Home: the foundations of belonging

To be at home means to be embedded in a dense pattern of relationships to people and place which gives rise to an inherently meaningful experience of the world. This order is neither abstract nor imposed from without, but crystallises from the shared experience of people inhabiting a concrete location. Home involves the localisation of meaning in a concrete setting and in the activities of everyday life, and this embodies an ongoing process of ‘cosmicisation’ which is vital for both social life and individual well-being. Home is not a fixed structure, static and frozen, which shuts out the external world; it is a dynamic centre which draws in experience and gives it meaning. It is a constellation of significance rather than a singular and unitary essence. It is produced by localising processes, which work to concentrate and stabilise value around a secure centre. The elaboration of seven interlinked localising processes forms the core of the thesis: The cultivation of place The accumulation of collective memory The crystallisation of life-ways and their evolution into tradition The generation of mutuality of being through sharing in fundamental biological processes which generate and preserve life Social circles of gift exchange and recognition which reinforce this mutuality of being The elaboration of symbolic boundaries The counterparts of localising processes are globalising ones. These involve the dismantling of the taken-for-granted relationships of everyday life and their reconstitution within spatially extended networks, governed by rationalised institutions, within separate spheres of economic production, commercial transactions, political administration and cultural exchange. The global market, the public arena, technological development and the bureaucratic state are all solvents of localised associations, which result in the dissipation and relativisation of value. However globalising processes never entirely displace localising ones. Even today, localising processes shape those areas of our lives which anchor our identities and provide a sense of meaning: the everyday interactions of home, family, community and intimate circles of friendship.

On the Threshold of Paradise and Present: Memory in Contemporary Cuban – American Literature

The exile leaving his or her homeland for new and unknown territory travels with much more than just luggage and the clothes on his or her back. He or she carries a weighty collection of memories. Available for the exile in times when the harmony of the past is far removed from the difficult circumstances present during the process of cultural assimilation, these memories present an opportunity for the exile to fashion for him or herself an identity that mimics the realities of life in the home left behind. In this creative endeavor, I seek to examine the powerful potential of memory as it is exercised by a collection of Cubans and Cuban-Americans in different corners of the United States. Analyzing Achy Obejas’ Memory Mambo, Cristina García’s Dreaming in Cuban, Ana Menéndez’s In Cuba I Was a German Shepherd, and Elías Miguel Muñoz’s Brand New Memory, I aim to trace the suggestive potential of memory as it is used by each of the characters in these works in an effort to reconcile their Cuban identities with the ones that are in the process of creation in the U.S. I will borrow from a collection of literature dealing with identity and exile, relevant graduate-level theses on Cuban-American literature, as well as theoretical perspectives on memory formation and nostalgia in order to trace the various ways in which memory is relied on in the process of cultural assimilation and emotional coping. Being presented in Miami, which hosts the largest concentration of Cuban immigrants, this thesis aims to present itself as a reflective tool for Cubans and Cuban-Americans who may find value in seeing their personal sentiments portrayed in literature, thus allowing for a potential reevaluation of identity. If the existing literature on my topic of analysis reveals anything, it is that the scope of my project is one that has not been inspected previously, thus making my analytical contribution a new one that will add a new interpretive set of lens through which readers of contemporary Cuban-American literature can examine the works.

On the Threshold of Paradise and Present: Memory in Contemporary Cuban‐American Literature

