, Valeria. "Re-thinking human-computer interaction research and design with a growing ageing population: widening contexts of technology use, changing the subject and object of design." Doctoral thesis, Universitat Pompeu Fabra, 2016. http://hdl.handle.net/10803/383057.

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This dissertation analyses, reflects on, and re-thinks the way in which Human-Computer-Interaction (HCI) research is conducted with a growing ageing population. This dissertation draws upon a 5-year research-through design study that combined ethnography and participatory design to explore the use and design of technologies aimed to enhance the social life of older people in civic contexts. The findings show a varied, proactive, dynamic and mutually shaping relationship between older people and digital technologies. This dissertation argues that this relationship challenges current ways in which older people and technologies are theorized within HCI. The results highlight the relevance of considering the communities in which older people interact in their daily lives in order to better understand their relationship with interactive technologies and design new digital artefacts that they find worthy of appropriation. By drawing upon the findings and theoretical discussions of dominant approaches in HCI research with older people, the dissertation proposes a re-formulation of fundamental aspects of thinking about and conducting HCI research and design with a growing and heterogeneous ageing population. Central to this re-formulation is to (a) widen the contexts of ICTs use by conducting more HCI research in civic contexts, (b) change the object of design, shifting the focus from defining the features of a technological artefact to fostering a mutual shaping relationship between technologies and everyday practices, and (c) re-think the subjects of design by moving from designing “for older people” to designing for “situated communities”. Keywords: HCI, older people, research-through design, ethnography, participatory design, technology appropriation, communities, civic contexts
Esta tesis analiza, reflexiona y reconsidera la forma en que la investigación en el campo de la “Interacción Persona-Ordenador” (IPO) con personas mayores se ha estado realizando durante las últimas décadas. Esta tesis se basa en 5 años de investigación a través del diseño (research-through-design), combinando etnografía y diseño participativo para explorar el uso y el diseño de tecnologías destinadas a mejorar la vida social de las personas mayores en entornos cívicos. Los resultados muestran una relación variada, proactiva, dinámica y mutuamente condicionada entre las personas mayores y las tecnologías digitales. Esta tesis sostiene que dicha relación desafía el discurso actual utilizado para teorizar sobre la relación de las personas de edad avanzada y las nuevas tecnologías. Los resultados destacan la importancia de considerar las comunidades en las que las personas mayores interactúan en su vida diaria con el fin de comprender mejor su relación con las tecnologías interactivas y diseñar nuevos artefactos digitales que realmente sean apropiados por los mayores en su vida diaria. Partiendo de los resultados de este estudio y discusiones teóricas sobre los enfoques dominantes en la investigación IPO con las personas mayores, esta tesis propone una reformulación de los aspectos fundamentales de reflexión y desarrollo de la investigación y el diseño IPO con una población anciana heterogénea y en constante crecimiento. Temas centrales de esta reformulación son: (a) ampliar los contextos de uso de las TIC, realizando más investigaciones IPO en entornos cívicos, (b) modificar el objeto de diseño, desplazando el enfoque de la definición de las características de un artefacto tecnológico, por el impulso de una relación de condicionamiento mutuo entre tecnologías y prácticas cotidianas, y (c) repensar los sujetos del diseño, sustituyendo el concepto de diseñar “para las personas mayores" por diseñar para “comunidades situadas".
Aquesta tesi analitza, reflexiona i reconsidera com s'ha estat realitzant la recerca amb persones grans en el camp "Interacció Persona-Ordinador" (IPO) durant les darreres dues dècades. Aquesta tesi es basa en 5 anys d'investigació a través del disseny (research-through-design), que combina l'etnografia i el disseny participatiu, per explorar l'ús i el disseny de tecnologies destinades a millorar la vida social de les persones grans en entorns cívics. Els resultats mostren una relació variada, proactiva, dinàmica i mútuament condicionada entre la gent gran i les tecnologies digitals. Aquesta tesi sosté que aquesta relació desafia la manera de teoritzar la relació entre les persones grans i les TIC en el marc de la IPO. Els resultats destaquen la importància de considerar les comunitats en què les persones grans interactuen en la seva vida diària per tal de comprendre millor la seva relació amb les tecnologies interactives i de dissenyar nous artefactes digitals que la gent gran vulgui utilitzar en la seva vida quotidiana. Tenint en compte els resultats d'aquest estudi i les discussions teòriques sobre els enfocaments dominants en la investigació IPO amb les persones grans, aquesta tesi proposa una reformulació dels aspectes fonamentals de reflexió i desenvolupament de la investigació i el disseny IPO amb una població anciana heterogènia i en constant creixement. Temes centrals d'aquesta reformulació són: (a) ampliar els contextos d'ús de les TIC, mitjançant la realització de més investigacions IPO en entorns cívics, (b) modificar l'objecte de disseny, desplaçant l'enfocament de la definició de les característiques d'un artefacte tecnològic cap a una formulació en la que la relació entre tecnologies i pràctiques quotidianes és de condicionament mutu, i (c) repensar els subjectes del disseny, substituint el concepte de “dissenyar per a la gent gran” per “dissenyar per comunitats situades”.

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Singh, Nivedita. "Vascular relaxant function and oxidant stress in healthy older subjects." Thesis, St George's, University of London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398220.

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Parry, Steve W. "Cardioinhibitory carotid sinus hypersensitivity and unexplained falls in older subjects." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.394737.

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Awais, Muhammad <1989&gt. "Physical Activity Classification Meeting Daily Life Conditions for Older Subjects." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amsdottorato.unibo.it/8270/1/Muhammad_Awais_PhD_Thesis.pdf.

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Physical inactivity can lead to several age-related issues such as falls, movement disorders and loss of independence in older adults. Therefore, promoting physical activity in daily life and tracking daily life activities are essential components for healthy aging and wellbeing. Recent advances in the MEMS devices make it happen to wirelessly integrate miniature motion capturing devices and use them in personal health care and physical activity monitoring systems in daily life conditions. Consequently, various systems have been developed to classify the activities of daily living. However, the scope and implementation of such systems are limited to laboratory-based investigations and they are mainly developed utilizing the sample population of younger adults. Therefore, this dissertation aims to develop innovative solutions for physical activity classification, with a specific focus on the elderly population in free-living conditions.

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Hawken, Malcolm Boyd. "Control of posture in older subjects and those liable to falls." Thesis, Imperial College London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271534.

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Wanamaker, Scot E. "The effects of vitamin E supplementation and resistance training on muscle function in elderly subjects." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1231404.

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Findings were that caregivers considered all items on the Information Needs and Patient Care Needs subscales to be important but most of the unmet needs were from the Patient Care subscale. The needs less satisfied in relation to importance were (a) ways to improve patient appearance, (b) activities that will make patient feel purposeful, (c) information on how to give medications, (d) ways to reassure patient, (e) ways of coping with patient's diagnosis, (f) ways to dress patient comfortably, (g) ways to deal with patient's decreased energy, and (h) importance of not leaving patient alone.The implications for nursing are to assess and anticipate the needs of the caregiver of the stroke survivor so that his or her needs can be met. Preparing caregivers for their new role by meeting their needs will help the nurse met the primary goal of helping the patient.
School of Physical Education

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Shim, Jae Kun. "Kinetic analysis of pole-walking in elderly subjects : variability in ground reaction force during weight bearing." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1236373.

