Should I stay or should I go – Factors associated with hospitalization risk among older persons in Sweden

An increasingly older population will most likely lead to greater demands on the health care system, as older age is associated with an increased risk of having acute and chronic conditions. The number of diseases or disabilities is not the only marker of the amount of health care utilized, as persons may seek hospitalization without a disease and/or illness that requires hospital healthcare. Hospitalization may pose a severe risk to older persons, as exposure to the hospital environment may lead to increased risks of iatrogenic disorders, confusion, falls and nosocomial infections, i.e., disorders that may involve unnecessary suffering and lead to serious consequences. Aims: The overall aim of this thesis was to describe and explore individual trajectories of cognitive development in relation to hospitalization and risk factors for hospitalization among older persons living in different accommodations in Sweden and to explore older persons' reasons for being transferred to a hospital. Methods: The study designs were longitudinal, prospective and descriptive, and both quantitative and qualitative methods were used. Specifically, latent growth curve modelling was used to assess the association of cognitive development with hospitalization. The Cox proportional hazards regression model was used to analyse factors associated with hospitalization risk overtime. In addition, an explorative descriptive design was used to explore how home health care patients experienced and perceived their decision to seek hospital care. Results: The most common reasons for hospitalization were cardiovascular diseases, which caused more than one-quarter of first hospitalizations among the persons living in ordinary housing and nursing home residents (NHRs). The persons who had been hospitalized had a lower mean level of cognitive performance in general cognition, verbal, spatial/fluid, memory and processing speed abilities compared to those who had not been hospitalized. Significantly steeper declines in general cognition, spatial/fluid and processing speed abilities were observed among the persons who had been hospitalized. Cox proportional hazards regression analysis showed that the number of diseases, number of drugs used, having experienced a fall and being assessed as malnourished according to the Mini Nutritional Assessment scale were related to an increased hospitalization risk among the NHRs. Among the older persons living in ordinary housing, the risk factors for hospitalization were related to marital status, i.e., unmarried persons and widows/widowers had a decreased hospitalization risk. In addition, among social factors, receipt of support from relatives was related to an increased hospitalization risk, while receipt of support from friends was related to a decreased risk. The number of illnesses was not associated with the hospitalization risk for older persons in any age group or for those of either sex, when controlling for other variables. The older persons who received home health care described different reasons for their decisions to seek hospital care. The underlying theme of the home health care patients’ perceptions of their transfer to a hospital involved trust in hospitals. This trust was shared by the home health care patients, their relatives and the home health care staff, according to the patients. Conclusions: This thesis revealed that middle-aged and older persons who had been hospitalized exhibited a steeper decline in cognition. Specifically, spatial/fluid, processing speed, and general cognitive abilities were affected. The steeper decline in cognition among those who had been hospitalized remained even after controlling for comorbidities. The most common causes of hospitalization among the older persons living in ordinary housing and in nursing homes were cardiovascular diseases, tumours and falls. Not only health-related factors, such as the number of diseases, number of drugs used, and being assessed as malnourished, but also social factors and marital status were related to the hospitalization risk among the older persons living in ordinary housing and in nursing homes. Some risk factors associated with hospitalization differed not only between the men and women but also among the different age groups. The information provided in this thesis could be applied in care settings by professionals who interact with older persons before they decide to seek hospital care. To meet the needs of an older population, health care systems need to offer the proper health care at the most appropriate level, and they need to increase integration and coordination among health care delivered by different care services.

"If I Could Think of Somewhere to Go" : Alienation in S.E. Hinton's Rumble Fish

This essay focuses on the alienation experienced by Rusty-James in S.E. Hinton’s Rumble Fish (1975). It more specifically centers on the causes of his alienation and how the alienation is illustrated in the novel. The analysis shows that the alienation Rusty-James experiences is caused partly by socioeconomic factors; for example his lack of hope for the future is closely connected to the fact that he belongs to a low socioeconomic class. In addition, there are also psychological factors, for example a childhood trauma. The alienation and its causes are mainly illustrated through the symbolism of the featured Siamese fighting fish and how Rusty-James’ relationships are depicted.  

