Victims, Violence and Voice: Transitional Justice, Oral History and Dealing with the Past

Transitional justice is concerned with the legal and social processes established to deal with the legacy of violence in post-conflict and post-authoritarian contexts. These processes are essentially “creatures of law” – they are established by statute, their work is molded and shaped by lawyers, and their outcomes are benchmarked against what is or is not acceptable in domestic and international law. Concerns have mounted in recent years about the dominance of legalism within the field and the instrumentalization of those most directly affected by past violence. A commonly prescribed – but as yet largely empirically untested – corrective is that transitional justice theory and practice must become more open to interdisciplinary insights and perspectives. The interview – in different guises, contexts and settings – is at the heart of most transitional justice processes. As a historian now working in a School of Law I reflect in this article on the theoretical and practical intersections between law, history, and the interview. Drawing on more than 200 interviews concerning the Northern Ireland conflict and six other international case studies I concentrate in particular on interview-based initiatives that purport to be “victim-centered”. Having identified three interrelated risks - the manipulation of victim voice by vested interests, the affording of authority to particular voices, and the reification or “freezing” of identity - and having related these to the constraints of legal mechanisms and a wider failure to manage victims’ expectations, I argue that a greater familiarity with oral history theory and praxis can usefully illuminate the tensions between legal and historical approaches to engaging voice, and ultimately offer guidance to the shared challenge of victim-centered transitional justice.

THE TEACHING ABOUT THE CARE OF THE ELDERLY IN NURSING TRAINING: THE SITUATION IN PORTUGAL

This paper aims to look at the teaching situation of the nursing undergraduate degree’s courses about eldercare in Portugal. A documentary research on the teaching programs in 39 nursing schools, 26 schools presented syllabus units related to the topic ‘eldercare’ and in eight of these schools the contents of the units were identified. Using textual analysis and from the categories we concluded that the teaching regarding eldercare for the nurse training in Portugal is focused on hospital care; it is directed to the adult/elderly/family; it explores the definitions related to the aging process; it explores community issues, legislation and research. People responsible for the design/monitoring of teaching programs should include teaching regarding eldercare in the nurse training, considering that the elder population is increasing in Portugal.

Medication regimen complexity in institutionalized elderly people in an aging society

Background Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting Five nursing homes in mainland Portugal. Methods A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure Medication regimen complexity index. Results The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion Medication regimen complexity proved to be high. There is certainly potential for the pharmacist’s intervention to reduce it as part as the medication review routine in all the patients.

Prevention of falls in the elderly in the home: promoting active ageing

Objective: To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

Increased physical activity and fitness above the 50th percentile prevents the institutionalization of elderly people: a cross-sectional pilot study.

Introduction Institutionalization in a nursing home restricts autonomy, most notably free will, free choice, and free action. Decreased physical activity and fitness are predictive of disability and dependence (Rikli & Jones, 2013; Tak, Kuiper, Chorus, & Hopman-Rock, 2014); however little is known about the impact of these factors on institutionalization. Thus, this study aimed to analyze the impact of physical activity and fitness and on the risk of elderly people without cognitive impairment become institutionalized. Methods This cross-sectional study involved 195 non-institutionalized (80.14.4yrs) and 186 institutionalized (83.85.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, physical activity was assessed using the International Physical Activity Questionnaire, and measures of physical fitness were determined by the Senior Fitness Test. Results: Multivariate binary logistic analysis selected 4 main predictors of institutionalization in both genders. The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs, BMI≥26.7kg/m2, aerobic endurance ≤367.6m, and physical activity ≤693MET-min/wk) were computed using Receiver Operating Characteristics analysis as cut-offs discriminating institutionalized from non-institutionalized elderly people. Conclusion The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance) may prevent the institutionalization of elderly people without cognitive impairment only if they are above the 50th percentile; the following is highly recommend: expending ≥693MET-min/wk on physical activity, being ≤26.7kg/m2 on BMI, and being able to walk ≥367.6m in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cut-offs in old, and very old people. References Rikli, R., & Jones, C. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist, 53, 255-267. Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2014). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis. Ageing Res Rev, 12, 329-338.