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The purpose of this study was to determine how walking with T-Poles, training using T-Poles and increased walking speed would change GRF measures in elderly subjects. The magnitudes of peak force, average force, and impulse force variables decreased as a result of the T-Pole use. Time during support phase increased when using T-Poles. The magnitudes of peak force, average force, and impulse force, and time variables decreased with extended training using T-Poles. However, loading rate increased with training and practice. FZ3, AZP, and AZ showed interactions between T-Pole use and training and TP showed an interaction between T-Pole use and walking speed. The results of this investigation suggest that using T-Poles generally reduces foot-ground force interaction during walking. It is a tendency that the foot-ground interactions during walking with TPoles decreased more with the longer period of T-Pole use and significant interactions between T-Pole use and training were observed in AZ3, AZP, and AZ. The reductions of foot-ground interaction induced by the T-Pole and practice time using T-Poles were present regardless of increased walking speed.
School of Physical Education

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Wisniacki, Nicolas. "Insulin resistance, inflammatory activation and vascular function in older subjects with diastolic heart failure." Thesis, University of Liverpool, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417970.

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Bowles, Kristen. "ERG assessment of scotopic and photopic critical flicker frequency in older and younger human subjects." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2009. https://www.mhsl.uab.edu/dt/2009m/bowles.pdf.

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dos, Santos Gaspar Cabete Dulce. "Autonomy and empowerment of hospitalised older people : a Portuguese case study." Thesis, Northumbria University, 2011. http://nrl.northumbria.ac.uk/2623/.

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Thomas, Elju Eldho. "Ambulation training of older subjects on a treadmill with an apparatus to relieve the body weight." Thesis, University of Strathclyde, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435119.

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Rickard, Norman Alexander Stuart. "The meaning of involvement for older people in their rehabilitation after acute illness." Thesis, Northumbria University, 2012. http://nrl.northumbria.ac.uk/10457/.

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As the population of people in the UK, over 65, increases and the welfare system moves from a collectivist, towards a consumerist system, involving older people in their rehabilitation and care becomes more important. It is recognised that the effectiveness of practices to increase involvement varies. The reasons for this include the lack of clarity about the meaning of involvement in health care. The aims of this research were to develop a substantive theory, which explains the meaning of involvement for older people in their rehabilitation after acute illness and facilitates recommendations for health care practice development. Grounded theory was employed to collect longitudinal data from four older people, their practitioners and support staff, during the participants’ rehabilitation stay of around six weeks in an Intermediate Care unit in the UK and at home. Data were collected using recorded, semi-structured interviews and conversations, from December 2008 to November 2009 and were analysed qualitatively. The findings suggest that involvement in rehabilitation operates through an Involvement Attribute set consisting of two interdependent groups of Involvement Attributes (the psychologically-based and the action-based). Collectively, the Involvement Attributes are: the possession of a Vision, Incentive and Goals, a positive Disposition; a propensity for Cognitive Development; Goal planning, setting and achievement; and Risk Management. To be maximally involved the Involvement Attribute set has to be strong, balanced and with alignment between the two groups. Involvement in rehabilitation is also related to the type of relationships developed with the health care staff and relatives. Improvements in Involvement Attribute sets require a move away from paternalistic relationships towards the collaborative, partnerships suggested within relationship-centred care. In this way, involvement of older people in rehabilitation is: “A joint commitment within therapeutic relationships to determine and be determined in the pursuit of an Involvement Attribute set that is strong, balanced and aligned”.

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Strube, Amanda Nicole. "The Effects of Simulated Muscle Weakness on Lower Extremity Muscle Function during Gait in Healthy, Older Subjects." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1354550696.

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Cutshaw, Laura M. (Laura Marie). "Assessment of Functional Communication Skills in Institutionalized and Non-Institutionalized Elderly Subjects Using the Spontaneous Speech and Auditory Comprehension Subtests of the Western Aphasia Battery." Thesis, University of North Texas, 1990. https://digital.library.unt.edu/ark:/67531/metadc500560/.

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The purpose of this study was to determine if there is a difference in functional communication skills between elderly persons in nursing homes and those living independently in the community. Thirty non-institutionalized elderly subjects were given the Western Aphasia Battery (WAB) screening tool. These scores were compared to WAB screening scores obtained from 20 institutionalized subjects. The difference between these scores was statistically significant. The institutionalized subjects' scores were also correlated with a Facilitators Evaluation of Communication Skills (FECS) inventory. Results showed a moderate correlation between the institutionalized subjects' WAB screening score and their FECS rating. The benefits of a screening tool for elderly populations are discussed.

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Williams, David H. H. "The relationship between exercise tolerance and a single rate of perceived exertion as modified by training among older male and female subjects." Thesis, Loughborough University, 1995. https://dspace.lboro.ac.uk/2134/12453.

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Most testing and training studies make objective measurements of responses to exercise by means of a wide range of physiological parameters of varying degrees of sophistication. However, rarely do such studies take as their central theme how the individual feels in response to a test or to exercise, before and after training. Some studies even conclude that a period of training has had no measurable effects on their subjects because the range of measurements made before and after training was unchanged -yet the subjects report that they felt better and could cope with exercise more effectively. Thus, the aim of this thesis is to describe a series of studies which examined the physiological responses to exercise of middle-aged subjects with the emphasis placed on their subjective reaction to that exercise before and after training. Rather than employ a battery of psychological tests to assess such reactions the simple, but effective, expediency of using a single Rate of Perceived Exertion (RPE) was adopted [continued]…

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Liu, Xiayang. "Experiences of ageing and support networks for accessing formal care services among older Chinese immigrants in England : a grounded theory study." Thesis, Northumbria University, 2014. http://nrl.northumbria.ac.uk/21610/.

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The Chinese group is the fastest growing ethnic group in the UK; this group is ageing fast, with the number of older Chinese doubling in 8 years. The majority of older Chinese immigrants in the UK have low education levels and limited English proficiency, and were reported to have low service use rate, lack of social support, and poor emotional status. This suggests that they may have difficult ageing experiences. This research set out to understand the UK older Chinese immigrants’ ageing experiences and coping strategies with the challenges of ageing, with a focus on the formal service use in their later life. The research adopted grounded theory as methodology, and used semi-structured interviews for data collection. The research had two phases. The first phase was exploratory using, mainly, focus groups to investigate perceptions of ageing, and for orientation to the field. Based on the contextual data provided by the phase one study, the phase two study was more focused on the support network and its influences on services use. Here individual interviews with follow-ups were used to gain in-depth understanding. Together, 58 participants, including older Chinese immigrants (n=44), family members of older Chinese (n=9), staff from organizations that work with Chinese people (n=3), and acquaintance who provided support for older Chinese (n=2), were interviewed. During phase two of the study, a group of key support providers who facilitated access to formal services for older Chinese were identified, and named as Bridge People. The outcomes of this research revealed that older Chinese immigrants used Bridge People, consisting of people from family, public sectors, Chinese community, and personal social network, to communicate with formal service providers. Older Chinese immigrants also rely on Bridge People to bridge other gaps in service delivery, such as lack of transportation, informational support, emotional support, and other cultural issues. In return, Bridge People gained trust and incurred power with older Chinese immigrants. Properties of Bridge People were identified as bilingual, bicultural, accessible, costless, and no social debt. Within the concept of Bridge People, each category provides a different combination of support, and older Chinese immigrants used this range of support in different combinations. In this study new theory and knowledge were generated about older Chinese and their key support providers. The Bridge People network model highlights the importance of interactions between Bridge People and older Chinese immigrants in accessing and using formal services. As many factors, including limited information resources, availability, role, emotional attachment, confined the performance of Bridge People, there are implications for policy makers; namely the role and importance of Bridge People should be recognized across health, social care and housing provision for older people. To promote engagement and optimise service use by older Chinese, relevant support should also be provided to Bridge People.

