Intergenerational learning with ICT: a case study

In a context of rapid demographic and technological changes, digital skills are essential in order for citizens to actively participate in society. However, digital literacy for all citizens, especially for the older population, is not yet a reality. It is increasingly crucial for active ageing, lifelong learning, and life-wide learning that the elderly learn digital skills. Intergenerational learning can play a key role in achieving a wide range of goals. This paper focuses on the contribution of intergenerational learning to digital and social inclusion. We promoted ICT intergenerational workshops and chose the case study methodolog y to study three distinct cases of intergenerational learning with ICT. The results show that intergenerational learning with ICT contributes to the digital literacy of adults and seniors and fosters lifelong learning, active ageing, and understanding and solidarity among generations. We reveal the benefits of the intergenerational learning process for all participants and suggest some ways to achieve intergenerational learning through ICT in order to build more socially and digitally cohesive societies.

As competências interculturais no processo de integração das imigrantes brasileiras em Cascais

A presente dissertação levou-nos a recolher excertos dos inquéritos, por entrevista, aplicados a oito mulheres participantes que nos ajudaram a compreender como as competências interculturais influenciaram o processo de integração em Cascais, Portugal. Ver o/a outro/a como igual apesar da sua diversidade cultural, sabendo colocar-nos no seu lugar pode parecer simples, no entanto, passar da teoria à prática exige a desconstrução da nossa perspetiva sobre o outro/a e de nós próprios. Neste processo acabamos por compilar um conjunto de informação qualitativa, que apresenta um método psicossocial de interação empático e conciliatório com os outros/as, pessoas, seres humanos como nós, livres de terem ideias e convicções diferentes das nossas. Apresentamos uma aplicação aberta à mudança, flexível e articulante de conhecimentos, concretamente das competências interculturais em constante plasticidade evolutiva.

National survey of the portuguese elderly nutritional status : study protocol

© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Mild cognitive impairment

Abstract Mild Cognitive Impairment (MCI) is a disease between normal cognitive ageing and dementia. In recent years the term MCI has been recognized as a pre-dementia state, raising an important subject for investigation in the prevention of dementia. There are various terms related to pre-dementia MCI, such as isolated memory complaint and pre-Alzheimer’s disease; most of them do not comprise all the areas related to MCI. A central cholinergic deficit is present in amnestic MCI with neuronal loss in the Meynert basal nucleus. It is estimated that the rate of progression to dementia is about 10% every year. The prevalence of MCI is 10%-11% and the risk of progression to dementia is about 5%-16%. The continual development of pharmacologic approaches to modify and delay the natural history of progression of the disease motivates a great interest in an earlier diagnosis.

Indigenous sustainable land management practices: perspectives from Wadawurrung/Wathaurong Country

This paper discusses the role and potential of ethnobotany in Australian Aboriginal plant knowledge in supporting and enabling sustainable land management practices for land use developments. In particular, it draws upon the Wadawurrung / Wathaurong Country knowledge for the greater Geelong region of Australia, summarises recent investigations and research, offers a deeper insight into the risks of indigenous vegetation deterioration and opportunities relating to plant usage, and highlights the importance of this plant knowledge in sustainable land management practice. The focus of this investigation is upon the Wathaurong Country around the City of Greater Geelong, host city for the ISDRS conference, of which there is little published material and oral distillation.
The purpose of this paper is to demonstrate how the Wadawurrung / Wathaurong people survived for over 60,000 years through sustainable land management techniques, caring & healing themselves by holding deep knowledge of the plants available in this region. Ethnoecology is the governing theoretical framework, with ethnobotany being a subset of this and the primary focus of this paper.
Conclusions arising from this research include: there is limited knowledge as a modern colonised nation; what little knowledge there is left is ageing and will disappear; and, there is an urgent need to better understand what still grows in the region prior to further urban applications and this is also compounded by the driving forces of climate change. Accordingly this paper demonstrates the need to urgently undertake this research. The implications for ‘Tipping Points’ is that we are increasingly at the point of no return is when we forget about the indigenous knowledge base and watch the death of the knowledge holders, and their wisdom and its benefits have not been transposed into contemporary society.

Vulnerability at the end of life: Australian veterans requiring home-based palliative care

In Australia, veterans are a vulnerable group, because of ageing, and high rates of chronic or life-threatening illnesses and poor mental health .This retrospective pilot study explored the home-based palliative care needs of veterans as they face the end of their life, compared to non-veterans. Medical records of ten deceased veterans and ten non-veterans in a home-based palliative care service were analyzed both for demographic data, and qualitative content. Veterans had significantly more comorbidities and were older at death. Qualitative data indicated common concerns, including the role of families and practical aspects of care. Some differences were found between veterans and non-veterans in their end-of-life care requirements. More awareness of veterans’ status may assist in care more tailored to their specific needs.

