Living well to the end:a phenomenological analysis of life in extra care housing

OBJECTIVES: To understand older adults' experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. DESIGN: A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. METHODS: Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential-phenomenological theory of well-being. RESULTS: Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. CONCLUSIONS: An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents' quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling-empathic imagination-in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end.

Spatial and temporal patterns of true bug assemblages extracted with Berlese funnels (Data to the knowledge on the ground-living Heteroptera of Hungary, No. 2)

A rich material of Heteroptera extracted with Berlese funnels by Dr. I. Loksa between 1953–1974 in Hungary, has been examined. Altogether 157 true bug species have been identified. The ground-living heteropteran assemblages collected in different plant communities, substrata, phytogeographical provinces and seasons have been compared with multivariate methods. Because of the unequal number of samples, the objects have been standardized with stochastic simulation. There are several true bug species, which have been collected in almost all of the plant communities. However, characteristic ground-living heteropteran assemblages have been found in numerous Hungarian plant community types. Leaf litter and debris seem to have characteristic bug assemblages. Some differences have also been recognised between the bug fauna of mosses growing on different surfaces. Most of the species have been found in all of the great phytogeographical provinces of Hungary. Most high-dominance species, which have been collected, can be found at the ground-level almost throughout the year. Specimens of many other species have been collected with Berlese funnels in spring, autumn and/or winter. The diversities of the ground-living heteropteran assemblages of the examined objects have also been compared.

The relative influence of social support, rehabilitation program participation, and inmate preincarceration characteristics on incarcerated substance abusers' perceptions of adjustment to community reintegration

This dissertation identifies, examines, and assesses the relative influence of identified empirically and conceptually relevant variables on incarcerated substance abusers' expectations of postrelease adjustment. A purposive sampling procedure was used to recruit 101 male and female substance-abusing offenders participating in prison- and jail-based drug treatment programs in south Florida. A 92-item survey questionnaire was used to collect basic demographic data; measure inmate preincarceration characteristics, social support, and rehabilitation program participation; and record archival data. Regression equations were developed utilizing ten different measures of the participants' expectations of their postrelease adjustment. Two equations yielded statistically significant F ratios; maintaining a stable living and maintaining abstinence. Twenty-two percent of the variance in respondents' expectations of maintaining a stable living was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 1.89; df = 13,87; p $<$.05). The only significant predictor variable was perception of social support (b = $-$.05; t = $-$3.6; p $<$.001). Twenty-three percent of the variance in respondents' expectations of maintaining abstinence from substances was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 2; df = 13,87; p $<$.05). Once again, the only significant predictor variable was perception of social support. The results of the analyses indicate that social support was the only important variable for understanding these respondents' efficacy expectations of postrelease abstinence and stable living. The results of this investigation demonstrate the complexity of the social support variable for prisoners, and identify social support as a potential rehabilitative resource for substance-abusing inmates. The results of this investigation underscore the importance of continued, detailed empirical study in order to understand and clarify how social support, efficacy expectations, and actual postrelease performance interrelate for this population of offenders.

Social factors influencing antiretroviral therapy (ART) adherence among Black men living with HIV who use illicit drugs

In the United States 1.2 million persons are HIV infected. Among men, HIV rates in Blacks are seven times higher than Whites. More Black men progress to AIDS because of treatment failure and adherence problems. Antiretroviral therapy (ART), the only treatment effective for long term HIV suppression, requires near perfect adherence. Illicit drug use and homelessness pose further challenges. Suboptimal ART adherence leads to HIV mutations that can render entire classes of medication ineffective and transmission of mutated HIV to others in the community. The purpose of this study was to investigate ART adherence behaviors of Black men living with HIV who use illicit drugs. A sample of 160 Black men living with HIV who use illicit drugs was recruited using flyers and snowball sampling. These men completed study questionnaires that included: demographics, the K-10, PSOM and Social Capital Integrated Questionnaire, among others. One-way ANOVAs, multiple regression, and path analysis were used to address the study's research questions. Most of the Black men in this sample were high school graduates and single, with high rates of being marginally housed and homeless. Unemployment and disability were common, and personal and household income was low. The men reported high numbers of sexual partners both over the past year and during their lifetimes, suggesting continued engagement in high risk behaviors. The majority of the men attributed their HIV to heterosexual sex, with sexual commoditization being common. About half of the 105 men currently taking ART reported the current regimen was their first. Patient-provider relationship was positively associated with tolerability of ART. ART adherence was greater with less psychological distress, lower frequency of current illicit drug use, and greater tolerability of ART. Partner status negatively influenced ART adherence. This study of Black men's ART adherence behaviors has implications for public health. It identified social context factors that influence ART adherence among the men and provides evidence to refine existing, or develop new, ART adherence interventions.