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22

Dekenah, Ghabrielle Anne. "The development of a fall risk assessment and exercise intervention programme for geriatric subjects." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71783.

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Thesis (M Sport Sc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Falling is a common occurrence and one of the most serious problems in the elderly population (65 years and older). Falls account for 70% of accidental deaths in persons aged 75 years and older. Falls can be markers/indicators of poor health and declining function, and are often associated with significant morbidity. More than 90% of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age (Fuller, 2000). About one third of people aged 65 years and older fall each year, resulting in a substantial decrease in quality of life in addition to placing a huge burden on current health care systems. The purpose of this study was to determine whether a 12-week exercise intervention programme, consisting of two 30 minute exercise sessions a week, could lower the risk of falling in a group of elderly women. Female subjects (n=22) with an average age of 79.5 years were selected from three retirement homes situated in Stellenbosch, Western Cape, South Africa, according to specific inclusion and exclusion criteria. The subjects included presented no major cardiovascular and pulmonary disease signs and symptoms as recognised by the American College of Sports Medicine (2011); had no serious illnesses or co-morbidities; were mobile with no significant musculoskeletal disorders; had no uncorrected visual or vestibular problems as well as no significant cognitive impairments or major psychological disturbances; were not taking any psychotropic medications or Benzodiazepines that could affect their progress. Subjects also had to be willing to follow the 12-week exercise intervention programme and sign an informed consent document. The selected subjects then underwent a pre- and post-intervention assessment consisting of a subjective rating of their fear of falling, the Fall Risk Assessment: Biodex Balance system, Balance Evaluations Systems Test (BESTest) and the 30-Second Chair Stand Test. Statistica 10 was used to analyse the data. Data was analysed to assess any significant improvements that the exercise intervention had on each fall risk variable tested. The main fall risk variables consisted of: fear of falling, muscular strength, balance, gait and getting up strategies. Statistically significant improvements (p<0.001) were seen in: Fear of falling, muscular strength, balance, gait and getting up strategies after the 12-week exercise intervention programme. This study suggests that exercise intervention has the potential to decrease the risk of falling among elderly women and should play an extremely important role in the prevention of falling amongst this population group.
AFRIKAANSE OPSOMMING: Om te val is ‘n alledaagse gebeurtenis en een van die mees ernstige probleme vir ons bejaarde bevolking (65 jaar en ouer). Insidente van val verklaar tot 70% van toevallige sterftes met betrekking tot persone van 75 jarige ouderdom en ouer. Om te val kan ‘n teken van swak gesondheid en/of ‘n afname in funksionele kapasiteit wees, en is gewoonlik met morbiditeitspatrone gekoppel. Meer as 90% van heupfrakture kom as gevolg van valle voor, waar die meeste van die frakture in persone bo 70 jarige ouderdom voorkom (Fuller, 2000). Minstens een derde van persone bo 65 jaar en ouer val elke jaar, so ‘n val het ‘n noemenswaardige afname in lewenskwaliteit tot gevolg asook ‘n enorme druk wat op huidige gesondheidsorg sisteme geplaas word. Die doel van die studie was om te bepaal of ‘n 12 week oefenintervensieprogram, wat uit twee oefen sessies van 30 minute elk bestaan, die risiko van val vir n groep bejaarde vroue kan verlaag. Vroulike individue (n=22) met ‘n gemiddelde ouderdom van 79.5 jaar uit drie ouetehuise/aftree oorde in Stellenbosch, Wes-Kaap, Suid-Afrika geleë; is volgens bepaalde insluitings- en uitsluitingskriteria geselekteer. Individue wie ingesluit is het geen tekens of simptome van grootskaalse kardiovaskulêre of pulmonêre siekte getoon nie, soos herken deur die “American College of Sports Medicine (2011) ; het aan geen ernstige siektes of ko-morbiditeite gely nie; kon stap met geen merkwaardige muskulo-skeletale afwykings nie; het geen nie-gekorrigeerde visie of vestibulêre probleme asook geen beduidende kognitiewe gestremdhede of ernstige sielkundige steurnisse gehad nie; het nie enige psigotropiese medikasie of Benzodiazepines geneem wat hul kon beinvloed nie. Individue moes bereid gewees het om die 12 week oefenintervensieprogram te volg en moes ook ‘n ingeligte toestemmingsvorm onderteken. Die geselekteerde individue het ‘n pre- en post-intervensie assessering ondergaan wat uit ‘n subjektiewe bepaling van hul vrees vir val bestaan het, die Val Risiko Assessering asook “Biodex Balans System Test, Balance Evaluations Systems Test (BESTest)” asook die 30 Sekonde Stoel-staan Toets. Statistica 10 is gebruik om die data te analiseer. Data was geanaliseer om enige merkwaardige verandering wat die oefenintervensie op elke val risiko veranderlike wat getoets was gehad het, te bepaal. Die belangrikste val risiko veranderlikes het uit: die vrees vir val, spier sterkte, balans, stappatroon en opstaan tegnieke bestaan. Betekenisvolle statistiese veranderinge (p<0.001) is gerapporteer in: die vrees vir val, spiersterkte, balans, stappatroon en opstaan tegnieke na die 12 week oefenintervensieprogram. Die studie bevind dat die intervensieprogram die potensiaal het om die risiko van val onder bejaarde vroue te verminder en behoort ‘n uiters belangrike rol in die voorkoming van val onder die bevolkingsgroep te speel.

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Hesson, Jacqueline Barbara. "Cumulative estrogen exposure and prospective memory in older women." Thesis, 2007. http://hdl.handle.net/1828/2404.

