Dissertations / Theses on the topic 'Educations of the elderly and adults'

O presente trabalho tem como intenção averiguar como as experiências e aprendizagens pedagógicas desenvolvidas no Grupo Revivendo a Vida se relacionam no cotidiano dos adultos maduros e idosos que dele fazem parte. Como a construção de novos conhecimentos, a ressignificação dos saberes escolares, a manutenção e a ampliação das possibilidades cognitivas dos estudantes adultos maduros e idosos influenciam as atividades da vida diária desses sujeitos? Ainda nesse sentido, esta pesquisa almeja construir novos conhecimentos e refletir sobre as questões da aprendizagem escolar para as pessoas adultas maduras e idosas. Para tanto, foi realizada uma Pesquisa Participante ao longo do ano de 2010, com estudantes alfabetizados. Foram considerados nessa análise, a observação participante, os dados presentes na ficha de inscrição no grupo e um questionário que tencionou coletar algumas informações acerca das relações com o próprio processo de aprendizagem. Com relação aos respondentes, foram escolhidos os cinco (5) estudantes mais velhos para participarem de uma entrevista semiestruturada. A partir das entrevistas realizadas e, também, com base nas observações e na análise documental foi possível traçar algumas considerações acerca da indagação que deu origem a essa pesquisa. A partir da análise, as reflexões construídas foram agregadas em quatro temas centrais: a memória, a convivência, a imagem positiva de si mesmo e a capacidade de se manter atualizado. Entre outros achados, foi possível perceber que frequentar o ambiente acadêmico pode ressignificar as aprendizagens escolares e, ao mesmo tempo, permitir que se experimente o lugar de estudante anunciando que é possível viver a velhice de uma forma bem sucedida e feliz.
This research aims to investigate how both the educational and learning experiences, which have developed on the group Revivendo a Vida correlate in the daily lives of mature adults and elderly people. The question is how the new knowledge, the resignification of school knowledge, the maintenance and expansion of mature adults and elderly students' cognitive possibilities influence the daily activities of such subjects. Also in this sense, this research aims to build new knowledge and reflect on the issues of school learning for mature adults and elderly people. In order to achieve that, a Participant Survey was carried out throughout 2010, with literate students. For this analysis it was taken onto account the participant observation, the data present in the registration forms of the Group and a questionnaire intended to collect some information related to the associations with the learning process itself. Regarding the respondents, five (5) older students were chosen to take part into a semi-structured interview. Upon the conducted interviews and, also, based on the comments and on the documental analysis it was possible to draw some considerations about the question which has given rise to this search. From the analysis, the reflections built were grouped into four central themes: the memory, the coexistence, the positive image of oneself and the ability to keep oneself updated. Among other findings, it was possible to realize that participating on the academic environment can bring new meaning to the school learning and, at the same time, enable the experience of being on the student's place announcing that it is possible to live the old age successfully and happy.

Low-income older adults are at high risk for developing diet-related chronic diseases. Nutrition education programs can improve dietary and lifestyle practices, thereby decreasing the incidence of diet-related diseases. Focus groups were conducted to gain insight into the needs and preferences of low-income older adults for nutrition education. Results were made available for use in the Smart Choices Nutrition Education Program at Virginia Tech to aid in the development of nutrition education programs.

Four focus groups were conducted with a total of 35 elderly (28 females; 7 males), ages 55-90+ years, recruited from Congregate Meal Program sites in four regions of Virginia. Seventeen were African American, and 18 were non-Hispanic white. Discussion questions addressed practices for purchasing and preparing foods, importance of food to health, and preferences for education methods. The Determine Your Nutritional Health Checklist of the Nutrition Screening Initiative was used to assess nutritional risk of the elderly adults. Focus group discussions were audio-taped and written transcripts were made for use in data analysis. Themes of the discussions were identified in that analysis and reported in the following broad areas: Factors that Influenced Dietary Practices of Focus Group Participants and Perceived Needs and Preferences of Focus Group Participants for Nutrition Education.