Women-led community development organizations (CDOs) in Miami-Dade County: A model of community development efforts impacting the economic security of women

Recent studies on the economic status of women in Miami-Dade County (MDC) reveal an alarming rate of economic insecurity and significant obstacles for women to achieve economic security. Consistent barriers to women's economic security affect not only the health and wellbeing of women and their families, but also economic prospects for the community. A key study reveals in Miami-Dade County, "Thirty-nine percent of single female-headed families with at least one child are living at or below the federal poverty level" and "over half of working women do not earn adequate income to cover their basic necessities" (Brion 2009, 1). Moreover, conventional measures of poverty do not adequately capture women's struggles to support themselves and their families, nor do they document the numbers of women seeking basic self-sufficiency. Even though there is lack of accurate data on women in the county, which is a critical problem, there is also a dearth of social science research on existing efforts to enhance women's economic security in Miami-Dade County. My research contributes to closing the information gap by examining the characteristics and strategies of women-led community development organizations (CDOs) in MDC, working to address women's economic insecurity. The research is informed by a framework developed by Marilyn Gittell, who pioneered an approach to study women-led CDOs in the United States. On the basis of research in nine U.S. cities, she concluded that women-led groups increased community participation and "by creating community networks and civic action, they represent a model for community development efforts" (Gittell, et al. 2000, 123). My study documents the strategies and networks of women-led CDOs in MDC that prioritize women's economic security. Their strategies are especially important during these times of economic recession and government reductions in funding towards social services. The focus of the research is women-led CDOs that work to improve social services access, economic opportunity, civic participation and capacity, and women's rights. Although many women-led CDOs prioritize building social infrastructures that promote change, inequalities in economic and political status for women without economic security remain a challenge (Young 2004). My research supports previous studies by Gittell, et al., finding that women-led CDOs in Miami-Dade County have key characteristics of a model of community development efforts that use networking and collaboration to strengthen their broad, integrated approach. The resulting community partnerships, coupled with participation by constituents in the development process, build a foundation to influence policy decisions for social change. In addition, my findings show that women-led CDOs in Miami-Dade County have a major focus on alleviating poverty and economic insecurity, particularly that of women. Finally, it was found that a majority of the five organizations network transnationally, using lessons learned to inform their work of expanding the agency of their constituents and placing the economic empowerment of women as central in the process of family and community development.

Community-based older adults' perceptions of factors that influence successful aging in place

The purpose of this study was to obtain an understanding of older adults' perceptions of independence and the factors that allow them to remain living independently in the community. A questionnaire was mailed to a random sample of 500 community-based older adults. One hundred seventy eight questionnaires were returned (36%). Respondents were asked questions related to independence, self-health rating, functional difficulties, and social supports. Most respondents indicated Mental Health (97%), Physical Health (97%), Control of choices (97%), and Social Support Systems (93%) contributed to maintaining independence in the community. Age, education, fewer chronic health conditions, and a higher self-health rating were found to be significant predictors of actual independence. Family members were identified as the primary source of assistance with advice on major life decisions and financial matters. Findings indicate age, education, health status and the social support of family and friends all play an important role for older adults to live independently in the community. Occupational therapy could be instrumental in extending the health, highest level of independent functioning, and the number of years older adults remain living in the community.

Attachment, psychological functioning, and resilience within the street involved youth populations: describing youth who access community agency support

Youth homelessness is defined within the literature as youth who have left their homes and are living independent of parental figures and/or caregivers, have no stable residence or source of income, and lack access to the supports needed to make the challenging transition into adulthood (Canadian Observatory on Homelessness, 2015). Previous research studying homeless (or street-involved) youth has primarily focused on risk factors hindering the development of this population, and has largely ignored resilience, coping, and help-seeking behaviours. The current study examined the attachment styles (both categorically and dimensionally), psychological functioning, resilience, and help-seeking behaviours in street-involved youth of St. John’s, Newfoundland. Face-to face interviews were completed over a four-month period with 63 youth (42 males, 21 females) aged 15-29 (Mage = 20.00), recruited from a local community organization providing outreach services to street-involved youth. Results revealed the disproportionate struggles of the street-involved youth population, and highlighted higher levels of attachment insecurity, psychological distress and lower resilience compared to normative peers. Findings also showed a significant difference in psychological functioning, overall resilience, and emotional reactivity based on individual attachment style. In an exploratory model of help-seeking, a positive relationship was found between overall resilience (defined as a sense of mastery and sense of relatedness) and frequency of community service access. However, contrary to predictions, no relationships were found between frequency of community service access and attachment, psychological functioning, or emotional reactivity. Implications of the present findings in development of interventions for street-involved youth are discussed, in addition to strengths and limitations of the present research, and suggested areas of future inquiry.

