Research on persistent pain in late life: current topics and challenges

Older women often experience pain in their daily lives. This article provides an overview of topics addressed in the geriatric pain research published between 1999 and 2004. New areas of emphasis of research have emerged such as the recognition of body mass and weight as a factor in persistent pain, while other areas have expanded, including the focus on pain among elders with cognitive impairments and the use of alternative treatment approaches. Understanding of pain in late life is hindered by study samples that lack diversity, treatment approaches that are narrowly focused, and a lack of attention to quality of life issues.     

The Concept,Dimensions and Methods of Assessment of Human Well-Being within a Socioecological Context: A Literature Review

The concept of well-being has evolved over the past several decades as research has continued to reveal its multidimensional, dynamic, person-specific and culture-specific nature. Most recently, the ecological embeddedness of well-being has also gained recognition, and this development of the concept demands that we explore and identify new conceptual frameworks and appropriate methodological approaches towards the assessment of quality of life within a socioecological context. This paper offers a review of seminal and current research in the fields of social indicators, human development, ecological economics, and natural resources management, with the aim of examining the concept and the various methodologies designed to assess both the objective and subjective components and the multiple dimensions that comprise well-being. We also present some methodological approaches that have the capacity to account for the role of ecosystem services, considering several studies of rural populations whose well-being depends on the flow of ecosystem services, highlighting the participatory methods these studies employed to identify and assess locally relevant well-being indicators, and addressing some of the challenges inherent in such methods. We conclude with an appraisal of what we regard as the most appropriate methodological approach for measuring human well-being in the socioecological context.     

Vocational Experiences and Quality of Life of Migrants: Overview and Future Research

Quality of life is a complicated concept that has attracted broad attention from multiple disciplines. This article introduces a set of studies that employ diverse approaches to explore how work, vocational, and career experiences shape quality of life among migrants, and proposes a future agenda to extend this stream of research. Specifically, operationalizing quality of life in different ways, research showcased in this special issue has demonstrated how international and intranational migrants achieve, maintain, and enhance their well-being in different life domains. Reflecting on the literature and the showcased studies, this article proposes that future research should advance the current inquiry by better categorizing vocational experiences, uniquely operationalizing of quality of life in migration contexts, taking a more culturally sensitive perspective, and broadening methodological approaches.     

Social indicators of perceived life quality

Modern societies in both developing and developed countries have real and legitimate concerns about the enhancement, maintenance, and redistribution of individual well-being. Indicators of perceived well-being provide direct measures of what societies are trying to achieve, permit cross-sector comparisons, can indicate the adequacy of coverage of ‘objective’ indicators, and can contribute to social policy making. in both the long and short run. Some commentators, however, have suggested perceptual indicators suffer from methodological weaknesses associated with their validity, interpretability, completeness, and utility. Each of these possible weaknesses is addressed in some detail. New research evidence and certain philosophical perspectives are presented, and it is concluded that none of these presumed weaknesses is sufficient to invalidate the development and use of perceptual indicators. Suggestions are made concerning methodological research needed to support the development of indicators of perceived well-being. It is noted that the materials and results developed in the author's research on Americans' perceptions of life quality may be useful for suggesting approaches to the development of indicators of perceived life quality relevant to other cultures.     