The exile leaving his or her homeland for new and unknown territory travels with much more than just luggage and the clothes on his or her back. He or she carries a weighty collection of memories. Available for the exile in times when the harmony of the past is far removed from the difficult circumstances present during the process of cultural assimilation, these memories present an opportunity for the exile to fashion for him or herself an identity that mimics the realities of life in the home left behind. In this creative endeavor, I seek to examine the powerful potential of memory as it is exercised by a collection of Cubans and Cuban-Americans in different corners of the United States. Analyzing Achy Obejas’ Memory Mambo, Cristina García’s Dreaming in Cuban, Ana Menéndez’s In Cuba I Was a German Shepherd, and Elías Miguel Muñoz’s Brand New Memory, I aim to trace the suggestive potential of memory as it is used by each of the characters in these works in an effort to reconcile their Cuban identities with the ones that are in the process of creation in the U.S. I will borrow from a collection of literature dealing with identity and exile, relevant graduate-level theses on Cuban-American literature, as well as theoretical perspectives on memory formation and nostalgia in order to trace the various ways in which memory is relied on in the process of cultural assimilation and emotional coping. Being presented in Miami, which hosts the largest concentration of Cuban immigrants, this thesis aims to present itself as a reflective tool for Cubans and Cuban-Americans who may find value in seeing their personal sentiments portrayed in literature, thus allowing for a potential reevaluation of identity. If the existing literature on my topic of analysis reveals anything, it is that the scope of my project is one that has not been inspected previously, thus making my analytical contribution a new one that will add a new interpretive set of lens through which readers of contemporary Cuban-American literature can examine the works.

The elderly care and domestic services sector during the recent economic crisis. The case of Italy, Spain and France.

Over the past ten years in Italy, Spain and France, the demographic pressure and the increasing women’s participation in labour market have fuelled the expansion of the private provision of domestic and care services. In order to ensure the difficult balance between affordability, quality and job creation, each countries’ response has been different. France has developed policies to sustain the demand side introducing instruments such as vouchers and fiscal schemes, since the mid of the 2000s. Massive public funding has contributed to foster a regular market of domestic and care services and France is often presented as a “best practices” of those policies aimed at encouraging a regular private sector. Conversely in Italy and Spain, the development of a private domestic and care market has been mostly uncontrolled and without a coherent institutional design: the osmosis between a large informal market and the regular private care sector has been ensured on the supply side by migrant workers’ regularizations or the introduction of new employment regulations . The analysis presented in this paper aims to describe the response of these different policies to the challenges imposed by the current economic crisis. In dealing with the retrenchment of public expenditure and the reduced households’ purchasing power, Italy, Spain and France are experiencing greater difficulties in ensuring a regular private sector of domestic and care services. In light of that, the paper analyses the recent economic conjuncture presenting some assumptions about the future risk of deeper inequalities rising along with the increase of the process of marketization of domestic and care services in all the countries under analysis.    

Looking for Determinants of Ontological Security in the Spain of the Crisis

The concept of ontological security has a remarkable echo in the current sociology to describe emotional status of men of late modernity. However, the concept created by Giddens in the eighties has been little used in empirical research covering various sources of risk or uncertainty. In this paper, a scale for ontological security is proposed. To do this, we start from the results of a research focused on the relationship between risk, uncertainty and vulnerability in the context of the economic crisis in Spain. These results were produced through nine focus groups and a telephone survey with standardized questionnaire applied to a national sample of 2,408 individuals over 18 years. This work is divided into three main sections. In the fi rst, a scale has been built from the results of the application of different items present in the questionnaire used. The second part explores the relationships of the scale obtained with the variables further approximate the emotional dimensions of individuals. The third part observes the variables that contribute to changes in the scale: These variables show the structural feature of the ontological security.

Validação do Youth Quality of Life Instrument para a população portuguesa: YQOL-R