The Didache and Traditioned Innovation: Shaping Christian Community in the First Century and the Twenty-First Century

Church leaders, both lay and clergy, shape Christian community. Among their central tasks are: building communal identity, nurturing Christian practices, and developing faithful structures. When it comes to understanding the approach of the earliest Christian communities to these tasks, the Didache might well be the most important text most twenty-first century church leaders have never read. The Didache innovated on tradition, shaping the second generation of Christians to meet the crises and challenges of a changing world.

Most likely composed in the second half of the first century, the Didache served as a training manual for gentile converts to Christianity, preparing them for life in Christian community. This brief document, roughly one third the length of Mark’s gospel, developed within early Jewish-Christian communities. It soon found wide usage throughout the Mediterranean region, and its influence endured throughout the patristic and into the medieval period.

The Didache outlines emerging Christian practices that were rooted in both Jewish tradition and early Jesus material, yet were reaching forward in innovative ways. The Didache adopts historical teachings and practices and then adapts them for an evolving context. In this respect, the writers of the Didache, as well as the community shaped by its message, exemplify the pattern of thinking described by Greg Jones as “traditioned innovation.”

The Didache invites reflection on the shape and content of Christian community and Christian leadership in the twenty-first century. As churches and church leaders engage a rapidly changing world, the Didache is an unlikely and yet important conversation partner from two millennia ago. A quick read through its pages – a task accomplished in less than half an hour – brings the reader face to face with a brand of Christianity both very familiar and strikingly dissimilar to modern Christianity. Such dissonance challenges current assumptions about the church and creates a space in which to re-imagine our situation in light of this ancient Christian tradition. The Didache provides a window through which we might re-examine current conceptualizations of Christian life, liturgy, and leadership.

This thesis begins with an exploration of the form and function of the Didache and an examination of a number of important background issues for the informed study of the Didache. The central chapters of this thesis exegete and explore select passages in each of the three primary sections of the Didache – the Two Ways (Didache 1-6), the liturgical section (Didache 7-10), and the church order (Didache 11-15). In each instance, the composers of the Didache reach back into a cherished and life-giving aspect of the community’s heritage and shape it anew into a fresh and faithful approach to living the Christian life in a drastically different context.

The thesis concludes with three suggestions of how the Didache may provide a resource for the way the Church in the present thinks about training disciples, shaping community, and developing leadership structures. These conversation starters offer beginning points for a richer, fuller discussion of traditioned innovation in our current church context. The Didache provides a source of wisdom from our spiritual forebears that modern Christian leaders would do well not to ignore. With a look through the first century window of the Didache, twenty-first century Christians can discover fresh insights for shaping Christian community in the present.

Microbial community in the sediment of the arctic Smeerenburgfjorden

Fluorescence in situ hybridization (FISH) with 16S rRNA-targeted oligonucleotide probes were used to investigate the phylogenetic composition of a marine Arctic sediment (Svalbard). Hybridization and microscopy counts of hybridized and 4',6'-diamidino-2-phenylindole (DAPI)-stained cells were performed as described previously from Snaidr et al. (1997, http://aem.asm.org/content/63/7/2884.full.pdf). Means were calculated from 10 to 20 randomly chosen fields on each filter section, corresponding to 800 to 1,000 DAPI-stained cells. Counting results were always corrected by subtracting signals observed with the probe NON338. Formamide concentrations are given in further details. FISH resulted in the detection of a large fraction of microbes living in the top 5 cm of the sediment. Up to 65.4% ± 7.5% of total DAPI cell counts hybridized to the bacterial probe EUB338, and up to 4.9% ± 1.5% hybridized to the archaeal probe ARCH915. Besides delta-proteobacterial sulfate-reducing bacteria (up to 16% 52) members of the Cytophaga-Flavobacterium cluster were the most abundant group detected in this sediment, accounting for up to 12.8% of total DAPI cell counts. Furthermore, members of the order Planctomycetales accounted for up to 3.9% of total cell counts. In accordance with previous studies, these findings support the hypothesis that these bacterial groups are not simply settling with organic matter from the pelagic zone but are indigenous to the anoxic zones of marine sediments. Members of the gamma-proteobacteria also constituted a significant fraction in this sediment (6.1% ± 2.5% of total cell counts). A new probe (GAM660) specific for sequences affiliated with free-living or endosymbiotic sulfur-oxidizing bacteria was developed. A significant number of cells was detected by this probe (2.1% ± 0.7% of total DAPI cell counts), showing no clear zonation along the vertical profile. Gram-positive bacteria and the beta-proteobacteria were near the detection limit in all sediments.