All elderly believed that food was important to their health and were interested in nutrition education. The predominant theme was the influence of a health condition on dietary practices. The elderly made food choices according to dietary restrictions imposed by their health condition. The most prevalent health conditions were chronic diseases, primarily hypertension, diabetes, and hiatal hernia. The majority (32) were at nutritional risk, with a larger number at high risk (20) than at moderate risk (12). Food preferences and sensory attributes of food also were important to them when making food choices. Some reported that convenience was important because they did not want to spend time and effort to purchase and prepare foods. Some also reported experiencing food insecurity, primarily from lack of money. The majority learned about food and cooking from family members, and only a few learned about nutrition and food choices from health professionals. Most wanted information about disease-specific food choices and preparation methods, and preferred to receive this information during group discussions because sharing ideas and opinions was an effective way to learn. Only a few were interested in television programs, while many were interested in written materials. Nutrition education programs for low-income elderly should teach these adults how to choose and prepare foods that are appealing and nutritious, as well as within dietary restrictions imposed by their health conditions. Educators should convey this information to them in group settings and distribute written materials, such as pamphlets and brochures, that outline "how-to" information.
Master of Science

Dementia is a serious public health concern in the United States, with a prevalence of 5.2 million. There is currently no effective way to prevent or cure dementia, and the precise etiology is unknown, but it appears there are multiple risk factors. Prediabetes (PD) has been identified as a risk factor although the scientific evidence is conflicting. This study is important to those at high risk for dementia and to healthcare professionals who lack substantiated dementia prevention strategies. The purpose of this case control study was to determine whether PD is associated with dementia in adults aged 65-95 years and whether the association varies according to demographic (age, gender, race, and socioeconomic status [SES]) and health (atherosclerosis, body weight, cerebrovascular disease, dyslipidemia, hypertension, and stroke) risk factors. The ecosocial theory was selected to bridge the study findings to life-course exposures and risk factors. Cases (n = 574) and controls (n = 2,157) were sampled from a large ambulatory care dataset, and multivariable logistic regression was used to test the research hypotheses. No unadjusted association between PD and dementia was found (OR 1.08, 95% CI = .854, 1.241, p = .604). The regression analysis revealed no association between PD and dementia; however, atherosclerosis, hypertension, low body weight, and low/average SES were found to be significantly and independently associated with dementia. A stratified analysis revealed that race and SES did not alter the effect of PD on dementia. The implications for positive social change include the potential reduction of incident dementia through initiatives targeted toward demographic and health risk factors including atherosclerosis, hypertension, low body weight, and low/average SES.

As the baby boomer generation continues growing older, the geriatric community, and their needs grow larger. Many of those needs will necessitate the assistance of social workers’ knowledgeable of geriatrics. Research suggests that many social workers have negative attitudes toward older adults and show little interest in working with the population. The research question of this study was, does social workers’ personal, educational, and professional experience in geriatrics influence their knowledge on aging, and attitudes toward older adults? The researcher hypothesized that social workers with more experience have more knowledge on aging and view older adults more positively. Quantitative and Qualitative data was collected through the administration of a survey created through the online platform Qualtrics. Study participants consisted of 33 social workers located in the state of California. The data was analyzed using univariate and bivariate tests such as frequency, percentage, Pearson r correlation coefficient, and One-Way ANOVA, through the JMP data analysis software program. Additionally, the researcher read over study participants written responses in order to identify themes that emerged. Significant findings were found that supported the hypothesis. A significant relationship was found between social workers’ professional experience (number of years of job experience caring for an older adult), and their knowledge on aging (Facts on Aging II score). Also, the effect of study participants reported education level on their attitudes toward older adults, and knowledge on aging were also significant. Finally, nearly half of study participants reported some degree of interest in working with older adults, while the other half were either impartial or uninterested. The themes identified by the researcher, identified in participants written explanation of their level of interest in working with older adults, suggests that social workers’ interest in working with older adults is influenced by the degree to which they perceive the work as important, enjoyable, and fulfilling their professional goals. The results and findings of this study could contribute to the body of research focused on identifying what influences social workers’ interest for working in geriatrics.