A Meta-Analysis of the Relationship Between Spirituality and Quality of Life

The relationship between spirituality and various dimensions of health and quality of life has been extensively examined during the past decade. Though several literature reviews have been conducted in an attempt to synthesize research findings pertaining to the relationship between spirituality and health, a meta-analysis of studies examining spirituality in relation to quality of life has not been identified. The present study was designed to: (a) determine whether there is empirical support for a relationship between spirituality and quality of life, (b) provide an estimate of the strength of this relationship, and (c) examine potential moderating variables affecting this relationship. The research design followed accepted methods for quantitative meta-synthesis. Potential moderating effects of several methodological differences and sample characteristics were examined using meta-analytic approaches with multivariate linear regression and analysis of variance. An extensive multidisciplinary literature search resulted in 3,040 published reports that were manually screened according to pre-established selection criteria. Subsequent to the selection process, 62 primary effect sizes from 51 studies were included in the final analysis. A random effects model of the bivariate correlation between spirituality and quality of life resulted in a moderate effect size (r = 0.34, 95% CI: 0.28–0.40), thereby providing support for the theoretical framework underlying the study wherein spirituality was depicted as a unique concept that stands in relationship to quality of life. Subsequent regression analyses indicated that differences among operational definitions of spirituality and quality of life were associated with the variability in estimates of the magnitude of the relationship (R² = 0.27). Other potential moderators, such as age, gender, ethnicity, religious affiliation and sampling method were examined but the findings pertaining to these variables were inconclusive because of limitations associated with the sample of primary studies. The implications of this study are mostly theoretical in nature and raise questions about the commonly assumed multidimensional conceptualization of quality of life.     

Forging ahead: Linking health and behavior to improve quality of life in older people

This chapter will focus on conceptual and methodological issues related to health promotion/disability prevention for older people. The first section will begin with a discussion of why older people, as compared to younger persons, are not traditionally seen as targets of health promotion efforts. In recent years several national working groups have been established to examine how older people's health and functioning can be improved. Their objectives and recommendations for older Americans will be reviewed. The second section will address the conceptual framework underlying health and behavior research supported by the National Institute on Aging. The movement from correlational studies to studies of basic mechanisms linking health and behaviour will be discussed, with particular attention to interactions with aging processes. Examples of health and behavior research representing these processes will be presented as well as methodological issues in the measurement of health and functional outcomes for older people. Measurement of quality of life in the cognitively impaired is seen as especially difficult. The third section will review several common themes emanating from these research studies. These include attention to a life course perspective, variability in aging processes, alternative research approaches, and intervention strategies for both initiating and maintaining recommended behavioral changes. A fourth section will review current areas of investigation at the National Institute of Aging. Successful intervention strategies in both community and institutional settings will to presented. These include: (1) a comprehensive behavioral and environmental falls prevention program which has been shown to reduce falls in the community; (2) a health education program to increase older women's use of cancer-related health practices; and (3) behavioral strategies for reducing incontinence in nursing homes. A new NIA initiative on special care units for persons with dementia will also be discussed. The fifth and final section will deal with issues involved in the translation of research into policy and practice. Approaches for increasing the relevance of research to policymakers will be discussed.     

The impact of life events and changes in domain satisfactions on well-being

Previous research has shown that QOL measures are reasonably reliable and valid for static analysis. This article is concerned with the validity of the measures for use in panel studies/dynamic analysis. Are they sensitive enough to register changes (i.e., enhanced satisfaction and well-being) of the kind one would expect to follow favourable life events, and also changes (i.e., reduced satisfaction and well-being) due to adverse life events? Also, do changes in satisfaction with specific domains of life produce concomitant changes in the general sense of well-being? These questions are addressed by means of a small panel study (N=184) in which respondents were interviewed first in November 1978 and a second time in January 1981. The questionnaire included a more detailed life events inventory (Dohrenwendet al., 1978) and one which contained a larger number of favourable events than inventories included in previous QOL panel studies (Campbellet al., 1976; Atkinson, 1982). Unlike previous researchers, we found some statistically significant relationships between aggregate life events scores and changes in well-being. Changes in relatively affective measures of well-being were greater than in relatively cognitive measures. We also found strong, predictable relationships between changes in domain satisfactions and changes in the general sense of well-being.     

