Challenges Experienced at Age 100: Findings From the Fordham Centenarian Study

ABSTRACT

This article examines the challenges experienced by very old individuals and their consequences for well-being and mental health. In order to capture unique issues experienced in very old age, 75 participants of the population-based Fordham Centenarian Study answered open-ended questions on everyday challenges. Theme-based coding was then used to categorize and quantify responses. The challenges mentioned most often were challenges faced in the functional (e.g., physical health/activities of daily living restrictions, mobility, sensory impairment), psychological (e.g., loss of well-liked activity, dependency, negative emotions, death), and social (e.g., family loss) life domains. Functional challenges were negatively associated with aging satisfaction and positively associated with loneliness. Psychological challenges were positively linked to aging satisfaction. Social challenges were marginally related to loneliness. Notably, challenges were not related to depression. In conclusion, the challenges experienced in very old age are multidimensional and multifaceted, unique in nature, and have differential relations to mental health. Functional, psychological, and social challenges affect very old individuals’ lives and therefore need to be better understood and addressed. Given their consequences, it is imperative for policy makers to develop an awareness for the different types of challenges faced by centenarians, as there may be unique policy implications related to each.     

Friends or foes? Migrants and sub-state nationalists in Europe

ABSTRACT

How do sub-state nationalists respond to the growing presence of cultural diversity in their ‘homelands’ resulting from migration? Sub-state nationalists in Europe, in ‘nations without states’ such as Catalonia and Scotland, have been challenging the traditional nation-state model for many decades. While the arguments in favour of autonomy or independence levelled by these movements have become more complex, sub-state nationalist movements remain grounded by their perceived national community that is distinct from the majority nation. Migration to the ‘homeland’ of a sub-state nation, then, presents a conundrum for sub-state elites that we label the ‘legitimation paradox’: too much internal diversity may undermine the claim to cultural distinctiveness. We engage with three common intervening variables thought to influence how sub-state nationalists confront the ‘legitimation paradox’: civic/ethnic nationalism, degree of political autonomy, and party competition. Our overarching argument is that none of these factors have a unidirectional or determinate effect on the sub-state nationalism-immigration nexus, which is why the nuanced case studies that comprise this Special Issue are worthwhile endeavours.     

Erosion oder Stabilität der Beruflichkeit?

Regarding the changing patterns of mobility processes in the German labor market, this paper takes up the scientific debate on the declining significance of occupational qualifications. By comparing several labor market entry cohorts, the matching of the learned occupation and the practiced occupation is analyzed in both the horizontal and the vertical dimension of occupational mobility. In doing so, the question of a successful utilization of the skills acquired in the educational process can be addressed. Changes of occupations will be operationalized on the basis of a new professional classification by using the data set “Working and Learning in a Changing World” (ALWA). First, the Kaplan Meier survival curves show that the risks of horizontal occupational mobility have increased across cohorts. This indicates that the formerly close relationship between the education system and the employment system has weakened. Furthermore, according to our multivariate Cox regression analysis, the mobility towards inadequate status positions has increased. Thus, due to the expansion of atypical forms of employment and the increased volatility of the markets, altered mobility patterns of the younger cohorts entering the labor market can be shown. Consequently, the increase of unsuccessful transfers of skills in inter-firm mobility suggests a weakened cohesiveness between professionalism and a growing risk to loose professional qualifications.     

Global Environmental Change and Historical Transitions

What do transition processes in rural areas in Thailand, biomass consumption in nineteenth-century Austria and the ecology of hunter-gatherers have to do with the appropriation of plant production and global environmental change? More than one might think of in the first place. They are part of a scholarly discourse on our changing relations with the environment. We argue that global change can be analysed in terms of transitions between major modes of subsistence and try to document this with several case studies.     

Drivers of biodiversity patterns in parks of a growing South American megacity

How urban habitats contribute to biodiversity conservation is a key challenge in a rapidly urbanising world. Urban parks can provide important habitats for native species, but previous studies are geographically biased; fast growing megacities, in particular in South America, are clearly understudied. To assess habitat functions and underlying drivers in parks of Santiago de Chile, we analysed the assemblages of wild growing plant species in two ubiquitous park habitat types (grasslands, wooded areas) in 15 parks (150 plots) along an urban-rural gradient. We first used linear contrasts to compare species richness, beta diversity and the proportion of introduced species. We then tested for the explanatory value of environmental variables operating at different spatial scales (plot, park, urban matrix). Unlike in most previous studies, biodiversity patterns were not related to the position of the parks on the urban-rural gradient. Introduced species, mostly from Europe, generally dominated both habitat types (>90 %). Socio-economic (population growth or density), but not spatial, variables were retained in most models. Maintenance intensity was most influential in predicting species assemblages, complemented by park age in wooded areas. A high proportion of European grassland species indicates a trend of homogenisation in park grassland at a cross-continental scale. We conclude that habitat functions of urban parks for native species that have been mainly demonstrated for Europe cannot be generalised to South American megacities. This highlights the need for innovative and locally appropriate conservation approaches (e.g., re-introduction of native species) to foster biodiversity functions in urban parks of South American megacities.     

Knowledge Regarding Hymens and the Sex Education of Parents

The objective of this study was to ascertain beliefs and knowledge of pediatricians and parents regarding the hymen and to evaluate parental and pediatrician attitudes regarding sex education by pediatricians. Surveys were distributed anonymously to parents and pediatricians. Survey questions included knowledge of the female hymen and questions regarding attitudes toward sexual health education. There was a statistically significant difference in mean knowledge scores between pediatricians and parents regarding the hymen (3.7 versus 1.3; p < 0.0001). Almost two-thirds of pediatricians (63%) felt comfortable providing sexual health education directly to their patients, but only 41% felt comfortable educating parents. Pediatricians and parents demonstrate knowledge gaps about the hymen.     

End-of-Life Conversations and Hospice Placement: Association with Less Aggressive Care Desired in the Nursing Home

Education about end-of-life care and treatment options, communication between family and health care providers, and having advance directives and medical orders in place are important for older adults with chronic, progressive decline and end-stage disease who spend their last days in the nursing home. This study used retrospective data (6 months before death) of long-stay nursing home decedents (N?=?300) taken from electronic health records to capture the end-of-life experience. Findings showed for almost all decedents, Do Not Resuscitate and Do Not Intubate orders were in place, and just over one-half had Do Not Hospitalize and No Artificial Feeding orders in place. A small proportion had No Artificial Hydration or No Antibiotic orders in place. Overall, there was congruence between documented medical orders and treatment received. Findings showed that use of hospice and discussions about particular life-sustaining treatments each had significant associations with having less aggressive medical orders in place. These results can inform best practice development to promote high quality, person-directed, end-of-life care for nursing home residents.