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With the average female life expectancy in Canada currently at 82 years, women are now spending approximately one-third of their lives in a hypoestrogenic state. Numerous studies from the basic sciences have shown that estrogen is neuroprotective in a variety of ways. The findings from the clinical studies of the effects of estrogen replacement on cognition in postmenopausal women are more inconsistent, though current research suggests that the timing of initiation of estrogen replacement relative to menopause is a major contributing factor to the discrepant findings in this literature. Reproductive and biological variables that affect levels of endogenous estrogen throughout a woman's lifespan may also influence cognitive function later in life as well as modify a woman's response to exogenous estrogen. The present study looked at the effects of cumulative estrogen exposure on the performance of a measure of prospective memory in a group of older postmenopausal women. Cumulative estrogen exposure was estimated using a mathematical index that included variables known to influence estrogen levels across the life span such as age at menarche and menopause, parity, duration of breastfeeding and estrogen replacement therapy, body mass index and time since menopause. Prospective memory is memory for future intentions and it was chosen because of its relevance for independent function and possible utility as an early indicator of dementia. Imaging studies link prospective memory to the prefrontal cortex, an area of the brain that is known to be influenced by estrogen so it was hypothesized that women with higher levels of cumulative estrogen exposure would perform better on a measure of prospective memory than women with lower levels of endogenous estrogen. Measures of verbal memory were also included in the study for comparative purposes as verbal memory is the cognitive function reported most consistently in the previous literature to be affected by postmenopausal estrogen replacement use. The results of the multivariate analyses indicated a significant positive correlation between prospective memory scores and cumulative estrogen exposure but only when women who had initiated estrogen replacement more than five years after menopause were excluded from the analysis. The significant positive correlation between cumulative estrogen exposure and prospective memory performance remained significant when only women who had never used estrogen were included in the analysis. No relationships were observed between levels of cumulative estrogen exposure and performance on measures of verbal memory. While the study was limited by the fact that it was observational in nature and the sample size was small, the results are consistent with recent findings from the hormone literature, in that they suggest that the timing of hormone replacement as well as the influence of variables that affect endogenous estrogen levels over a woman's lifespan need to be considered when studying relationships between cognitive performance and estrogen. In addition, the finding that performance on a measure of prospective memory but not performance on a measure of verbal memory was associated with levels of cumulative estrogen exposure adds further support to the theory that the frontal cortex may be especially sensitive to estrogen.

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24

Houston, Melanie. "Phonological awareness and spelling intervention for older children." Thesis, 2007. http://hdl.handle.net/1828/2391.

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This intervention study investigated whether children aged seven to ten years, experiencing difficulty developing literacy skills, could increase their phonological awareness and spelling skills by participating in a program lasting for 20 hours. A single subject, multiple base-line design was used with six participants. Phonological awareness blending and segmenting skills as well as single word writing skills were practiced explicitly and systematically in a highly structured program. Written words included mono-syllables, multi-syllabic words and words with derivational and inflectional morphemes. The words in the program focused on words with consistent sound-letter correspondence. All participants scored in the normal range for phonological awareness skills after the first 5 hours of instruction. Gains in phonological awareness skills did not influence spelling skills. Single word spelling only increased when writing skills were specifically targeted. All participants showed improvements in sound-letter correspondence writing skills. Some small, inconsistent gains were made in overall spelling skills.

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25

Parke, Belinda Bernice. "Understanding the hospital environment and older people: a social ecological analysis." Thesis, 2007. http://hdl.handle.net/1828/2263.

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The complex health profile of older adults entering hospital presents staff and administrators with new challenges. In a climate of fiscal restraint, competing priorities and public pressure. it is necessary for acute care hospitals to rethink their views of caring for older adults. This critical ethnographic study applies a social ecological perspective using the concept of person-environment fit to illuminate how problems arise from conflict between needs and expectations. Constant comparative analysis and coding techniques take account of hospital operations and the perspectives of hospital employees and older people together. Data included hospital observations, and interviews with older adults (N=11) and hospital employees (N=14). Procedures to ensure rigor included continuous reflexivity. participant selection, triangulating data sources, peer debriefing, multiple checks. and an audit trail. Findings yield four areas of poor fit: architectural features, bureaucratic conditions. chaotic atmosphere, and hospital employee attitude. These environmental features act in independent and cumulative ways to produce a disempowering synergy that erodes independence and confidence: produces stress, worry, and anxiety; and enhances disabilities when functional impairments exist. Incongruent relationships emerge only when non-ideal older people enter the hospital's cultural space. A lack of fit exists for those considered different either because of their personal functional attribute or because hospital employees judge them to be unsuitable or inappropriate for the unit or service. Being different is key to lack of fit in the hospital environment and the construction of problems. The study also contributes groundwork for identifying indicators of older adult-hospital environment fit. and by doing so. aids in defining quality of hospital services based on what older people need and expect compared with what the hospital provides and the demands it places on older people. This research has the potential to set the stage for assessing hospitals and ensuring policies are better suited to the needs of older people.

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Ritchie, Lesley Jane. "Identifying mild cognitive impairment in older adults." Thesis, 2008. http://hdl.handle.net/1828/1336.

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The absence of gold standard criteria for mild cognitive impairment (MCI) impedes the comparison of research findings and the development of primary and secondary prevention strategies addressing the possible conversion to dementia. The objective of Study 1 was to compare the predictive ability of different MCI models as markers for incipient dementia in a longitudinal population-based Canadian sample. The utility of well-documented MCI criteria using data from persons who underwent a clinical examination in the second wave of the Canadian Study of Health and Aging (CSHA) was examined. Demographic characteristics, average neuropsychological test performance, and prevalence and conversion rates were calculated for each classification. Receiver operating characteristic (ROC) analyses were employed to assess the predictive power of each cognitive classification. The highest prevalence and conversion rates were associated with case definitions of multiple-domain MCI. The only diagnostic criteria to significantly predict dementia five years later was the Cognitive Impairment, No Dementia (CIND) Type 2 case definition. It is estimated that more restrictive MCI case definitions fail to address the varying temporal increases in decline across different cognitive domains in the progression from normal cognitive functioning to dementia. Using data from the CSHA, the objective of Study 2 was to elucidate the clinical correlates that best differentiate between cognitive classifications. A machine learning algorithm was used to identify the symptoms that best discriminated between: 1) not cognitively impaired (NCI) and CIND; 2) CIND & demented; and 3) converting and non-converting CIND participants. Poor retrieval was consistently a significant predictor of greater cognitive impairment across all three questions. While interactions with other predictors were noted when differentiating CIND from NCI and demented from non-demented participants, retrieval was the sole predictor of conversion to dementia over five years. Importantly, the limited specificity and predictive values of the respective algorithms caution against their use as clinical markers of CIND, dementia, or conversion. Rather, it is recommended that the predictors serve as markers for ongoing monitoring and assessment. Overall, the results of both studies suggest that the architecture of pathological cognitive decline to dementia may not be captured by a single set of diagnostic criteria.

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Low, Gail. "Quality of life among older adults: a proposed conceptual model." Thesis, 2005. http://hdl.handle.net/1828/1967.

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The purpose of this study was to develop and test a model of Quality of Life (QOL) of older adults in which overall QOL was the dependent variable and financial resources, perceived health and Activities of Daily Living (ADL) performance, emotional support, meaning and purpose in life, and the older adult's surrounding physical and home environment were the independent variables. It was hypothesized that each of these independent variables would have a significant and positive effect upon overall QOL, and meaning and purpose in life were expected to mediate the effects of perceived health upon overall QOL. To address the hypotheses being posed in this study. a secondary analysis was undertaken of two cross-sectional data sets. namely the Canadian WHOQOL-OLD Group 2004 Field trial (data set 1: n = 202) and the WHOQOL-OLD Group 2002 Pilot study (data set 2: n = 420). At the bivariate level, in data set 1, all six independent variables were found to be significantly and positively associated with overall QOL. In the multiple regression analysis, the pattern of findings for all eight predictors indicated the hypothesized model was not likely to fit data set 1. In particular. the non-significant direct effects of ADL performance. emotional support, and the physical and home environment indicated either that they are not related to QOL or their relationship is mediated by another variable. The non-significant direct effect of purpose in life did not provide preliminary evidence of its mediating role in relation to the remaining predictors. The fit and modification indices arising from the path analysis of data set I gave rise to an alternate model wherein financial resources, perceived health, and meaning in life had a significant and positive direct effect upon overall QOL. Purpose in life partially mediated the effect of perceived health, and meaning and purpose in life also played significant mediating roles in relation to emotional support and the surrounding physical environment. and a structural path was added from purpose to meaning. In a second path analysis. the post-hoc model arising from data set 1 was evaluated using an independent sample of older adults (data set 2) but yielded poor Adjusted Goodness of Fit and Root Mean Square Error of Approximation indices. Points of disparity arising from the path analysis of data set 2 were the added structural paths from ADL performance, emotional support, purpose in life, and the surrounding physical and home environment to overall QOL itself. Additionally, meaning in life did not mediate the effect of the surrounding physical environment. The empirical support received in this validation phase of analysis for all six hypotheses highlighted the sample-dependent nature of post-hoc models and drew attention to the limitations of this study. including that of sample size discrepancies between data sets 1 and 2 and convenience sampling bias for data set 2. The nursing practice implications of this study closely align with the Canadian Gerontological Nurses Association (1996) practice mandate. Specifically, the findings of this study imply that collaborative clinical practice, in which the sharing of expertise contributes to comprehensive and informed assessment. planning and intervention aimed at enhancing and promoting QOL among chronically ill older adults, would be valuable.