Estimating Increment-Decrement Life Tables with Multiple Covariates from Panel Data: The Case of Active Life Expectancy*

A fundamental limitation of current multistate life table methodology-evident in recent estimates of active life expectancy for the elderly-is the inability to estimate tables from data on small longitudinal panels in the presence of multiple covariates (such as sex, race, and socioeconomic status). This paper presents an approach to such an estimation based on an isomorphism between the structure of the stochastic model underlying a conventional specification of the increment-decrement life table and that of Markov panel regression models for simple state spaces. We argue that Markov panel regression procedures can be used to provide smoothed or graduated group-specific estimates of transition probabilities that are more stable across short age intervals than those computed directly from sample data. We then join these estimates with increment-decrement life table methods to compute group-specific total, active, and dependent life expectancy estimates. To illustrate the methods, we describe an empirical application to the estimation of such life expectancies specific to sex, race, and education (years of school completed) for a longitudinal panel of elderly persons. We find that education extends both total life expectancy and active life expectancy. Education thus may serve as a powerful social protective mechanism delaying the onset of health problems at older ages.     

The Relationship Between Social Leisure and Life Satisfaction: Causality and Policy Implications

Social leisure is generally found to be positively correlated with life satisfaction in the empirical literature. We ask if this association captures a genuine causal effect by using panel data from the GSOEP. Our identification strategy exploits the change in social leisure brought about by retirement, since the latter is an event after which the time investable in (the outside job) relational life increases. We instrument social leisure with various measures of the age cohort specific probability of retirement. With such approach we document that social leisure has a positive and significant effect on life satisfaction. Our findings shed some light on the age-happiness pattern. Policy implications are also discussed.     

Perceptions of Quality Life in Hamilton’s Neighbourhood Hubs: A Qualitative Analysis

This paper examines perceptions of quality of life in Hamilton, Ontario, Canada from the perspective of residents and key community stakeholders. A series of eight focus groups were conducted. Six sessions were held with residents of neighbourhood ??hubs??, areas characterized by high levels of poverty. The following themes were highlighted as significant to neighbourhood quality of life: (1) housing quality and affordability (2) diversity and cultural integration; (3) crime and safety; (4) community engagement and recreation; (5) green space and the physical environment, and; (6) transportation. Two focus groups were then conducted with key informants who provided recommendations for improving quality of life and discussed relevant policy issues such as employment and income security. The findings of the focus groups resonate with local research and policy action in Hamilton, including a new Neighbourhood Development Strategy for the City. This research advocates for decision-makers to support and work alongside context-based, resident-led community development efforts. The hub model, as well as Hamilton??s broader neighbourhood-based research and community development approach may assist social researchers, civic leaders and various levels of government across Canada as they work to improve quality of life in their communities.     

Spatial weighting improves accuracy in small-area demographic forecasts of urban census tract populations

Existing research in small-area demographic forecasting suffers from two important limitations: (1) a paucity of studies that quantify patterns of error in either total or age/sex-specific estimates and (2) limited methodological innovation aimed specifically at improving the accuracy of such forecasts. This paper attempts to fill, in part, these gaps in existing research by presenting a comparative evaluation of the accuracy of standard and spatially-weighted Hamilton–Perry forecasts for urbanized census tracts within incorporated New Mexico municipalities. These comparative forecasts are constructed for a 10-year horizon (base 1 April 2000 and target 1 April 2010), then compared to the results of the 2010 Census in an ex post facto evaluation. Results are presented for the standard Hamilton–Perry forecasts as well as two sets that incorporate two common variants of spatial weights to improve forecast accuracy. Findings are discussed in the context of what is currently known about error in small-area demographic forecasts and with an eye toward continued innovations.     

Demographic models of birth outcomes and infant mortality: An alternative measurement approach

Most demographic studies use 2,500 grams of birth weight and 37 weeks of gestation as cutpoints for evaluating the effects of adverse birth outcomes on infant mortality. We propose an alternative strategy, which relies on continuous measures of birth outcomes, identifies an optimal combination of birth weight and gestational age for infant survival, and estimates the effects of adverse birth outcomes in terms of their departure from this "optimal point." We illustrate the advantages of this approach by estimating a logistic model using data from the 1989-1991 NCHS linked birth/infant death files. Finally, we discuss future applications and methodological issues to be resolved in subsequent research.     