Prevention of falls in the elderly in the home: promoting active ageing

To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

The daily life of informal caregivers of elderly

Objectives: To identify the reasons why the informal caregivers to take care of the elderly; to identify enjoyed support and the problems/needs senses. Methods: A descriptive, exploratory and cross study. The sample was 366 informal caregivers of the elderly residents in the District of Évora (Alentejo). Applied a questionnaire, which identified the reasons that led to cohabitation, the difficulties experienced by caregivers, experienced changes in their health and support they receive. Results: Most caregivers are women, with a mean age of 54 years. The main reason of care was elderly disease. These caregivers have changed in relaxation and leisure activities, on the organization of day-to-day and on economic aspects. They receive support from health institutions, social security and firemen’s. Conclusions: Family is the support in the disease, despite the difficulties, particularly in relaxation and leisure activities, organization of day-to-day and economic matters. They requested support in healthcare, transportation and economic aid.

Patient classification for intelligent wheelchair adaptation

A importância e preocupação dedicadas à autonomia e independência das pessoas idosas e dos pacientes que sofrem de algum tipo de deficiência tem vindo a aumentar significativamente ao longo das últimas décadas. As cadeiras de rodas inteligentes (CRI) são tecnologias que podem ajudar este tipo de população a aumentar a sua autonomia, sendo atualmente uma área de investigação bastante ativa. Contudo, a adaptação das CRIs a pacientes específicos e a realização de experiências com utilizadores reais são assuntos de estudo ainda muito pouco aprofundados. A cadeira de rodas inteligente, desenvolvida no âmbito do Projeto IntellWheels, é controlada a alto nível utilizando uma interface multimodal flexível, recorrendo a comandos de voz, expressões faciais, movimentos de cabeça e através de joystick. Este trabalho teve como finalidade a adaptação automática da CRI atendendo às características dos potenciais utilizadores. Foi desenvolvida uma metodologia capaz de criar um modelo do utilizador. A investigação foi baseada num sistema de recolha de dados que permite obter e armazenar dados de voz, expressões faciais, movimentos de cabeça e do corpo dos pacientes. A utilização da CRI pode ser efetuada em diferentes situações em ambiente real e simulado e um jogo sério foi desenvolvido permitindo especificar um conjunto de tarefas a ser realizado pelos utilizadores. Os dados foram analisados recorrendo a métodos de extração de conhecimento, de modo a obter o modelo dos utilizadores. Usando os resultados obtidos pelo sistema de classificação, foi criada uma metodologia que permite selecionar a melhor interface e linguagem de comando da cadeira para cada utilizador. A avaliação para validação da abordagem foi realizada no âmbito do Projeto FCT/RIPD/ADA/109636/2009 - "IntellWheels - Intelligent Wheelchair with Flexible Multimodal Interface". As experiências envolveram um vasto conjunto de indivíduos que sofrem de diversos níveis de deficiência, em estreita colaboração com a Escola Superior de Tecnologia de Saúde do Porto e a Associação do Porto de Paralisia Cerebral. Os dados recolhidos através das experiências de navegação na CRI foram acompanhados por questionários preenchidos pelos utilizadores. Estes dados foram analisados estatisticamente, a fim de provar a eficácia e usabilidade na adequação da interface da CRI ao utilizador. Os resultados mostraram, em ambiente simulado, um valor de usabilidade do sistema de 67, baseado na opinião de uma amostra de pacientes que apresentam os graus IV e V (os mais severos) de Paralisia Cerebral. Foi também demonstrado estatisticamente que a interface atribuída automaticamente pela ferramenta tem uma avaliação superior à sugerida pelos técnicos de Terapia Ocupacional, mostrando a possibilidade de atribuir automaticamente uma linguagem de comando adaptada a cada utilizador. Experiências realizadas com distintos modos de controlo revelaram a preferência dos utilizadores por um controlo compartilhado com um nível de ajuda associado ao nível de constrangimento do paciente. Em conclusão, este trabalho demonstra que é possível adaptar automaticamente uma CRI ao utilizador com claros benefícios a nível de usabilidade e segurança.