Chronic disease self-management in Aboriginal communities : towards a sustainable program of care in rural communities

The Chronic Disease Self-Management (CDSM) strategy for Aboriginal patients on Eyre Peninsula, South Australia, was designed to develop and trial new program tools and processes for goal setting, behaviour change and self-management for Aboriginal people with diabetes. The project was established as a one-year demonstration project to test and trial a range of CDSM processes and procedures within Aboriginal communities and not as a formal research project. Over a one-year period, 60 Aboriginal people with type-2 diabetes in two remote regional centres participated in the pilot program. This represents around 25% of the known Aboriginal diabetic population in these sites. The project included training for four Aboriginal Health Workers in goal setting and self-management strategies in preparation for them to run the program. Patients completed a Diabetes Assessment Tool, a Quality of Life Questionnaire (SF12), the Work and Social Adjustment Scale (WASAS) at 0, 6 and 12 months. The evaluation tools were assessed and revised by consumers and health professionals during the trial to determine the most functional and acceptable processes for Aboriginal patients. Some limited biomedical data were also recorded although this was not the principal purpose of the project. Initial results from the COAG coordinated care trial in Eyre suggest that goal setting and monitoring processes, when modified to be culturally inclusive of Aboriginal people, can be effective strategies for improving self-management skills and health-related behaviours of patients with chronic illness. The CDSM pilot study in Aboriginal communities has led to further refinement of the tools and processes used in chronic illness self-management programs for Aboriginal people and to greater acceptance of these processes in the communities involved. Participation in a diabetes self-management program run by Aboriginal Health Workers assists patients to identify and understand their health problems and develop condition management goals and patient-centred solutions that can lead to improved health and wellbeing for participants. While the development of self-management tools and strategies led to some early indications of improvements in patient participation and resultant health outcomes, the pilot program and the refinement of new assessment tools used to assist this process has been the significant outcome of the project. The CDSM process described here is a valuable strategy for educating and supporting people with chronic conditions and in gaining their participation in programs designed to improve the way they manage their illness. Such work, and the subsequent health outcome research planned for rural regions, will contribute to the development of more comprehensive CDSM programs for Aboriginal communities generally.

Rural health systems change

Much effort has been expended in recent years attempting to reform the Australian health system in order to deliver more efficient and effective systems of care for an ageing and increasingly chronically ill population. Rural health care systems in particular have been a focus of reform programs, and new initiatives such as University Departments of Rural Health, Regional Health Service structures and Commonwealth primary care initiatives have been designed to improve service provision and health status for rural people. However, with these attempts to reform the way rural communities understand and manage their health care, surprisingly little has changed in the day-to-day business of health care in rural and regional areas. Paradoxically, while rural communities have moved to embrace new farming technologies and environmental perspectives along with modern land management practices, revegetation and sustainable production systems, the same enthusiasm for change does not appear to have been kindled in relation to health system reforms. Rural communities, in terms of health care, are still using the equivalent of outmoded farming practices and other environmentally and economically unsustainable approaches to managing their affairs. Why might this be and what can be done to improve the current state of health reform in our rural and regional areas? The paper explores systems change in relation to health reform in rural communities and highlights several strategies for bringing about a functional synthesis of research and health service practice to create a more effective health care system in rural South Australia.

Social determinants of health - why we continue to ignore them in the search for improved population health outcomes!

There is now unequivocal evidence that the health status of individuals and of whole communities is socially and economically determined, as are many other aspects of our lives. This suggests, as advocates of public health and population health approaches argue, that our efforts in managing our health and wellbeing should focus much more on early intervention and prevention programs than has been the case to date. However, although this ideology of social and economic determinism is generally accepted, practice does not reflect such values. Indeed, as increasing demand at the critical end of health service provision sees us spending more and more of our limited health care resources on acute and chronic illness, less resources are devoted to constructing and maintaining health-creating communities and environments. Paradoxically, while most of our leaders, academics and policy makers have themselves been nurtured in a sound understanding of cause and effect in the world, they are ignoring these fundamental premises in their approaches to the provision and management of health care. This paper explores some of the reasons why this might be the case and draws on key evidence to suggest that the time has come for us to think more ideologically in approaching health care in the future.

Health systems change in 2010

Whilst health science, epidemiology and public health developments have forged enormous progress in understanding, prevention and cure in the health care area we still appear to lack the motivation to tackle the fundamental antecedents of many of our emerging population-based community health problems; the prevention of chronic illness being a prime example.

In spite of much progress in the area of health science, the social, economic and evolutionary forces that cast our physical being in the world still remain poorly understood or accepted in the health care arena. However, if our health care systems are to be manageable and sustainable in the future, these wider antecedents of our health status and wellbeing must be factored more fundamentally in to our management models with more effort being put into preventing lifestyle related chronic illnesses than is currently the case.

As in the past where public health infrastructure innovations such as running water and efficient waste disposal systems served to add greatly to the wellbeing of individuals and communities, we now need to make similar efforts to control preventable illnesses such as metabolic syndrome, type 2 diabetes and lifestyle related cardio-vascular disease at their source rather than waiting until the manifestation of these conditions require major medical and chemical intervention and management before we act. Our young people are at risk of early onset chronic conditions as a result of their emerging sedentary lifestyles, un-healthy dietary habits and health related behaviours, yet we continue to concentrate our health management effort on managing those with existing chronic conditions while leaving younger generations with lifestyle practices and behaviours that pre-dispose individuals to developing chronic illness earlier and earlier in their lives.