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Ebert, Patricia Lynn. "Cognitive, metacognitive, and psychosocial predictors of benefit following memory enhancement intervention for older adults." Thesis, 2006. http://hdl.handle.net/1828/1471.

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Cognitive aging research has demonstrated reliable declines in memory ability with age, and, in response, several memory enhancement programs have been developed to address these concerns. Most research indicates that these programs are beneficial. However, research into the predictors of memory enhancement outcomes is limited. In brief, age, cognitive status, and memory ability have been shown to be influential. Only a few studies have investigated other potentially important psychosocial influences such as personality, metacognition, and coping styles. The goal of this study was to identify potentially important demographic, cognitive, and psychosocial influences on memory enhancement intervention outcomes. Thirty-nine older adults completed a multifaceted memory enhancement program that included psycho-education, memory compensatory strategy instruction, and discussion aimed at addressing metacognitive concerns and ageist stereotypes. Eighteen participants served as delayed-treatment controls. Predictor variables included demographic, cognitive (3MS, HVLT, Buschke Cued Recall Protocol), personality characteristics (NEO-PI-R), coping styles (Brief Cope), and metacognitive measures (MCI, MIA). Dependent measures including subjective (MMQ) and objective (Face/Name Recall, Grocery List Recall, Story Detail Recognition, Strategy Application) memory measures were obtained pre- and post-intervention. The current memory enhancement program was effective in improving both subjective and objective memory functioning immediately following program completion. Results revealed individual variation in outcomes ranging from 30 to 60 percent of participants showing improvement depending on the measure assessed. Improvements in subjective memory functioning were maintained at three-month follow-up. Investigation of predictors of individual differences in outcome indicated that memory performance scores were the most consistent predictor of objective memory functioning improvement, although metacognitive factors were also influential. Immediate improvement in subjective memory functioning was associated with both metacognitive ratings and memory performance scores whereas only metacognitive ratings were associated with lasting subjective improvement. In general, metacognitive constructs of memory efficacy, controllability, and locus of control appeared to be associated with positive intervention outcomes. An unexpected finding of higher levels of memory-related anxiety being associated with positive outcomes was noted. Personality characteristics (e.g., openness, neuroticism) were predictive of immediate increases in memory strategies usage. Implications for cognitive rehabilitation and social cognitive theory and clinical application are discussed.

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Hilborn, Jennifer Victoria. "Intraindividual variability across cognitive domains: investigation of dispersion levels and performance profiles in older adults." Thesis, 2006. http://hdl.handle.net/1828/2075.

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A growing body of research suggests that substantial variability exists among cognitive abilities within individuals. This within-person variability, across cognitive domains is termed dispersion. The present study examined 304 non-demented, older adults to investigate the relationship between aging and the dispersion of cognitive functions in both a quantitative (overall levels of dispersion) and qualitative manner (patterns of dispersion). Quantitatively, higher levels of dispersion were observed in older-old adults and those identified as having suffered cognitive decline, suggesting that dispersion level may serve as a marker of cognitive integrity. Qualitatively, three distinct dispersion profiles were identified through clustering methods and found to be related to demographic, health and performance characteristics of the individuals displaying the particular profile patterns, suggesting that the patterns of dispersion may be a meaningful indicator of individual differences.

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Bielak, Allison Anne Marie. "The relationship between short-term intraindividual variability and longitudinal intraindividual cognitive change in older adulthood: covariation and prediction of change." Thesis, 2008. http://hdl.handle.net/1828/1042.

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This dissertation presents two studies of intraindividual variability in a longitudinal context to further explore the relationship between short-term intraindividual variability and longer-term cognitive change in older adults. A sample of 304 community-dwelling older adults initially aged 64-92 years completed between 1 to 6 waves of annual testing over a 5-year period. Participants completed an extensive battery of accuracy- and latency-based tests covering a wide range of cognitive complexity. The first study addressed the longitudinal nature of intraindividual variability over 3 years. Group-based increases in inconsistency were limited to the latter half of older adulthood (i.e., 75 years and older), but there were significant individual differences across the entire sample. The covariation relationships between change in cognition and change in inconsistency were significant across the one-year interval, and found to remain stable across both time and older age. For each additional unit increase in intraindividual variability, participants’ cognitive performance correspondingly declined. The strength of the coupling relationship however was stronger for fluid cognitive domains such as memory, reasoning, and processing speed, and variability based on moderately and highly complex tasks provided the strongest prediction. Building on these results suggesting that intraindividual variability is highly sensitive to even subtle changes in cognitive ability, the second study addressed the capacity of intraindividual variability to predict cognitive ability and other meaningful change outcomes 5 years later. Inconsistency at Wave 1 was particularly sensitive to changes reflecting the early behavioural characteristics of dementia, including episodic memory ability, cognitive status, and attrition. In each case, greater inconsistency at baseline was associated with a greater likelihood of being in a maladaptive group 5 years later. Mean rate of responding was a comparable predictor of change in most instances, but differences emerged according to the complexity of their derived tasks. Variability based on moderate to high cognitively challenging tasks appeared to be the most sensitive to longitudinal changes in cognitive ability, and was uniquely predictive of the rate of attrition compared to neuropsychological tasks. These findings are promising of the potential utility and applicability of intraindividual variability in understanding and predicting intraindividual cognitive change in older adulthood.

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Druyts, Eric Bene Furnes. "Regional, temporal and age trends in avoidable hospitalization rates among older adults in British Columbia, Canada, 1991-2000." Thesis, 2010. http://hdl.handle.net/1828/3088.

