Happy Living in Darkness! Indoor Lighting in Relation to Activities of Daily Living,Visual and General Health in 75-Year-Olds Living at Home

ABSTRACT

Lighting has been identified as a significant environmental attribute for promoting vision and general health among older people, enabling successful aging at home, but it has received little attention in the literature. Indoor lighting levels, self-reported vision and general health, and activities of daily life were measured in 114 healthy 75-year-old Norwegians. Despite very low levels of indoor lighting, the subjects were happy and healthy. There is a large discrepancy between self-assessed health and recommended lighting levels, and low awareness of the effect of lighting on age-related vision loss or daily living in the future. Knowledge of how to utilize indoor lighting to ensure healthy and safe aging in the home is needed.     

Impairments and perceived competence in persons living with HIV/AIDS

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.     

Lighting Effects on Older Adults’ Visual and Nonvisual Performance: A Systematic Review

Lighting plays an important role in daily life: It helps people perform daily activities independently and safely, and also benefits their health. This study assesses the research evidence of lighting’s impacts on older adults in four domains: (a) performance of activities of daily living and instrumental activities of daily living; (b) circadian rhythm; (c) fall prevention and postural stability; and (d) sleep quality. A comprehensive review of lighting studies on older adults’ visual and nonvisual performance was conducted using a modified PRISMA systematic review process. For the first domain, some older adults had difficulty in using the toilet, preparing meals, and doing laundry under lower illuminance. For the second domain, brighter and bluish lighting improved older adults’ circadian rhythm. For the third domain, low-intensity LED lighting affixed on door frames can help older adults maintain postural stability and prevent falling during nighttime movement. Finally, some studies concluded that receiving outdoor daylight during exercise was beneficial to older adults’ sleep quality. This study provides several methodological, theoretical, and collaborative suggestions for developing a more conclusive evidence base for lighting standards and strategies for older adults.     

Relations between Status and Power Structures: Toward a General Theory*

Contemporary work on the development of status and power structures is reviewed. It is shown that theorists have conceptualized the relationship between these structures in opposite ways. Some have held that the structures tend toward alignment. Specifically, they have held that persons tend to be equally high or low in both structures. Others have held that the structures tend toward non-alignment. Specifically, they have held that the range of persons statuses tends to be greater than the range of their power. An attempt is made to reconcile the different theories underlying these two conceptions by postulating that one conception is correct under certain conditions and that the other is correct under other conditions. The conditions specified involve an important but somewhat neglected aspect of the overall stratification structure, what is called the secondary stratification structure, and the importance persons assign to this structure.     

Personal Responses to Traumatic Brain Injury: A Qualitative Study

This paper reports the findings of a qualitative study of ten persons with traumatic brain injury (TBI) based upon a series of in-depth interviews conducted over a period of 12 months. Data was analysed with procedures similar to those utilised by grounded theory and ethnographic researchers, and resulted in a typology that reflected different experiences of living with TBI as well as different meanings it had for persons with TBI. A thematic analysis of the data yielded information about self, disability and handicap, and involvement in social networks; and, reflected the participants' sense of personal well-being. This analysis provided an alternative to the data yielded by traditional quantitative research designs.     

The fertility of migrants before and after crossing the border: the ethnic German population from the former Soviet Union as a case study

Empirical data on persons of German ethnic origin migrating to Germany from the former Soviet Union are used to calculate their relative ferility levels before and after arriving in their new host country. Despite small numbers in the survey , a suitable method was used to effecitvely compare fertility before and after crossing the border with an index measure of national fertility rates. A relatively strong fertility decline was observed for German origin migrants ( Aussiedler ) from the former Soviet Union during their first years in Germany.
More interesting, we consider, is how and to what extent the change in living conditions affected reproductive behaviour after arrival in Germany.
Surprisingly, the fertility of this former high-fertility population fell to a level much lower than the already low German fertility. The extraordinarily high fertility levels of certain religious groups within the former Soviet Union fell even more rapidly after arrival in their new home country.
The results of the study may shed light on another development in Germany: that immediately after reunification the total fertility rate in the former GDR fell to the extremely low level of about 0.6 in 1993 and 1994. The experience of the former East German population is therefore similar to that of German-origin migrants from the former Soviet Union.     

Differential labeling of mental illness by social status: a new look at an old problem

Whether the higher rates of mental hospitalization and involuntary treatment for marginal social groups are due to differential labeling or simply to the occurrence of higher rates of disorder in these groups remains unresolved. I reexamine this issue with data from the National Comorbidity Survey (N = 5,877) that allow comparisons between disturbed individuals living in the community untreated and disturbed persons who have been hospitalized or seen a professional for their mental health problems under pressure or voluntarily. Contrary to labeling theory, members of lower status groups are not consistently overrepresented among those who have been hospitalized or seen a professional against their will. Consistent with self-labeling theory, persons with greater education and those not in poverty are disproportionately present among individuals who sought treatment by choice. Additional analyses show that factors that predict service utilization are important determinants of mental health service use but do not account systematically for status disparities in hospital or outpatient treatment, especially disparities by poverty status. Although I do not confirm a central tenet of labeling theory here, the negative consequences of labeling and stigma continue to be well-supported in the literature.     