É incontornável o estatuto que o conceito de qualidade de vida assume hoje na prática e políticas de saúde pública. Na infância e adolescência é ainda escassa a investigação, tornando-se crucial o desenvolvimento de instrumentos de qualidade vida relacionada com a saúde validados para esta população. O presente trabalho tem como objetivo fundamental analisar as qualidades psicométricas e validar a versão portuguesa do Youth Quality of Life (YQOL-R) (Patrick, et al., 2002). A amostra é constituída por 507 adolescentes, com idades compreendidas entre os 12 e os 19 anos, a frequentar o 3º ciclo do ensino básio e ensino secundário de escolas públicas do ensino regular. Para além do citado instrumento a validar, os jovens preencheram também, para a análise da validade convergente e divergente, o Kidscreen-27 (Gaspar & Matos, 2008) e a Escala da Depressão, Ansiedade e Stresse (EADS-21) (Pais-Ribeiro, Honrado & Leal, 2004). Os resultados mostram que o YQOL-R apresenta uma estrutura fatorial de quatro fatores, semelhantes à versão original americana (individual, relações sociais, ambiente e qualidade de vida em geral). Possui uma boa consistência interna e uma adequada estabilidade temporal. Mostrou correlações significativas e no sentido esperado com as variáveis em estudo. Foram igualmente encontradas diferenças de género em relação à qualidade de vida, sendo os rapazes a reportarem em média níveis mais elevados de perceção da qualidade de vida, comparativamente às raparigas. Futuros estudos devem ser realizados em amostras clínicas para confirmação dos dados. Não obstante esta limitação, o presente estudo contribuiu para a disponibilização de um novo instrumento para avaliação da qualidade de vida em crianças e adolescentes, o qual evidenciou boas propriedade psicométricas, apoiando, assim empiricamente, a sua utilização nas práticas de saúde e investigação em amostras da comunidade. / Nowadays, it´s unavoidable the status that, the concept of quality of life assumes in practices and politics of public health. In childhood and adolescence it´s weak the investigation but it´s crucial the development of instruments of quality of life related to health validated to this population. The present work has an important aim, it´s analyze the psychometric qualities and validate the Portuguese version of Youth Quality of Life (YQOL-R) (Patrick, et al., 2002). The sample consists of 507 adolescents, aged between 12 and 19 years old and they attend the 3 rd cycle of basic education and secondary education schools in villages of regular education. Apart from that instrument, teenagers fill in, also, to the analysis convergent and divergent, the Kidscreen-27 (Gaspar & Matos, 2008) and the Depression, Anxiety and Stress Scale (EADS-21) (Pais-Ribeiro, Honrado & Leal, 2004). The results show that the YQOL-R presents a factorial structure with four factors similar to original American version (individual, social relations, environment and general quality of life), presenting a good internal consistence and an adequate temporal stability. Substantial correlations showed and in the expected way with the variables in study. Have been found differences of gender related to quality of life, boys reported on average higher levels of quality of life perception, comparatively to the girls. Future studies must be performed in clinical samples to confirm the findings. In spite of this restriction, the actual study contributes to providing a new instrument to evaluate the quality of life in children and adolescents, this evidenced good psychometric properties, supported empirically its application in heath practices and investigation in community samples.

Impact of oral diseases and disorders on oral health-related quality of life of preschool children

BACKGROUND The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. OBJECTIVE To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. METHODS Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children's OHRQoL and socioeconomic conditions. Two calibrated dentists (κ>0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0=caries free; 1-5=low severity; ≥6=high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. RESULTS In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P<0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P>0.05). The increase in the child's age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P<0.05). The multivariate adjusted model showed that the high severity of ECC (RR=3.81; 95% CI=2.66, 5.46; P<0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR=0.93; 95% CI=0.87, 0.99; P<0.001). CONCLUSIONS The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.

Extending the capabilities of smartphone sensors for applications in interaction and health

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

Design Guidelines and Development Policies for an Adaptable Historic Urban Street: The Case of West Street in Quanzhou, Fujian, China

Thesis (Master's)--University of Washington, 2016-06

Using technology to overcome the tyranny of space: information provision and wayfinding.

Urban wayfinding technology offers many possibilities by which older people and mobility-impaired users can overcome the barriers encountered on every-day journeys in the built environment. Previous work has highlighted the extent to which personal mobility and independence are significant determinants of the quality of life amongst both elderly and visually impaired groups. The paper outlines the development of the auditory location finder (ALF), which is a beacon-based local information system designed to enhance the wayfinding activities of these, and potentially other, user-groups in the community. The proposed system provides the user with an audio message, which is obtained on request via a small portable hand unit. The messages inform the user of their whereabouts and give information about the area that they are currently in. The development of the device involves issues such as message content and structure, route choice, orientation, landmarks, clues and the extent of user reliance on technology. Preliminary trials have been carried out in a UK city and have obtained initial user feedback to help underpin the technological development of the device and its potential application. The paper concludes by outlining the importance of new urban technology and the way in which such local information systems can potentially contribute to overcoming particular patterns of exclusion experienced by mobility-impaired groups, such as the visually impaired

Chronic respiratory diseases and quality of life in elderly nursing home residents

Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.