Modelling change in perceived quality of life (PQOL)

Almost all previous research on PQOL has examined static relationships. This paper, based on two waves of an Australian panel study (N=677), investigates change. We estimate a model in which changes in PQOL are seen as depending directly on changes in satisfaction with particular domains of life (marriage, job, etc.), which in turn are affected by life events occurring within these domains. This model accords with a “bottom-up” rather than a “top-down” theory of PQOL or well-being (Diener, 1984). Chief interest lies in the strong relationships between domain specific events and changes in domain satisfactions. In previous research life events have been directly linked to PQOL, or to physical or mental illness. The different result here arises from estimating a more appropriate model with an additional link (changes in domain satisfactions) in the chain. From a methodological standpoint, the paper suggests that life events inventories can be valuable research instruments and that recent validity criticisms (e.g. Schroeder and Costa, 1984) have been overstated. The second part of the paper deals with relationships between personality traits, social support and life events. We test hypotheses about links between (1) personality and subsequent life events (2) the “buffering” effects of personality and social support on the impact of adverse events (3) the effects of events on personality. Personality traits apparently do affect the subsequent incidence of life events. Extraversion is associated with favourable subsequent events, and neuroticism with adverse events. Internal locus of control apparently wards off adversity. An alternative hypothesis that these relationships are due to biassed reporting (i.e. personality traits are associated with degrees of bias) appears to be false. Contrary to findings from cross-sectional data, our panel results indicate that neither personality traits nor social support “buffer” the impact of adverse events on PQOL. Finally, life events appears to have small but statistically significant effects in modifying adult personality.     

Assessing Spirituality Through Personal Goals: Implications for Research on Religion and Subjective Well-Being

This article is concerned with the conceptual and methodological issues in the measurement of personal goals, with special emphasis on assessing spiritual and religious content in goals. The research literature on personal goals and subjective well-being is reviewed and synthesized. A comparison of several popular goal units in the research literature is included. Goal content and goal conflict have been reliably associated with well-being in past research. Spiritual or religious content in personal goals emerges as having an especially strong influence on well-being, and recent research on spiritual personal strivings and well-being is summarized. One of the primary purposes of the article is to consider conceptual and methodological challenges in the measurement of spirituality through personal goals. The advantages of a combined idiographic-nomothetic approach to measuring spirituality through purposive behavior are enumerated. A personal goals approach to studying spiritual motivation can make an important contribution to understanding how religiosity affects well-being, thus expanding religion's role in quality of life research.     

The Non-Economic Quality of Life on a Sub-National Level in South Africa

Most research on the non-economic quality of life have been (a) on a national level or performed on cross-country comparisons, and/or (b) used subjective indicators to measure how people perceive their non-economic quality of life. In this paper, our main contribution is to construct objective indicators of the non-economic quality of life for 354 sub-national magisterial districts in South Africa. We also compare changes in these indicators over time, and consider methodological issues in the construction of objective indicators of non-economic quality of life. We find that although income does matter for the overall quality of life, non-income components of the quality of life can make an important difference. We find a number of places with low incomes that have been able to achieve higher than expected outcomes in terms of the non-economic quality of life, and that some of the relative income poor areas have improved their non-economic ranking between 1996 and 2004. We also find that the geographical/environmental quality of life in South Africa is better in non-urban areas, where fewer of the country’s population is residing. Significant improvements in the overall quality of life may be achieved through improvements in the urban natural environment.

Developing a Measure of Internet Well-Being: Nomological (Predictive) Validation

This paper reports on an effort to develop an Internet well-being measure for possible use by government agencies and industry associations that are directly involved with the promulgation of the Internet. Such measures can help officials gauge the social health of those Internet-related industries and institutional sectors, which in turn can guide the development of policies to enhance the quality-of-life impact of the Internet. The Internet well-being measure is based on the theoretical notion that the perception of the overall impact of the Internet on users of the Internet is determined by their perceptions of the impact of the Internet in their life domains such as consumer life, work life, leisure life, social life, community life, sensual life, among others. In turn, the perception of impact of the Internet in a given life domain (e.g., consumer life, work life) is determined by perceptions of benefits and costs of the Internet within that domain. We conducted a focus group to identify all the perceived benefits and costs within salient life domains of college students. We also conducted a thorough literature search to identify studies that examined the quality-of-life impact of the Internet in a variety of life domains. We then tested the nomological validity of the measure through two surveys at two major universities (one in the USA and the other in Korea). The statistical analysis allowed us to identify those measurement items that are most predictive, and therefore considered as nomologically valid. Policy implications of the study are discussed along with future research avenues.     