Mobility,education and life trajectories: new and old migratory pathways

Travel for educational purposes, once the privilege of the upper class, has become a global mass phenomenon in recent years. This special issue examines, within different cultural and historical contexts, the close relationship between migration, education and social mobility. Adopting the perspective that education includes a broad range of formative experiences, the articles explore different educational trajectories and the local, regional and transnational relations in which they are embedded. Three key issues emerge from the analyses: firstly, the central role of temporality in terms of both the overall historical conditions and the specific biographical circumstances shaping educational opportunities; secondly, the complex agendas informing individuals’ migration and the adjustment of these agendas in the light of the vagaries of migrant life; and thirdly, the importance of migrants’ self-perception as ‘educated persons’ and the invention of new, and the maintaining of old, identities that this involves.     

Transport-related social exclusion amongst older people in rural Southwest England and Wales

Rural dwelling and older age are both associated with a higher risk of social exclusion, with accessibility identified as having an important facilitating role. The interactions between transport-related exclusion and older age, particularly in a rural context, are considered though analysis of quantitative and qualitative data collected from over 900 older persons living in rural areas of Southwest England and Wales. Although few respondents reported feeling excluded within their communities, more reported difficulties in accessing specific necessary and discretionary activities, including specialist hospitals and cinemas. Analysis revealed that car availability is not a strong indicator of overall inclusion, although non-availability was important in limiting access to particular types of location. It is concluded that the relatively short travel distances required to access community activities was a key factor in the high levels of community inclusion. However, the car-dependent nature of travel overall means that there is a rising risk of mobility-related exclusion in rural areas, particularly amongst the oldest old. Greater consideration needs to be given to more formalised lift-giving as a transport solution, along with greater attention to mobility needs by sector-specific service providers, such as the health sector.     

Measuring Differences in Living Standards Within Households

This article presents a quantitative approach used to investigate differences in living standards between spouses within households. Adopting a specially adapted, standard poverty measurement approach—nonmonetary indicators—it explores differences between spouses in terms of possessions and access to certain goods and services and the control and management of household resources. Using data from a unique module in the Living in Ireland Survey (N = 2,248 individuals) as an exemplar, the article focuses on 3 methodological issues: (a) the development of specially designed nonmonetary indicators to explore differences in living standards within households rather than between households (including the role played by qualitative findings in developing those indicators and how focus groups were used to assess and validate the method), (b) the use of multivariate analysis to assess the impact of a wife's independent income in ameliorating differences in living standards between spouses, and (c) the deployment of a mechanism for use in quantitative surveys to record spousal presence and allow measurement of any subsequent difference in individual responses.     

Chapter 5 Impacts of Profit Status of Assisted Living Facilities

Abstract

Florida is a bellwether state in terms of the need for assisted living among elderly persons and has more than 2,000 of the nation's estimated 11,459 assisted living facilities (ALFs). The authors of this article surveyed 140 ALFs in Florida in order to examine the relationship of profit status to ownership of other facilities, willingness to serve low income groups, formal policies, and persons involved in decisions about resident retention. Significant differences were found between for-profit and non-profit facilities in terms of ownership of nursing homes and resident involvement in retention decisions. A discussion of how the profit motive and formal policies can impact residents concludes the article.     

Social Integration and Mental Well-Being Among Jail Inmates

Although social integration has consistently been linked to mental well-being among the general population, this relationship has not been explored for persons confined in total institutions. Jails, in particular, represent unique conditions that have the potential to alter the traditional relationship between social ties and mental health. Although previously unexamined, social ties maintained by jail inmates outside and inside of the institution are commonly presumed to weaken some of the adverse effects of a stressful environment and positively influence mental health. The current study explores the impact of social integration on mental well-being among 198 male and female inmates incarcerated in a large county jail. The impact of marital status, parental status, and social support (both inside and outside of the jail) on various dimensions of mental health was examined. The results indicate that rather than promoting mental well-being, social relationships inside and outside of the institution are associated with higher levels of distress. Specifically, married inmates report higher levels of depression and anxiety, and inmates with close social relationships inside of the jail report higher levels of hostility, although gender differences in these patterns are evident. The results of this study suggest that social integration may play a different role for persons incarcerated in total institutions than among the general population due to the unique conditions of social stigmatization and separation from support networks.     

Meanings of place and displacement in three groups of older immigrants

Using a theoretical framework that encompasses concepts of space and place, this research addresses meanings of place to three groups of older immigrants living in an inner city. This qualitative research is based on multiple interviews with 211 persons over the age of 50 in three ethnic groups: Latinos, Filipino Americans, and Cambodian Americans. Living conditions were found to be complex and difficult for most respondents, yet living arrangements were also sources of intergenerational family support and long-term, intimate friendships. An examination of meanings of place illustrates how seemingly disparate topics such as social relationships, memory, displacement, the reworking of identity, and the presence of identity politics are interwoven in the lives of these elders, and how people work to ameliorate their sense of displacement while living in problematic living conditions in old age.     