The benthic foraminiferal community in a naturally CO2-rich coastal habitat of the southwestern Baltic Sea

It is expected that the calcification of foraminifera will be negatively affected by the ongoing acidification of the oceans. Compared to the open oceans, these organisms are subjected to much more adverse carbonate system conditions in coastal and estuarine environments such as the southwestern Baltic Sea, where benthic foraminifera are abundant. This study documents the seasonal changes of carbonate chemistry and the ensuing response of the foraminiferal community with bi-monthly resolution in Flensburg Fjord. In comparison to the surface pCO2, which is close to equilibrium with the atmosphere, we observed large seasonal fluctuations of pCO2 in the bottom and sediment pore waters. The sediment pore water pCO2 was constantly high during the entire year ranging from 1244 to 3324 µatm. Nevertheless, in contrast to the bottom water, sediment pore water was slightly supersaturated with respect to calcite as a consequence of higher alkalinity (AT) for most of the year. Foraminiferal assemblages were dominated by two calcareous species, Ammonia aomoriensis and Elphidium incertum, and the agglutinated Ammotium cassis. The one-year cycle was characterised by seasonal community shifts. Our results revealed that there is no dynamic response of foraminiferal population density and diversity to elevated sediment pore water pCO2. Surprisingly, the fluctuations of sediment pore water undersaturation (Omega calc) co-vary with the population densities of living Ammonia aomoriensis. Further, we observed that most of the tests of living calcifying foraminifera were intact. Only Ammonia aomorienis showed dissolution and recalcification structures on the tests, especially at undersaturated conditions. Therefore, the benthic community is subjected to high pCO2 and tolerates elevated levels as long as sediment pore water remains supersaturated. Model calculations inferred that increasing atmospheric CO2 concentrations will finally lead to a perennial undersaturation in sediment pore waters. Whereas benthic foraminifera indeed may cope with a high sediment pore water pCO2, the steady undersaturation of sediment pore waters would likely cause a significant higher mortality of the dominating Ammonia aomoriensis. This shift may eventually lead to changes in the benthic foraminiferal communities in Flensburg Fjord, as well as in other regions experiencing naturally undersaturated Omega calc levels.

Meiofauna and the structure of the benthic community in the Iberian deep sea basin

1. On the cruises 3 and 15 of R.V. "Meteor" 6 grab samples, and 6 hauls with the 6 m Agassiztrawl were taken and at 2 stations the deep sea camera was lowered. This material gave quantitative results on the meiofauna and minimum counts of the macrofauna. 2. The nematodes constitute nearly 95% of the meiofauna, the copepoda only 2%. With increasing sediment depth the density of animals decrease gradually. In the uppermost centimeter of sediment 42.6% of the meiofauna are found while only 3.7% live in layer 6-7 cm. Meiofauna weight ranges from 0.6-5.7 mg/25 m**2 surface i.e. 0.24-2.8 g/m**2. 3. Mean numbers of individuals and weights show standard errors of 20-30 %. As an approximate average values for further considerations the weight of the meiofauna in the area was taken as 1 g/m**2 4. Quantitative information on the macrofauna is derived from the trawls and the photographs for the actinia Chitonanthus abyssorum only, which is found in the rate of 1 individual/36-72 m**2, but seems to be less abundant generally. 5. Animal density does not decrease steadily from nearshore to offshore biocoenoses, i.e. generally with increasing depth. The decrease is more pronounced for macro- than for meiofauna. For the deep sea the weight proportion of macrofauna : meiofauna is of the order of 1 : 1. 6. With the assumption, that adaptation of metabolism to deep sea conditions is similar in macro- and meiofauna total metabolism of invertebrates is ascribed to meiofauna to more than 80%. 7. The structure of the biocoenosis of the deep sea floor is characterized by the meiofauna living on and in the sediment and by the dominance of sediment feeders in the macrofauna. 8. Considering the large numbets and high partition rates of bacteria a comparative large part of the metabolism in the deep sea sediment must be ascribed to bacteria. This favours the hypothesis, that with increasing depth and decreasing addition of organic material to the sediment, the importance of meiofauna and microorganisms for total metabolism increases. 9. Considering the different modes of food transport to the deep sea environment, i.e. sinking of dead particles, transport by vertical migration of organisms, aggregation of organic particles, adsorption of dissoloved organic substance to inorganic particles, and heterotrophy, the sediment may be assumed to contain more food for invertebrates than the water above the bottom. 10. Suspensions feeders of macrofauna are fixed to hard substrates in the sediment surface. Some of them are shown to bend themselves down to the bottom in underwater photographs. This suggests the idea that some deep sea suspension feeders partly depend on food from the sediment surface, on which they feed directly.