On constructing and implementing an extended goal variable for economic policy

Multidimensional objective concepts, such as ‘quality of working life’ (‘quality of environment’ etc.), have gained increased importance in politico-economic programs, but much less in practical economic policy. Conventionally, ‘hard’ quantities of market-related monetary success, such as national product, predominate. These are supposed to be developing parallel to all other life areas. A condition for becoming relevant to policy-making is that extended objective concepts can be defined exactly, operationalized, and measured. Hence, theoretical, methodological, and empirical work is required. A possible method for devising an index of quality of working life together with some empirical results are presented in this paper. By employing the results, the decision basis of labor market and employment policies could be improved.     

Non-Economic Quality of Life and Population Density in South Africa

The purpose of this study is to investigate the relationship between population density and non-economic quality of life. Popular opinion has generally been that population density can be seen as beneficial for economic growth, as it allows for greater productivity, greater incomes and can be translated into higher levels of quality of life. Recently though, growing evidence tends to suggest the exact opposite in that increases in productivity and incomes are not translated into better quality of life. As economic or income variables have always played a significant role in this research, questions regarding the relationship between population density and non-economic quality of life has largely remained unanswered. In this light, the paper utilises a panel data set on the eight metropolitan cities in South Africa for the period 1996–2014 to determine the relationship between population density and non-economic quality of life in the South African context. In the analyses we make use of panel estimation techniques which allows us to compare changes in this relationship over time as well as adding a spatial dimension to the results. This paper contributes to the literature by firstly studying the aforementioned relationship over time and secondly conducting the analyses at a sub-national level in a developing country. Our results show that there is a significant and negative relationship between population density and non-economic quality of life. Based on our findings policy measures to encourage urbanisation should not be supported if the ultimate outcome is to increase non-economic quality of life.     

The Link Between Political Participation and Life Satisfaction: A Three Wave Causal Analysis of the German SOEP Household Panel

Is there a relationship between political participation and individual life satisfaction? The idea that political participation makes people more satisfied with their lives has long been debated. However, the existing empirical research has not been very successful in demonstrating that such a relationship exists while some studies show that instead it is individual life satisfaction that impacts political participation. This paper aims to shed some light on the issue of causality between political participation and individual life satisfaction. Unlike former studies, we resort to panel data and apply a three wave model which allows us great flexibility to test several hypotheses. Also unlike previous studies, after correcting for measurement error, our analysis shows no compelling evidence of a causal relationship between political participation and life satisfaction.     

Analyzing Accessibility Dimension of Urban Quality of Life: Where Urban Designers Face Duality Between Subjective and Objective Reading of Place

The subject of urban quality of life and the promotion of its concept in particular, has always been the central focus of urban designers. This term is a multi-conceptual and dimensions. However most of the scholars have agreed that the concept consisted from two main dimensions; objective and subjective which these two approaches are used for its measuring. One of the important goals of urban designers is to create urban environment that all citizens have easy access to urban services, as accessibility reflects the quality of an urban environment. The present research intends to measure the public space accessibility by using objective approach in first and then by using the subjective approach for measuring in the study area to compare the results. The results revealed that there are considerable differences between objective and subjective measuring of urban quality of life in a urban space, therefore urban designers can not rely only on the results of objective measuring to understand such spaces for planning, if so, their attitudes towards urban spaces could not be an appropriate guide for explaining the quality of life for urban residents.