The Social Stratification of Older Adults' Preparations for End-of-Life Health Care

I use data from the Wisconsin Longitudinal Study (n = 4,971) to evaluate the extent to which socioeconomic status affects three health-related (living will, durable power of attorney for health care, and discussions) and one financial (will) component of end-of-life planning. Net worth is positively associated with all four types of planning, after demographic, health, and psychological characteristics are controlled. Low rates of health-related planning among persons with low or negative assets are largely accounted for by the fact that they are less likely to execute a will, an action that triggers health-related preparations. Rates of health-related planning alone are higher among recently hospitalized persons, whereas financial planning only is more commonly done by homeowners and those with richer assets. The results suggest that economically advantaged persons engage in end-of-life planning as a two-pronged strategy entailing financial and health-related preparations. Implications for health policy, practice, and theory are discussed.     

CONVICTED MURDERERS' ACCOUNTS OF THEIR CRIMES: A STUDY OF HOMICIDE IN SMALL COMMUNITIES

In-depth interviews were conducted with a sample of 25 persons recently convicted of homicide in a largely rural, midwestern state. The primary focus of the study was the definition of the situation, particularly the vocabulary of motives, employed by the respondents at the time of their crime. The results showed that the vast majority of the respondents cited motives involving excuses (e.g., it was an accident, judgment impaired by alcohol/drugs, not oneself because of severe stress). These excuses assumed, or appealed to, conventional moral views of violence. Six of the individuals provided motives that they felt justified their actions. However, these justifications tended to be based upon a plea of self-defense and demonstrated a commitment to conventional morality rather than to the norms of a violent subculture. There was no evidence that the respondents viewed their behavior as part of a character contest. In most instances, they were unemployed or underemployed persons, living rather dead-end lives, who in the course of mounting life stress struck out at someone, usually while intoxicated. Frequently they were depressed, and in some cases suicidal, at the time of the act, and the victim was usually a relative or friend. In half of the cases it appeared that the homicide would not have taken place if a handgun has not been present.     

The relationship between the community participation of disabled youth and socioeconomic factors: mixed-methods approach in rural Sri Lanka

Mixed methods were applied to examine the association of community participation by disabled youth with socioeconomic factors in rural Sri Lanka. There was a significant association between community participation and socioeconomic factors in the quantitative survey (n = 116): participants living in socioeconomically disadvantaged conditions had lower levels of community participation than those living without these disadvantages. Consistent with the findings of the survey, previous educational experiences, household economic conditions, and perceived resource information were common themes in the qualitative study (n = 26). The dynamics of these factors, including marginalisation of disabled youth within the household, were also observed.     

The influence of the tasks characteristics in physical performance and psychosocial aspects of workers

The work and life conditions have influence on the health and life quality of workers. Physically active persons can demonstrate a life style that are and affect the physical performance, psychosocial aspects and work capacity. The purpose of this study was to investigate the physical activity level and work capacity in different tasks characteristics, one with more physical exertion and other with more cognitive exertion. A total of 193 workers from an institution of higher education and 457 workers from a metallurgical industry participated in the current study. All participants completed the International Physical Activity Questionnaire (IPAQ-short) and Work Ability Index (WAI). The results indicated that both groups were classified as having high level of physical activity while only few of them were considered sedentary (less than 27%). However, the group of metallurgical workers had greater indices (82%) than the workers from higher education institution (74%). Overall, the workers reported their work ability as moderate to excellent, suggesting that overall they are satisfied with their working and health conditions. It can be concluded that even though workers performed tasks with different demands (cognitive versus physical), they demonstrated similar level of physical activity as well as work ability.     

HIV/AIDS and return to work: a literature review one-decade post-introduction of combination therapy (HAART)

It has been a little over one decade since the introduction of the first protease inhibitor that ushered in new era of treatment for persons living with human immunodeficiency virus (HIV) and Acquired Immune-Deficiency Syndrome (AIDS). As of the end of 2003, an estimated 37.8 million people worldwide were infected with the HIV. It is estimated that there are 850,000-950,000 persons in the United States living with human immunodeficiency virus (HIV) and that the incident rate is new cases each year. Since AIDS affects so many people of working age in the US, issues of employment, work rehabilitation and AIDS in the workplace have all become major concerns. The paper presents a review of the literature published during a ten year period that is relevant to understanding the various needs and barriers related to work as well as services designed to address them.     

Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

Peer assistance for personal assistance: analysis of online discussions about personal assistance from a Swedish web forum for disabled people

This paper describes and analyses a community of disabled people in Sweden that use an online forum to discuss personal assistance issues. The forum is a community of practice (CoP) that has its roots in everyday living with personal assistance. The contributions to the forum were studied over a 4½ year period, including a total of 2755 postings from 146 persons. The levels of the CoP learning system were analysed using the FACE tool, which examines function based on attitude, control and enabling. The results indicate that a learning system was established within the CoP that made it possible for disabled people to complement, confront and counterbalance the influences of existing learning systems, theories and methods of professionals in the area of personal assistance.