Identificação de utilizadores seniores em televisão interativa (iTV) : uma matriz de decisão tecnológica

Desde que surgiu há mais de 50 anos, a televisão sofreu muitas transformações, tanto ao nível tecnológico (por exemplo com a passagem da emissão a preto/branco para cor, o som analógico para digital, a difusão digital) como a nível da sua influência nas sociedades. Entre outros fatores de ordem tecnológica, a consolidação da Internet com o seu elevado nível de personalização, da experiência de utilização, e a sua enorme quantidade de conteúdos disponíveis, catapultou a televisão no sentido de esta se tornar mais interativa. Assim, o telespectador passou a poder usufruir de uma experiência televisiva que pode, por um lado, ser mais participativa, sendo-lhe possível, por exemplo, alvitrar sobre a qualidade de um programa enquanto assiste à sua exibição, e, por outro, ser mais personalizada, possibilitando-lhe, por exemplo, receber conteúdos automaticamente adequados ao seu perfil e contexto. No entanto, esta experiência mais participativa e personalizável carece de uma identificação, idealmente automática e não intrusiva, de quem pode beneficiar da mesma – o telespectador. Contudo, e apesar de significativos avanços na área da televisão interativa, tanto ao nível da infraestrutura de suporte como ao nível dos serviços disponibilizados, a identificação dos utilizadores é, ainda, uma área de estudo com muitos aspetos por compreender. Os seniores, em particular, são grandes consumidores de televisão e representam uma fatia muito considerável das pessoas que podem beneficiar das potencialidades disponibilizadas pela interatividade presente em muitos serviços atuais. Um número crescente destes serviços são desenhados com o objetivo de promoverem um envelhecimento ativo e um concreto apoio à vida, pelo que os seniores podem beneficiar, em vários aspetos do seu quotidiano, se os utilizarem. Nesta faixa etária, a identificação de utilizadores tem, como elemento potenciador da experiência de utilização, um papel especialmente importante ao nível de um aproveitamento personalizado e dirigido destes serviços. No entanto, atendendo às diferentes combinações de características físicas, sensoriais, cognitivas e, mesmo, de literacia digital que tipificam os seniores, perspetivou-se existir uma dependência do perfil do utilizador na seleção do método de identificação mais adequado, os quais podem ser baseados, por exemplo, num leitor de impressões digitais, instalado no telecomando; na leitura de uma wearable tag ou de um cartão RFiD; no reconhecimento da face e, eventualmente, na voz do utilizador. Assim, a inerente investigação desenrolou-se em várias fases, no sentido de permitir alicerçar a construção de uma matriz de decisão tecnológica que, em função do perfil de utilizador, selecione o sistema de identificação mais adequado. O procedimento metodológico inerente à construção desta matriz de decisão, passou por um longo processo envolvendo utilizadores reais, que se iniciou com a realização de entrevistas exploratórias com o objetivo de permitir conhecer melhor os seniores e a forma como estes encaram a tecnologia e, mais concretamente, a televisão interativa. Foi depois implementado um protótipo de alta-fidelidade, completamente funcional, para a realização de testes com o objetivo de perceber qual a preferência relativamente a um subconjunto de tecnologias de identificação. Estes testes, uma vez que não permitiram testar todas as tecnologias em estudo, revelaram-se inconclusivos, porém permitiram reforçar a necessidade de identificar e caracterizar os referidos aspetos do perfil do utilizador que podem interferir na sua preferência relativamente ao sistema de identificação. As características identificadas constituíram-se como os parâmetros de entrada da matriz, sendo que para preencher as respetivas células realizaramse testes de aceitação, com um conjunto de seniores, tendo por base um protótipo, wizard of oz, especificamente implementado para permitir experienciar todas as tecnologias em estudo. Estes testes foram precedidos pela avaliação das capacidades funcionais dos participantes, nos diversos parâmetros definidos. Este texto relata, assim, todo o processo de investigação que foi conduzido, terminando com uma descrição de exemplos de utilização da matriz de decisão implementada e com a identificação de potenciais caminhos de desenvolvimento deste trabalho.