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Certain indicators are useful in examining the impact of health care restructuring on the population. Avoidable hospitalization rates are used as an indicator of access to primary care. The purpose of this study was to examine regional, temporal, and age-related trends in avoidable hospitalization rates among older adults during a decade of significant health care restructuring in British Columbia, 1991-2000. The specific objectives of this study were 1) to calculate avoidable hospitalization rates among older adults in British Columbia by regional health authority and health services delivery area, 2) to examine the extent to which avoidable hospitalization rates among older adults in each regional health authority and health service delivery area differ from the provincial avoidable hospitalization rate, and 3) to examine the temporal changes in avoidable hospitalization rates among older adults in British Columbia by regional health authority. Analyses draw on linked administrative health data from the province of British Columbia for the population of health system users age 55 and older. Analyses are stratified by age group (55 to 64, 65 to 74, and 75 and older) and regional health authority and health service delivery area. Age-sex standardized avoidable hospitalization rates for the years 1991 through 2000 were first calculated. Analysis of means for rate data were also undertaken to examine the extent to which avoidable hospitalization rates in each region differed from the provincial average. Additionally, joinpoint regression analyses of annual avoidable hospitalization rates were performed to examine temporal changes in the trends. Comparing the avoidable hospitalization rates observed in the health authorities and health service delivery areas to the avoidable hospitalization rates for the province revealed regional disparities, whereby the most rural and northern health authorities and health service delivery areas tended to have higher avoidable hospitalization rates. Joinpoint regression results showed significantly decreasing trends over time. The results also generally indicated that as age increased, so did the likelihood of encountering an avoidable hospitalization. This was consistent across geographical locations and time. The data suggest that access to primary care services may be problematic in several areas of the province, including northern British Columbia, and rural and remote areas. Although avoidable hospitalization rates decreased over time, it may be the case that health care restructuring initiatives in the 1990s have not completely addressed regional disparities in access to primary care. Additionally, the finding that the oldest adults tend to be more prone to an avoidable hospitalization is of concern. Policy efforts intended to reduce the overall number of avoidable hospitalizations should address the complexities associated with access to the primary care system.

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Dibert, Corinne Christine. "Moving towards coordinated accessible transportation for older adults : identification of barriers and incentives to implementation in the Captial Regional District, British Columbia." Thesis, 2007. http://hdl.handle.net/1828/959.

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Communities such as the Capital Regional District (CRD) of Vancouver Island (BC) currently struggle to meet the transportation needs of older adults and other vulnerable populations, particularly in terms of resources and funding. In the future, these challenges will continue given the current demographic shift and the existing structure of the transportation system. Since the provision of transportation is an important element for the quality of life of older adults, it is important to consider solutions that promote a more effective use of transportation opportunities to ensure health, self-sufficiency and community connectedness amongst this population. This research study examines one solution to the issues surrounding the provision of transportation to older adults. A Coordinated Accessible Transportation (CAT) approach supports the pooling and sharing of existing transportation resources within a formalized framework, and aims to provide safe, efficient and affordable transportation options to older adults. This research focuses on the identification of barriers and incentives to the implementation of a CAT program. This project used a qualitative, case study approach to reach its objectives. Twenty-three semi-structured interviews were conducted with stakeholders involved in the provision of transportation. A Program Logic Model (PLM) was used to organize and analyze the information gathered. In summary, although aware of the need for a new approach, transportation providers in the CRD are reluctant to change the current system without active governance being in place at all levels. The results of this research provide a `blueprint' for the implementation of a CAT program and have relevance for other Canadian communities facing similar challenges.

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33

Longley, Autumn Myrdell. "Reforming old age security: income distribution and poverty among single senior Canadian women." Thesis, 2005. http://hdl.handle.net/1828/1968.

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Canada's public pension programs have raised seniors' incomes, but have not succeeded in lifting some, especially single women, above the Low Income Cut-Off. Old Age Security (OAS) may need structural reforms, due to its nearly universal nature and its use of an individual income test. Many single women rely on OAS as their main income source, though demographic trends may lead to reductions in the program. Relevant research around these issues is discussed and policy options are suggested. Each option is simulated using the Social Policy Simulation Database and Model and the distributional impacts are analyzed. Removing the income test would increase income inequality and low-income rates. Reducing the income threshold for the test would decrease these rates. Changing to a family income test is also examined. Given the costs involved, it would be difficult to make large improvements for single senior women by reforming OAS alone.

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Funk, Laura Megan. "Responsibility for aging parents: independence and obligation within filial relationships." Thesis, 2008. http://hdl.handle.net/1828/2094.

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Thoughts and feelings around commitments and responsibilities to ensure the well-being of others are an important aspect of the everyday experience of relationships, particularly family relationships, and are especially salient in caregiving situations. In this dissertation I focus on the interpretation of the meaning of filial responsibility, from a sociological perspective: that is, how discourses are enacted within adult children's descriptions and assessments of what they do and feel towards aging parents. Between 2005 and 2006, I interviewed a non-random sample of 28 men and women with one or both elderly parents living in or near Victoria. British Columbia. Interviews were loosely structured explorations of participants' feelings and thoughts about their personal sense of responsibility for their parent(s). I viewed the data not only as windows into individual experiences. but as interpretive accounts mediated by dominant socio-cultural discourses. Participants responded to the construct of responsibility for parents by contradicting themselves, repeatedly qualifying their responses, or rejecting or revising the concept. There was particular difficulty in talk about "feeling responsible." Participants" accounts are explained with reference to the interpretive construction of personal meaning, and to the broader symbolic meanings of responsibility: as externally imposed obligation, as involving control over others, and as burdensome and unwanted. In their own accounts, participants reacted to this meaning by redefining or rejecting the concept at the level of their personal experiences. In doing so, they often prioritized individualistic ideals of personal choice and parental autonomy. Many also emphasized the role of love and affection in their relationships, although the extent to which this represents the manifestation of individualistic or familialistic discourses varies between individuals. Lastly, despite privileging individualism in their accounts of personal responsibility for parents, when asked to comment about "Canadian society," a cultural emphasis on individualism tended to be characterized negatively by participants and blamed for a decline in filial responsibility more broadly. Participants- accounts are explored for what they reflect about the symbolic meaning of filial responsibility in contemporary Canadian society, as well as for what they suggest about the process of its interpretation at the individual level.

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35

Burton, Catherine Louisa. "Cognitive ability and inconsistency in reaction time as predictors of everyday problem solving in older adults." Thesis, 2007. http://hdl.handle.net/1828/181.

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The purpose of the present investigation was to examine whether across-trials inconsistency in reaction time (RT), in addition to level of cognitive performance, is predictive of older adults’ performance on a measure of everyday problem solving through a series of three investigations. A sample of community dwelling non-demented older adults, ranging in age from 62 to 92, completed the Everyday Problems Test (EPT), a measure of everyday problem solving that indexes instrumental activities of daily living (IADLs). Performance on the EPT varied according to age, cognitive status, and education, and was significantly predicted by measures of global cognitive status, cognitive decline, and various basic cognitive abilities (i.e., speed of processing, fluid abilities, episodic memory, crystallized abilities). Both inconsistency and mean latencies on measures of RT were found to be significantly associated with concurrent EPT performance, such that slower and more inconsistent RTs were associated with poorer everyday problem solving abilities. Finally, inconsistency in RT made a unique contribution in predicting performance on the EPT two years later, over and above age, education, and various basic cognitive abilities. Structural equation modeling analyses indicated that the relationship between inconsistency in RT and future EPT performance was mediated by fluid and crystallized abilities. Neither inconsistency nor cognitive functioning were significantly associated with changes in EPT performance across two years. Examination of the relationships between IADL functioning, as assessed through self- and informant-report, and inconsistency and basic cognitive abilities demonstrated that everyday problem solving and measures of IADLs tap into related but distinct constructs. The overall pattern of results obtained lends support to the idea that inconsistency in RT represents a behavioural marker of neurological dysfunction. In addition, the present investigation is the first to suggest a relationship between inconsistency in RT and real-world outcomes, such as everyday problem solving and IADL functioning.