Implications of coping strategies and community cohesion for mental health in Colombia

In the face of mass human rights violations and constant threats to security, there is growing recognition of the resilience of people and communities. This paper builds on such work by investigating the effects of individual coping strategies, perceived community cohesion, and their interaction on mental health symptoms in Colombia. The study was conducted five years after the mass demobilisation of the former paramilitaries and takes an exploratory quantitative approach to identify two distinct forms of coping approaches among participants living in the Caribbean coast of Colombia. A constructive coping approach included active engagement, planning behaviours, emotional support, acceptance and positive reframing of daily stressors. A destructive coping approach in this study entailed denial of problems, substance use and behavioural disengagement from day-to-day stress. In addition, the strength of perceived community cohesion, or how close-knit and effective the individuals feel about the community in which they live, was examined. Structural equation modelling revealed that a constructive coping approach was significantly related to lower depression, while a destructive coping approach predicted more symptoms of depression. Although there was not a significant direct effect of perceived community cohesion on mental health outcomes, it did enhance the effect of constructive coping strategies at the trend level. That is, individuals who used constructive coping strategies and perceived their communities to be more cohesive, reported fewer depression symptoms than those who lived in less cohesive settings. Implications for promoting constructive coping strategies, as well as fostering cohesion in the community, are discussed.

Reducing Social Isolation in a Rural Community Through Participation in Creative Arts Projects

This article reports the initial findings from the evaluation of four creative arts projects involving groups of older people living in a rural community. The purpose of the projects was to reduce social isolation among participants through providing direct access to arts and social activities. The view was that these activities would improve life skills and independence, increase levels of activity and improve the health, wellbeing and quality of life of participants. Evaluation of these projects demonstrated increased levels of self-worth and self-esteem among participants, and many of the older people involved agreed that they had made new friends while having the opportunity to try out a new activity.

Community perceptions of collaborative processes for managing freshwater resources

Six of New Zealand’s 16 regional councils are trialling collaborative planning as a means of addressing complex challenges in freshwater management. Although some work has been undertaken to evaluate similarities and differences across those processes, the success or failure rests with the public’s acceptance of the processes and their outcomes. This is the first study to evaluate public perceptions of freshwater management in regions with collaborative processes. We surveyed 450 respondents in Hawke’s Bay, Northland, and Waikato, some of whom live in catchments in which collaborative processes are under way and some of whom do not. In addition to assessing awareness of the collaborative planning processes, the survey measured perceptions regarding the regional council’s management of freshwater resources, the extent of agreement regarding freshwater management among various interests, the fairness of freshwater management, and the extent to which respondents believe that their interests and concerns are included in freshwater management. We hypothesized that relative to respondents in parts of the region in which traditional processes are in places, respondents in catchments with collaborative management of freshwater resources would have more positive perceptions of management, agreement, fairness, and interests, even if there is low awareness that a collaborative planning process is under way. Survey results indicate that knowledge of collaborative processes is generally low and that living in catchments with collaborative processes does not impact respondents’ perceptions of management, agreement, fairness, or interests in Northland or Waikato. However, relative to Hawke’s Bay respondents living outside of the collaborative catchment, respondents living inside the collaborative catchment believe that the regional council’s freshwater management is better and fairer. Moreover, Hawke’s Bay residents living inside the collaborative catchment perceive less conflict over freshwater management than Hawke’s Bay respondents living outside the collaborative catchment. Further research is needed to identify the reasons for this regional variation.

Early stage memory loss interventions: utilization, impact, and the experience of living alone.

Thesis (Ph.D.)--University of Washington, 2016-08