Profiles of ageing in the South of Portugal: education and cognitive functioning in elderly persons living in institutionalized and community contexts

The region of the Algarve shows huge differences between the coastline where population in the urban areas grows, and the inland rural areas, in some cases very isolated, which frequently have high ageing indexes. This general scenario, with an elderly population with very different economic and social conditions, frames the ongoing PhD research designed as a cross-sectional study of an intentional sample of elderly persons. The basic theoretical framework departs from the perspective of developmental psychology of life-span and the model of selection, optimisation and compensation for optimal ageing (Baltes & Baltes, 1990; Freund & Baltes, 2002). The present study is a first step in the analysis of empirical data collected in the PhD sample (N=156; age range 65 to 97 years; M = 80.4 years; SD = 7.2 years). Its purpose is to assess the cognitive functioning of participants, screening for cognitive impairment and examine the relations between the cognitive status of the subjects and a number of selected variables including educational level, age, physical activity and living contexts of the subjects. We accessed the cognitive status of the participants with the Portuguese version of Mini Mental State Examination (MMSE) finding a 10.3% prevalence of positive cases with cognitive impairment. The results also show significant relationships between the cognitive status accessed by the MMSE and educational level, professional qualification, age, living arrangement and activity level of the participants. The relationship verified between educational level and cognitive status of the participants was the largest correlation found in the study with the variability in educational level accounting for 44.8% of the variability in MMSE score. This results points in the same direction of several lines of research that corroborate the strong intercorrelation between education and cognitive functioning in old age.

Pharmacist intervention on adherence to therapy in the elderly

Background: Non-adherence to therapy contributes to the increase in hospitalizations, admissions to nursing homes, decreased quality of life and consequent increased morbimortality in the elderly. Aim: To assess whether pharmacist intervention contributes to the adherence to medical prescription by elderly patients.

A Graduate Voice Recital May 25, 1979

Concert Program for A Graduate Voice Recital May 25, 1979

On the development of an automatic voice pleasantness classification and intensity estimation system

In the last few years, the number of systems and devices that use voice based interaction has grown significantly. For a continued use of these systems, the interface must be reliable and pleasant in order to provide an optimal user experience. However there are currently very few studies that try to evaluate how pleasant is a voice from a perceptual point of view when the final application is a speech based interface. In this paper we present an objective definition for voice pleasantness based on the composition of a representative feature subset and a new automatic voice pleasantness classification and intensity estimation system. Our study is based on a database composed by European Portuguese female voices but the methodology can be extended to male voices or to other languages. In the objective performance evaluation the system achieved a 9.1% error rate for voice pleasantness classification and a 15.7% error rate for voice pleasantness intensity estimation.

Determination of airborne nanoparticles in elderly care centres

According to numerous studies, airborne nanoparticles have a potential to produce serious adverse human health effects when deposited into the respiratory tract. The most important parts of the lung are the alveolar regions with their enormous surface areas and potential to transfer nanoparticles into the blood stream. These effects may be potentiated in case of the elderly, since this population is more susceptible to air pollutants in general and more to nanoparticles than larger particles. The main goal of this investigation was to determine the exposure of institutionalized elders to nanoparticles using Nanoparticle Surface Area Monitor (NSAM) equipment to calculate the deposited surface area (DSA) of nanoparticles into elderly lungs. In total, 193 institutionalized individuals over 65 yr of age were examined in four elderly care centers (ECC). The occupancy daily pattern was achieved by applying a questionnaire, and it was concluded that these subjects spent most of their time indoors, including the bedroom and living room, the indoor microenvironments with higher prevalence of elderly occupancy. The deposited surface area ranged from 10 to 46 mu m(2)/cm(3). The living rooms presented significantly higher levels compared with bedrooms. Comparing PM10 concentrations with nanoparticles deposited surface area in elderly lungs, it is conceivable that living rooms presented the highest concentration of PM10 and were similar to the highest average DSA. The temporal distribution of DSA was also assessed. While data showed a quantitative fluctuation in values in bedrooms, high peaks were detected in living rooms.