This study determined the number of self-directed learning projects undertaken by older adults and examined the motivational factors and anticipated benefits related to the learning activities. In addition, obstacles to conducting self-directed learning were identified by the respondents. A list of 20,032 names of adults, aged 50 or more years and residing in Tom Green County, Texas, was obtained from voter registration rolls and the residential rolls of four retirement complexes. Four hundred names were randomly selected to serve as the sample of the study. Of the 400 potential subjects, 120 persons agreed to be interviewed. Indepth interviews were conducted using the questions from Tough's Interview Schedule for Studying Some Basic Characteristics of Learning Projects and a probe sheet to identify obstacles to conducting self-directed learning projects. The interviews focused on the learning activities of older adults during the previous year. The 120 subjects of this study conducted a total of 239 learning projects in the previous year, an average of 1.99 self-directed learning projects per person. Ninety-five (95%) percent of the persons interviewed reported to have conducted at least one learning project in the past year. The majority of the learning projects were self-planned for the purpose of self-enjoyment and self-fulfillment. The most frequent obstacles to conducting self-directed learning projects identified by the subjects included: 1) finding the time for the learning activity; 2) the cost of the learning activity; 3) home responsibilities; 4) difficulty deciding what knowledge or skill to learn; 5) difficulty remembering new material or information; and 6) poor health. Comparisons of the results of this study were made with the results of previous studies by Tough, Hiemstra, and Ralston. The data support the belief that books, pamphlets, and newspapers are the primary source of information for the older adult. The results of this study indicate that older adults value self-directed learning as a major source of self~fulfillment in their lives and are motivated to develop new knowledge and skills through self-planned, self-directed learning projects.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
This research investigates the process of learning to read and write of the elderly segment. It presumes that the introduction in the world of the reading and the writing it can propitiate, even belatedly, the social inclusion and a transformation in personal life. In that sense, a study was accomplished on the analphabetism in our country acked into a theoretical framework, adopting the view of man as na unfinished and ongoing process of construction, process that can progress social, historical and temporality. To give concreteness the these objectives the option it was for the qualitative approach. They are subject of this study, enrolled students in the Education of Youths and Adults of an Organization No Government (ONG) - a religious institution - and also students of institutions that assist to the elderly segment. They were applied forty questionnaires, through which it was possible to infer that those students look for to rescue the possibility of they be included and accepted socially, as well as conviviality with their pairs.
A presente pesquisa investiga o aprender a ler e a escrever do segmento idoso partindo do pressuposto de que a introdução no mundo da leitura e da escrita pode propiciar-lhe, mesmo que tardiamente, a inclusão social e uma transformação na sua vida pessoal. Nesse sentido, foi realizado um estudo sobre o analfabetismo no nosso país amparado em um referencial teórico específico, adotando a visão de homem como um ser inconcluso e em constante processo de construção que pode progredir social, histórica e temporalmente. Para dar concretude a esses objetivos a opção foi pela abordagem qualitativa. São sujeitos deste estudo, alunos matriculados na Educação de Jovens e Adultos de uma Organização Não Governamental (ONG) uma instituição religiosa e também alunos de instituições que atendem ao segmento idoso. Foram aplicados quarenta questionários, por meio dos quais foi possível inferir que esses alunos buscam resgatar a possibilidade de serem incluídos e aceitos socialmente, bem como convívio com os seus pares.

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and the behavioral model of health services use and the socioecological model were chosen as the study’s theoretical foundations. Analyses were conducted using binary logistic regression. Controlling for confounding variables of education and region of residence, the key findings were that adults ≥ 65 years had higher odds of incurring higher expenditures overall. White patients had higher odds of incurring higher expenditures for medication (OR 1.251), office-based visits (OR 1.433), inpatient visits (OR 1.245), and outpatient visits (OR 1.451) when compared to other races. Older adults with HIV had higher expenditures for medication and home health (OR 1.850); and older adults with cardiovascular disease had higher outpatient (OR 1.235), inpatient (OR 2.142), and emergency room expenditures (OR 1.063). These findings might promote social change because assessing the influences of cost disparities on infectious and chronic diseases can help address variations in health care costs and can initiate the development of tailored evidence-based practice guidelines that can help older adults.