It is time we took notice of these emerging trends and began expending more effort to prevent what are essentially lifestyle related illnesses that can be eliminated before they become endemic. By concentrating more upon the social and environmental factors affecting our illness profiles as well as upon dealing more effectively with those who are already suffering from chronic illness we will reduce the need for major end-stage interventions and alleviate the impact and cost of early onset chronic disease. To achieve this new population health vision in Australia at least, we will not only need to utilize the new government funding structures more effectively; those structures that support coordination and more effective management of care, but also take a much broader, environmental and social view of cause and effect in relation to the health of populations.

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.

Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants

Background: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings: We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants

Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence - defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs - in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings: We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4-7·0) in 1980 to 9·0% (7·2-11·1) in 2014 in men, and from 5·0% (2·9-7·9) to 7·9% (6·4-9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.

Envelhecer já não é o que era

O aumento dos indivíduos idosos na sociedade fruto do aumento da longevidade a par de outros factores tornou a problemática relativa ao envelhecimento activo e as instituições criadas para estimular esse mesmo envelhecimento um tema de relevo na promoção dos recursos que os indivíduos mantêm nesta fase etária. De acordo com as politicas sociais actuais é necessário que estes sejam activos, ou seja, que participem nas questões sociais, económicas, culturais, espirituais e cívicas. Neste sentido, esta investigação pretendeu debruçar-se sobre a percepção que uma Directora de uma Universidade Sénior tem relativamente ao envelhecimento, ao impacto deste envelhecimento na família, e o enquadramento das Universidades Senior como agentes neste processo de mudança. Para isso, e para além da pesquisa bibliográfica, utilizámos um método qualitativo (Grounded Theory) que sustentou a entrevista realizada e a sua análise. Na globalidade deste estudo podemos concluir que através de instituições como a Universidade Sénior os idosos sentem-se úteis, desafiados e com capacidade de manter uma qualidade de vida bem sucedida.

Från ensamhet till gemenskap och hur det kommer sig : En studie om faktorer som kan påverka äldre personers väg från ensamhet till gemenskap

Syftet med studien är att öka förståelsen för vilka faktorer som kan leda till och påverka äldre personers deltagande i en social gruppaktivitet riktad till ensamma äldre. Då känslan av ensamheten kan ge stora negativa effekter för den äldre är det viktigt att öka förståelsen och kunskapen om de fenomen och faktorer som påverkar och leder till mer gemenskap och välbefinnande. Studien är en kvalitativ intervjustudie och det insamlade materialet har analyserats genom kvalitativ innehållsanalys med en induktiv ansats. Antonovskys salutogena perspektiv har använts som teoretisk referensram. Sex personer i åldern 75-90 år har deltagit i semistrukturerade intervjuer. Deltagarna ingick i frivilligorganisationen Äldrekontakts sociala gruppaktivitet vilket är riktad till ensamma äldre som söker gemenskap. I resultatet framkom tre olika teman vilket sammanfattar de faktorer som ledde till och påverkade de äldres deltagande i den sociala gruppaktiviteten. De teman som ingår är: förändringsgrunder, förutsättningar och fördelar. Temat förändringsgrunder belyser att motivet för de äldre att delta i aktiviteten grundar sig i en önskan om en ökad gemenskap då relationerna blivit färre och att det hade uppstått en känsla av ensamhet. Vidare framkommer att deltagarnas förhållningssätt riktades mot välbefinnande genom att vara aktiv, att ha en stärkande inställning och att våga exponera sig. Temat förutsättningar beskriver villkor för ett deltagande i aktiviteten. Yttre faktorer var stödet att komma till och från aktiviteten och att det var anspråkslöst att delta. Den inre faktorn var att deltagarna hade tillräckligt med ork så att aktiveten gick att genomföra. Temat fördelar visar på de vinster som uppkom i och med deltagandet i denna gruppaktivitet. Denna aktivitet berikade vardagen genom att det blev ett avbrott i det vardagliga livet och att det fanns något att se fram emot. Deltagarna blev sedda och hörda då det fanns någon att samtala med och något att prata om samt att det skapades nya bekantskaper. En känsla av att bli omhändertagen uppstod vilket uttrycktes genom en tacksamhet att få delta och att det kändes tryggt att medverka i aktiviteten. Resultatet har analyserats genom Antonovskys salutogena perspektiv och tre slutsatser har framtagits. Dessa tre teman har identifierats som en process. Temat förändringsgrunder har visat sig vara en grundförutsättning för resterande process och det har också framkommit att deltagarna har en hög känsla av sammanhang. Denna kunskap kan hjälpa de äldre och de som vill stödja ensamma äldre att ta steget från ensamhet till gemenskap.