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Wolse, Faye B. "Beyond liminality: seniors on making the transition to assisted living." Thesis, 2008. http://hdl.handle.net/1828/1339.

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This thesis explores the transition experiences of 21 older adults who moved to the Cridge Village Seniors’ Centre, an assisted living facility in Victoria, BC. A review of other studies on the transition to seniors’ housing revealed that most new residents of assisted living facilities did not feel at home in their new residence. Using Ritual Process Theory as a framework through which to analyze participant interviews, this qualitative study examines the factors which aided new residents of the Cridge in making a full transition and developing a sense of home in their new residence. Positive social relationships, the ability to develop routines and personal rituals, furnishing suites with personal possessions, the ability to exercise control over their daily lives and a noninstitutionalized environment were found to be important factors in Cridge residents’ successful transitions to assisted living.

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Panton, Douglas William Henry. "Effects of Hung Fut Kung Fu's ten basic stances on postural balance and quality of life in elderly women." Thesis, 2006. http://hdl.handle.net/1828/2180.

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This multi method, quasi pre and post intervention design evaluated the impact of Hung Fut Gung Fu's ten basic stances (TBS) on quality of life (QOL) and postural balance in elderly females. The purpose of this inquiry was to explore the effectiveness of TBS as an appropriate and health promoting form of physical activity for senior populations. Five females aged sixty-nine to eighty-three, participated in the eight-week intervention. Pre and post intervention data were collected through a Quality of Life Profile: Seniors questionnaire, the Berg balance test, and a self-report calendar of slips, trips and falls. Post-intervention interviews captured participants' reflections of the experience. Quantitative findings indicate that the TBS sessions generated slight improvements in QOL and postural stability and significant reductions in slips trips and falls. Qualitative data analysis identified two themes as contributing to participants' QOL - acquiring knowledge and socializing with peers. The TBS appears to be a promising strategy for enhancing QOL and postural balance for senior populations.

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Harvey, Jennifer Margaret Elizabeth. "Home beyond the house: later life experiences of place in a small community." Thesis, 2006. http://hdl.handle.net/1828/2198.

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This is a geographical study of the experience of place for older adults in the rapidly growing area known as `Oceanside' on Vancouver Island. Oceanside's population is one of Canada's oldest: more than 40% are aged 55 and over. The goal of the research is to explore notions of home and community, place and space, and to consider the implications for planning future environments for an aging population. Qualitative analysis of 27 in-depth interviews suggests that the physical, social, cultural and structural environments are multi-layered. When considering a move to the area, it was physical environment that was most important. Once participants moved to the area, social and cultural environments became central in their lives. Finally, the structural environment, particularly the shortage of health services, may cause people to leave the area. Personal identity and past place experience influence participants' experience of the present and their hopes for the future.

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Lindstrom-Forneri, Wendy. "Safety Awareness For Elderly Drivers (SAFE): the development and evaluation of an educational intervention on age-related driving issues and safe driving behaviours for older drivers." Thesis, 2009. http://hdl.handle.net/1828/1993.

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Maintaining independence is a primary reason that many older drivers continue to drive. Safety, however, is a growing concern for all older drivers. Numerous studies have noted that many older drivers lack an awareness of their driving abilities and driving safety issues for older adults. Identifying the awareness level of older drivers from a theoretical standpoint is important. The current educational interventions for older drivers show promising results and suggest that educational programs can impact older driver knowledge, self-reported awareness, and behaviours. However, rarely have older drivers with cognitive deficits been included. This research study fills a gap in the current literature regarding the utility of a theoretically-based intervention program to increase older driver awareness, improve attitudes towards driving, and increase behaviours around older driver safety. The purpose of this research study was to develop, pilot, and examine the effectiveness of a novel, theoretically based, in-class education program entitled “Safety Awareness for Elderly Drivers” (SAFE) for older drivers both with and without cognitive impairment. The SAFE education program was based on five relevant models/theories: 1) Driving as an Everyday Competence, 2) Hierarchical Awareness Theory, 3) Toglia & Kirk’s Awareness Model, 4) Theory of Planned Behaviour, and 5) Transtheoretical Model. A convenience sample of 47 current older drivers aged 70 years or older currently contemplating changing their driving behaviours and their passengers were recruited and randomly assigned. Participants in the intervention group received the group education session, while those in the treatment as usual control group received a copy of the Insurance Board of British Columbia’s “Roadsense for Driver’s” handbook. We measured general knowledge, awareness of individual driving abilities, attitudes, intention to change driving behaviours, driving behaviours, and readiness to change before, immediately after the intervention (intervention group only), and at 2-month follow-up. Results indicated that the “Safety Awareness for Elderly Drivers” education program was well received by older drivers. The education program demonstrated immediate impacts, such as increased knowledge of older driver safety issues (general level awareness), increased individual awareness, and some changes in attitude and intentions toward changing driving behaviours. Older drivers with mild cognitive impairment showed similar benefits from the education program. However, the program did not appear to be more effective than the review of a drivers handbook available though ICBC in follow-up, with most follow-up measures being similar to baseline. Implications of this research and further research suggestions for older drivers are discussed.

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Brennan, Shelagh Marie. "A narrative inquiry of older adults' stories of choosing to not share information with health care professionals." Thesis, 2008. http://hdl.handle.net/1828/1307.

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This study used narrative inquiry to answer the question “What are the stories of older adults who choose not to share information with health care professionals?” The study explored the experiences of older adults who did not share information with health care professionals (HCPs), who they defined as doctors. A thematic analysis of five participants’ stories revealed three themes: Illusions of Care, describing the participants’ experiences with doctors before they chose not to share information; The Last Straw, revealing the final incident that caused participants to choose not to share information; and The Mask of the Non-sharing Older Adult, describing how participants interacted with their doctors after they decided not to share information. Relationship development between older adults and their doctors, sensitive topics, issues and perceptions of ageing, and structure of the health care system contribute to the complex issue of older adults not sharing information. The decision not to share information with health care professionals may adversely affect the health and health care of older adults.

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Love, Janet Anne. "Perspectives on transportation: building on the age-friendly cities project - a World Health Organization initiative." Thesis, 2008. http://hdl.handle.net/1828/1329.

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The impact of transportation concerning older adults is under scrutiny as the number of older adults is expected to significantly increase in the coming years. The World Health Organization (WHO) spearheaded a world wide initiative that sought to examine what contributed to an “age-friendly community” in both developed and underdeveloped nations. This paper examines, in particular, the role that transportation plays in relation and contribution to an “age-friendly” community in Saanich, British Columbia, as an addition to the WHO initiative. Focus groups were conducted to ensure that information received was the lived experience of the individual. Results suggested that transportation was more than the ability to operate a vehicle, but in the ability to move safely within an environment. Additional information provided by participants spoke to the necessity of increasing awareness of licensing systems and improvements that could be implemented to ensure safety for older adult drivers and the community.