Vaccination is regarded by many as the most effective means of reducing influenza infection and disease; however, many people in the United States are hospitalized from flu-related illness each year. Adults 65 years and older account for more than half of these hospitalizations and almost all flu-related deaths. This project aimed to identify barriers to receiving the influenza vaccine among the adult population (> 65 years of age) in a community setting. The goal was to develop a teaching tool that would assist practitioners towards improving influenza vaccination rates among this population. The Health Belief Model was the theoretical framework utilized. The project was conducted at a primary care practice located in a community outside of New York City. Fifty participants (> 65 years) with no prior influenza vaccination were invited to take part in a short survey involving immunization status and reason for lack of influenza vaccination. Participants completed a researcher designed survey in a private location within the practice setting. Descriptive analysis was completed. Results revealed that 45 (32 females and 13 males) participants refused the influenza vaccine based on fear of becoming infected with the flu from the vaccine itself. The remaining 5 (males) participants based their refusal on never having the flu and therefore deemed the vaccine unnecessary. An educational handout was developed to aid in patient education related to influenza vaccination. Future implications involve the utilization of this tool by all healthcare worker and providers, as well as educating the target population in all community settings where influenza vaccines are administered, ultimately reducing the incidences of influenza and its associated complications by overcoming barriers to vaccination.

OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities. METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission. RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure. CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.

This qualitative study uses interviews to examine factors explaining why 20 elderly individuals from a variety of occupations and still living in the community independently did or did not exercise. Within the limits of this qualitative study, the reasons elderly participants gave for avoiding exercise included fear of injury, joint pain, poor health, complications from various degenerative diseases, and a lack of enjoyment of exercise. The reasons for exercising included necessity due to post-heart attack motivation, work-site exercise program or equipment availability, opportunity to habituate work-related tasks, spouse support, history of exercise experience, ability to exercise without injury, enjoyment of family outings, and an appreciation of the enjoyment of exercise.
Ph.D.
Curriculum and Instruction
Education
Curriculum and Instruction

Thesis (Ph. D.)--Ohio State University, 2004.
Title from first page of PDF file. Document formatted into pages; contains xi, 163 p.; also includes graphics. Includes bibliographical references (p. 150-163).