Uma viagem insólita: de um território pesqueiro a um paraíso turístico

O presente trabalho intitulado Uma viagem insólita: de um território pesqueiro a um paraíso turístico tem como objetivo buscar compreender e interpretar as mudanças socioespaciais que ocorreram na Praia da Pipa/RN, decorrentes da expansão da atividade turística e seus reflexos no território, no período compreendido entre os anos de 1970 e os dias atuais, recorrendo-se a fontes bibliográficas, entrevistas e observações in loco, além de levantamento de dados secundários, cartográficos e fotográficos. Reporta à nova territorialidade que emergiu com a expansão da atividade turística para o litoral norte-rio-grandense, atraída pela praia e pelo sol, que fez convergir para essa área, produtores e consumidores não apenas locais, mas também regionais, nacionais e internacionais. Do ponto de vista social, a população nativa vem sendo expropriada de seus espaços, da sua cultura, das suas tradições e, até mesmo, do mercado de trabalho, o que vem provocando um processo de desterritorialização e o surgimento de novas territorialidades marcadas pela atividade turística. A expansão da atividade turística em Pipa/RN, a partir de 1970, tem provocado um processo de construção de um novo território o território turístico que se reflete dialeticamente através do surgimento de um novo cenário socioespacial constituído de formas e imagens expressas materialmente no lugar

A educação física e a dança: a abordagem estética do desporto como uma possibilidade na área da composição coreográfica, com alunos do 5º vocacional da Academia de Música de Vilar do Paraíso

Relatório Final de Estágio apresentado à Escola Superior de Dança, com vista à obtenção do grau de Mestre em Ensino de Dança.

Education at last! Taiwanese grandmothers "go to school"

Language socialization is a life-long process in which individuals are continuously socialized into new roles, statuses, and practices. This process becomes more complex in multilingual contexts. However, we know little of the language socialization of older adults and we know even less of minority-speaking elders' experiences of linguistic marginalization in contemporary communicative milieus. In this ethnographic and discourse-analytic study, I examine the language socialization of non-Mandarin-speaking elderly Taiwanese women in senior adult education programs in a rural township in Taiwan. Through examining autobiographical narratives, master narratives about elders, and classroom discourses, this study explores the historical construction of their sociolinguistic marginalization and their negotiation and resistance of such marginalization. The majority of the elderly women were denied education when they were young. Some received Japanese education during the Japanese colonization period. While the uneducated and illiterate elders have a strong aspiration for learning, they are dismissed as "unable to learn" by their teachers, peer students, and community leaders. By contrast, the Japanese literate exhibit a strong learning identity associated with colonial modernity. These two groups, however, have to contend with the social stereotype associated with their non-Mandarin speaking status. Under a Mandarin-only ideology that links Mandarin with modernity, discourses that have actively mobilized the category of “illiterate” to reference the older population are part and parcel of Taiwan’s modern identity. By demonstrating how these women are treated, in official discourses and in classroom interactions, as children for their lack of Mandarin abilities, I argue that the literacy education that set out to “compensate” these women for their earlier lack of educational opportunity has paradoxically reinforced their marginalization. Further, in recent years, they have become even more marginalized as the government has prioritized the education of recent young female marriage immigrants from Southeast Asia, who are considered in charge of educating the “future sons and daughters of Taiwan.” This research demonstrates how language socialization is a contested and life-long process and calls attention to the effects of language ideologies on literacy and language education. The findings have policy implications for improving literacy and language education both within Taiwan and elsewhere in the world.

Guiding Monte Carlo tree searches with neural networks in the game of go

A dissertation submitted in fulfillment of the requirements to the degree of Master in Computer Science and Computer Engineering

Gestão e desenvolvimento regional na ride/DF: corsap-DF/GO como modalidade de associativismo territorial

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Geografia, Programa de Pós-Graduação em Geografia, 2015.

"Let Us Sing as We Go": The Role of Music in the United States Suffrage Movement

Music played a prominent role in the United States women’s suffrage movement (1848–1920). Suffragists left behind hundreds of compositions supporting their cause and historical accounts indicate that musical performances were common at suffrage events. With only a few exceptions, scholars have disregarded the music used in this movement, and have underemphasized its significance. This study examines the use of music in the suffrage movement from three perspectives: music with lyrics, titles, and images that espouse women’s enfranchisement; music performed at national suffrage conventions held by the National American Woman Suffrage Association; and music accompanying suffrage parades. Though the music used varies in each case, it is clear that music played an important role in unifying suffragists and underscoring the ideals and goals of the movement.

Determinação de cenários futuros de uso e cobertura do solo e sua influência na vulnerabilidade ambiental : o caso do município de Formosa – GO

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Civil e Ambiental, Programa de Pós-Graduação em Tecnologia Ambiental e Recursos Hídricos, 2015.