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Friscia, Ashleigh. "Effects of posture and exercise training on cardiac output at rest and during exercise in older subjects." 2008. http://proquest.umi.com/pqdweb?did=1453218461&sid=14&Fmt=2&clientId=39334&RQT=309&VName=PQD.

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Thesis (M.A.)--State University of New York at Buffalo, 2008.
Title from PDF title page (viewed on Sept. 04, 2008) Available through UMI ProQuest Digital Dissertations. Thesis adviser: Pendergast, David R., Duffey, Michael E. Includes bibliographical references.

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Silva, Dina Lúcia Gomes da 1981. "Cognitive deficits in middle-aged and older patients with bipolar disorder : comparison with mild cognitive impairment subjects." Master's thesis, 2008. http://hdl.handle.net/10451/998.

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Tese de mestrado em Neurociências, apresentada à Faculdade de Medicina da Universidade de Lisboa, 2008
Background: The present literature has reported cognitive deficits in older bipolar disorder (BD) patients, namely in executive functions and verbal memory. Nevertheless, few studies have evaluated elderly BD patients using standardized cognitive assessments and more (to our knowledge) analysed elderly BD patients with recent cognitive complaints. Aim: Compare the cognitive deficits of middle-aged and older BD patients presenting cognitive complaints with the profile of impairment seen at the beginning of a neurodegenerative process, as in Mild Cognitive Impairment (MCI) patients. Method: A systematic search for all cases of BD patients with recent cognitive complaints submitted to a neuropsychological evaluation, from 1999 to 2007, at participant institutions, was performed, and cases were matched (1:2) by gender and age to a sample of MCI patients. Results: A sample of 135 patients: 45 patients with the diagnosis of BD, clinically stable, mean stage of 63.8 (8.8) years, and 90 patients with the diagnosos of MCI, mean age of 64.2 (8.4) years, was studied. BD patients showed more deficits in attention, verbal and motor initiative and conceptual thinking than the MCI patients, while in verbal memory the MCI patients were more impaired. According to a discriminant analysis, half of BD sample reported deficits similar to the MCI group in verbal memory and a higher functional impairment. Conclusions: Patients with BD and patients with MCI have distinct profiles of cognitive impairment. In spite of these neuropsychological differences, both groups presented similar recent memory complaints and functional impairments. Moreover, from the present results a subgroup of BD patients with recent cognitive complaints may actually suffer from concomitant incipient MCI, and this finding may have diagnostic and therapeutical implications.
Sumário: Diversos estudos identificaram a presença de défices cognitivos em indivíduos idosos com Doença Bipolar (DB), nomeadamente em áreas como as funções executivas e a memória verbal. Em doentes bipolares idosos a investigação do desempenho cognitivo pela aplicação de baterias estandardizadas de avaliação cognitiva tem sido escassa, e nenhum estudo analisou doentes bipolares idosos com queixas cognitivas recentes. Objectivo: Comparar os défices cognitivos de deoentes de meia-idade e idosos com DB e queixas cogniivas recentes com o perfil de défices que reconhecidamente surgem no início de um processo neurodegenerativo, como no caso de doentes com Defeito Cognitivo Ligeiro (DCL). Metodologia: Realizou-se uma pesquisa sistemática de todos os casos desde 1999 até 2007 de doentes bipolares com queixas cognitivas recentes, sujeitos a uma avaliação neuropsicológica, emparelhando-se posteriomente, por género e idade (1:2), com um grupo de indivíduos com o diagnóstico de DCL. Resultados: Um total de 135 doentes, dos quais 45 com DB, clinicamente estáveis, com média de 63.8 anos (8.8) de idade, e 90 doentes com DCL e média de 64.2 anos (8.4) de idade. Os doentes bipolares apresentaram mais defeitos em provas de atenção, de iniciativa verbal e motora, e de raciocínio abstracto, enquanto que os doentes com DCL apresentaram resultados inferiores em provas de memória verbal. Segundo uma análise discriminante dos resultados metade do grupo de doente bipolares apresentava defeitos na memória verbal semelhantes aos do grupo com DCL, e um grau inferior de desempenho funcional. Conclusão: O perfil de defeitos cognitivos entre doentes bipolares de meia-idade e idosos, e doentes com DCL é claramente diferente, apesar de apresentarem idênticas queixas cognitivas recentes e o mesmo grau de comprometimento funcional. No entanto, segundo os resultados metade dos doentes bipolares com queixas cognitivas recentes poderá apresentar um DCL concomit

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BECHI, GABRIELLI GIULIA. "The Attentional Boost Effect: What limits and what causes it? A behavioural and functional study in older adults, euthymic bipolar patients and healthy subjects." Doctoral thesis, 2018. http://hdl.handle.net/11573/1096353.

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La tesi rigurda un fenomeno controintuitivo chiamato “Attentional Boost Effect” (“Effetto dell’aumento attentivo”). Questo effetto è caratterizzato dal fatto che la detezione di un target (che richiede una risposta) durante la codifica di uno stimolo ad esso contemporaneo può migliorare la prestazione mnestica per quello stimolo in fase di test, rispetto a stimoli presentati contemporaneamente ad un distrattore (che non richiede una risposta). L’ “Attentional Boost Effect” è stato indagato con differenti tipi di materiali, in differenti condizioni attentive, con differenti paradigmi e in varie popolazioni. La tesi inizia con un’introduzione teorica dove sono esaminati la maggior parte degli studi effettuati sull’ “Attentional Boost Effect”. Sono inoltre presentati due capitoli in cui vengono riassunti i cambiamenti, principalmente cognitivi, che avvengono durante l’invecchiamento normale e nel disturbo bipolare. Infine, viene discusso un breve capitolo speculativo sul possibile ruolo di alcuni neurotrasmettitori nella genesi del fenomeno oggetto di interesse. In questo lavoro di tesi si è voluto estendere le conoscenze sull’ “Attentional Boost Effect”, iniziando con l’indagarne la presenza in anziani sani e pazienti bipolari eutimici, entrambe popolazioni che riportano disturbi cognitivi, principalmente attentivi e mnesici, rispetto a giovani controlli. Sono stati eseguiti 4 esperimenti sugli anziani, cambiando il materiale usato nel compito di memoria, il tipo di istruzioni date ai partecipanti e il tempo di presentazione dello stimolo in fase di codifica. In tutti gli esperimenti, l’effetto è robusto e significativo nel campione di controllo di giovani adulti mentre è abolito nel campione di anziani sani. È stato inoltre eseguito un ulteriore esperimento reclutando pazienti bipolari in una fase di remissione, che non hanno mostrato l’effetto. Interessante, i risultati in quest’ultimo studio sembrano indicare che l’ampiezza dell’effetto tende a diminuire all’aumentare dell’età (oltre i 35 anni) nel campione di controlli sani. Infine, è stato eseguito un esperimento di risonanza magnetica funzionale, volendo indagare l’attivazione cerebrale correlata al fenomeno in un campione di giovani adulti. I risultati indicano che una rete attentiva ventrale sembra essere alla base dell’effetto. Nel complesso, i dati sono in linea con la presenza di un deficit delle funzioni attentive negli anziani sani e nei pazienti bipolari eutimici che sarebbe alla base dell’assenza dell’effetto boost in queste popolazioni. Altre possibili ipotesi di spiegazione sono discusse nel capitolo conclusivo.

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Dissertations / Theses on the topic 'Older subject'

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