Using an end-of-life care pathway in acute stroke: a mixed methods study of decision-making and care experiences

Background: The evidence base on end-of-life care in acute stroke is limited, particularly with regard to recognising dying and related decision-making. There is also limited evidence to support the use of end-of-life care pathways (standardised care plans) for patients who are dying after stroke. Aim: This study aimed to explore the clinical decision-making involved in placing patients on an end-of-life care pathway, evaluate predictors of care pathway use, and investigate the role of families in decision-making. The study also aimed to examine experiences of end-of-life care pathway use for stroke patients, their relatives and the multi-disciplinary health care team. Methods: A mixed methods design was adopted. Data were collected in four Scottish acute stroke units. Case-notes were identified prospectively from 100 consecutive stroke deaths and reviewed. Multivariate analysis was performed on case-note data. Semi-structured interviews were conducted with 17 relatives of stroke decedents and 23 healthcare professionals, using a modified grounded theory approach to collect and analyse data. The VOICES survey tool was also administered to the bereaved relatives and data were analysed using descriptive statistics and thematic analysis of free-text responses. Results: Relatives often played an important role in influencing aspects of end-of-life care, including decisions to use an end-of-life care pathway. Some relatives experienced enduring distress with their perceived responsibility for care decisions. Relatives felt unprepared for and were distressed by prolonged dying processes, which were often associated with severe dysphagia. Pro-active information-giving by staff was reported as supportive by relatives. Healthcare professionals generally avoided discussing place of care with families. Decisions to use an end-of-life care pathway were not predicted by patients’ demographic characteristics; decisions were generally made in consultation with families and the extended health care team, and were made within regular working hours. Conclusion: Distressing stroke-related issues were more prominent in participants’ accounts than concerns with the end-of-life care pathway used. Relatives sometimes perceived themselves as responsible for important clinical decisions. Witnessing prolonged dying processes was difficult for healthcare professionals and families, particularly in relation to the management of persistent major swallowing difficulties.

Coarse-graining and renormalisation group methods for the elucidation of the kinetics of complex nucleation and growth processes

We review our work on generalisations of the Becker-Doring model of cluster-formation as applied to nucleation theory, polymer growth kinetics, and the formation of upramolecular structures in colloidal chemistry. One valuable tool in analysing mathematical models of these systems has been the coarse-graining approximation which enables macroscopic models for observable quantities to be derived from microscopic ones. This permits assumptions about the detailed molecular mechanisms to be tested, and their influence on the large-scale kinetics of surfactant self-assembly to be elucidated. We also summarise our more recent results on Becker-Doring systems, notably demonstrating that cross-inhibition and autocatalysis can destabilise a uniform solution and lead to a competitive environment in which some species flourish at the expense of others, phenomena relevant in models of the origins of life.

Use of GLP-1 mimetic in type 2 diabetes mellitus: is it the end of fragility fractures?

International audience

Quality of life in institutionalized elderly undergoing an active aging program

Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. This study aims to assess the quality of life of institutionalized elderly undergoing to an active aging program. Methods: We have developed a semi-experimental study that considers the quantitative methodology in which the following instruments were used to measure the quality of life: Eurohis-Qol-8 (Pereira, Melo, Gameiro, & Canavarro, 2011) and Whoqol-Old (Vilar et al., 2010), to which sociodemographic and clinical questions were added. Assessments were made in two different moments, before and after the intervention program, in a sample of 37 institutionalized elderly. Results: Concerning the assessment of quality of life related to health (Eurohis-Qol-8), significant higher scores were obtained in the second moment (p = 0.004). Regarding the quality of life related to the elderly significant better scores were also obtained in the second assessment (p = 0.001). Conclusions: The results obtained allow us to conclude that using either of the measuring scales of Eurohis-Qol-8 or Whoqol-old, there is a perceived improvement in quality of life in those using the active aging program. Thus, institutionalized elderly must be the main target in the design and implementation of active aging programs.