Global populations are aging and by the turn of the century elderly populations will have increased significantly. The United Nations predicts that by the year 2025 the elderly will constitute 25 percent of the global population (UN Chronicle, 1988). Specifically, the global population of people over 60 years of age was 380 million in 1980, is expected to rise to 610 million in the year 2000 and will reach an alarming billion plus by 2025 (UN chronicle, 1988). The UN Chronicle anticipates faster increases in the 80 plus age group with 34 million in 1980, 58 million in 2000 and 114 million in the year 2025. The Canadian population is not excluded in the United Nations predictions. Canadians are also growing older and grayer. The "graying of Canada" is a phrase frequently coined by the media, in the latter years of the past decade. It is predicted that by the year 2025 approximately one in five Canadians will be over the age of 65 (Cooper, 1989). Senior citizens, in Canada, are now being subcategorized into the "young-old", the "old-old", the "well-ederly" and the "frail-elderly" (Cooper, 1989, p.114). The new era of Canadian seniors boasts a philosophy of living longer and dying younger (at heart). The UN Chronicle suggest that the trend towards aging could significanlty affect a society's development potential, particularly if dependency rates among the elderly are high. Eight percent of older Canadians reside in long term care institutions compared with five percent of older Americans (Tamarkin, 1988). This may suggest that Canadian dependency rates among the elderly population is higher than the United States of America or it may reflect the availability of programs specific to the elderly in Canada. Provincial governments within Canada are attempting to decrease dependency rates among the elderly by intitiating health care programs which will promote individual independence. Present day long term care facilities encourage independence among the elderly, replacing the once predominant philosophy of promoting individual dependency. This theoretical framework attempts to decrease dependency rates within long term care institutions while promoting personal independence, decision making autonomy and lifestyle flexibility. The promotion of the above named concepts assumes that the institutionalized adult's quality of life is enhanced and maintained. The provincial government of Alberta, specifically the Department of Health or Alberta Health, has in the last decade researched and implemented program changes in long term care facilities. These initiatives have had a significant impact on the delivery of care, services and programs provided to the instiutionalized elderly of Alberta. Policy and program changes introduced at the nursing home level have greatly improved and enhanced the resources and quality of existing health care services provided to the institutionalized elderly. In 1985 the revised Nursing Home Act of Alberta was introduced. This document governs all nursing homes or long term care facilities within the province. Professional staff was increased in these facilities to better meet the demands of an aging instiutionalized elderly population. The previous Nursing Home Act had established minimum standards of care and services to be delivered to the elderly but the revised 1985 Nursing Home Act further developed these standards in an effort to increase or maintain the individual's quality of life within an institution and to further promote independence amont the institutionalized elderly. Alberta Health then introduced, in 1987, a classification system for all nursing homes. The ultimate goal of the classification system is to fund facilities in a more equitable manner taking into account individual facility care requirements. For example, a nursing home with heavy or intense care requirements will be funded at a higher rate compared with facilities which have light or minimal care requirements. The classification system determines staffing patterns for the nursing department within long term care facilities. For facilities with above average care requirements the non-professional nursing staff was increased. The professional nursing staff ratio was increased from 17 percent to 22 percent. Professional and non-professional nursing staff was not decreased in any facility. The provincial Department of Health has made a concerted effort to improve the quality of life for elderly individuals residing within Alberta institutions. Medicine Hat, a southeastern Alberta community, has a total population of 42,290 (Census Summary Part3, 1988). The Census Summary (1988) explains that 14 percent of Medicine Hat's total population consists of adults over the age of 65 years. This is much higher than the provincial percentage of 8.2 percent. The Medicine Hat News (1990) reported that in the early months of 1990, 6,000 of the city's residents were 65 years of age and older but that number will soar to 7,200 by the year 2000 with half of these individuals 75 years of age and older. As the past Director of Nursing in a nursing home in Medicine Hat, I am most concerned with meeting the needs of the institutionalized elderly. The revised Alberta Nursing Home Act of 1985 and classification systme of 1987 have created the resources within a nursing home to realistically meet the complex and varying health care needs of older individuals. According to Maslow's (1970) theory of human motivation a hierarchy of human needs exists. The beginning point or basis for motivation theory is the meeting of human physiological needs such as food, clothing and shelter. Maslow's hierarchy of needs then continues with the human need for safety, love and belonging, esteem and lastly, the need for self-actualization. Individual learning experiences promote and meet one's esteem needs. However, Maslow proposed that esteem needs cannot be met unless those needs below it on the hierarchy scale are initially met and maintained. Nursing homes do meet the basic survival or physiological needs of their residents. These individuals are fed, clother and sheltered. Safety needs of the instiutionalized elderly are met by the institution in terms of 'security, structure, order and protection" (Maslow, 1970, p. 39). The institutional setting may not adequately meet the individual's need for love and belonging. This can be attempted, collectively, on a group basis but individual loneliness may prevail. It is hoped that these needs can be met with the assistance of the individuals' family or friends. If love and belonging needs are adequately fulfilled then Maslow acknowledges that esteem needs may be attained. Esteem needs include the desire "for self-respect or self-esteem and for the esteem of others" (Maslow, 1970, p. 45). The long term care facility may attempt to meet an individuals' esteem needs by providing learning opportunities which will promote "individual recognition, achievement, mastery, competence, confidence, independence, status, importance, appreciation and dignity" (p. 45). The meeting of an individual's esteem needs may or may not lead one to strive for self-actualization which, according to Maslow is the epitome of being. The need for interdependence is perhaps a higher need than self-actualization. The need for interdependence suggest that each individual or groups of individuals must rely on the other for their co-existence. Interdependence is crucial within long term care settings as residents, their familiees and/or significant others and the institution strive for an environment of mutuality. Historically, the physical, social, spiritual and mental well being of the institutionalized elderly was a goal most long term care facilities strived for. This conceptual framework surmises that learning needs are a part of the individual's mental and social needs. Nursing homes contain several departments which address specific needs of the resident. For instance, the nursing, dietary, phsiotherapy and occupational therapy departments ensure that the physical needs of the institutionalized elderly are assessed and addressed by the recreational department within a long term care facility. In Medicine Hat, community senior citizen centers as well as the local college have provided learning opportunities for older adults who reside in a community setting. However, long term care facilities have not truly addressed the issue of providing learning sessions for the lucid institutionalized elderly. Perhaps this is due, to some extent, to certain attitudes espoused by society in general, towards aging and the institutionalized elderly. Nursing homes may be perceived by some members of society as the final resting place for the living. Inhabitants of nursing homes may be perceived as a collective group rather than individuals with uniquely varying personalities, preferences, desire and emotions. The institutionalized elderly are individuals who wish to live their lives as do otje members of society, with definition, purpose and the desire to be recognized. Society has in the past negatively stereotyped aging and has held an infatuation with youth which has contributed to the ideology that aging was not an important process to be studied (Groombridge, 1982). However, with the realization that the elderly population is increasing significantly researchers are becoming more interested in understanding aging as it constitutes a complex process which involves biological, psychological, social, political and economic factors. According to McDaniel (1986) aging is poorly understood at present but is receiving greater attention and an increasing amount of research has rectnely been intiated on the subject. In my opinion, research initiatives concerning the institutionalized elderly are long overdue. Long term care facilities are now placing greater emphasis on the goals of resident individuality, personal autonomy and institutional flexibility with regard to the reidents' lifestyles. Long term care professionals are now motivated to inquire and seek clarification from their clientele in an effort to achieve this new goal. An increasing elderly population has prompted researchers to consider new and unexplored areas of critical thinking concerning elderhood. The identification of learning needs among the lucid institutionalized elderly is an unexplored area of elderhood. Past research on learning needs among the elderly indicates that gaps do exist in the research. Further studies are required in order to understand and plan future learning programs for the lucid instiutionalized individual.
ii, 151 leaves : ill. ; 29 cm.

PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO
CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
A presente tese de doutorado aborda a temática: treinamento da memória de trabalho (MT) em adultos idosos saudáveis na interface da psicologia clínica e neurociências. Esta tese foi composta por dois estudos: um teórico e outro empírico. O estudo teórico teve como objetivo revisar a literatura nos últimos dez anos, em busca de um panorama sobre estudos de intervenções neuropsicológicas na MT, em amostras com adultos. Esta busca apresentou como resultado um número escasso de investigação. Na literatura internacional (site de busca PubMed), apenas sete delas foram encontradas, sendo três com adultos idosos saudáveis e quatro com adultos que sofreram lesões cerebrais adquiridas. Em relação ao grupo de adultos idosos saudáveis, o aprimoramento da MT só foi observado após dois anos de intervenção cognitiva, com frequência semanal de no mínimo duas sessões. Em contraste, o grupo de adultos com lesões cerebrais adquiridas apresentaram melhoras em três meses de treinamento. O outro estudo, o empírico, teve como objetivo verificar o efeito do Programa de Treinamento da MT (TMT) em adultos idosos saudáveis e independentes, por meio de comparações intra e entre grupos de desempenhos nos testes neuropsicológicos administrados pré e pós intervenção. O desempenho das funções cognitivas que apresentaram diferenças significativas nos testes neuropsicológicos, na análise intra-grupo, foram atenção e memória episódica visuo-verbal, que são diretamente relacionadas à MT. Na análise entre-grupos diferenças de desempenhos foram encontradas na memória verbal episódica e nas funções executivas. Esses resultados sugerem que o presente TMT, mesmo sendo de curta duração, pode proporcionar um efeito de transferência a outras funções cognitivas relacionadas à MT, mostrando assim que mesmo de forma indireta essa função pode ser aprimorada. Sugere-se replicar o presente estudo empírico, de forma que o período de intervenção seja mais longo, além de três meses e a frequência de sessões semanais sejam aumentadas, no mínimo duas vezes por semana, verificando assim se o presente programa TMT com adultos idosos saudáveis e independentes apresentará aprimoramento significativo de forma direta no desempenho da MT.
The present doctoral thesis addresses the thematic: working memory cognitive training in elderly adults, in the interface of clinical psychology and neuroscience. This thesis was composed by two studies: one theoretical and one empirical. The theoretical study aimed to review the literature in the last ten years, searching for an overview of studies about working memory (WM) neuropsychological interventions in adult samples. This search presented as a result, a very scarce number of investigations in this area. In the international literature (PubMed search site), only seven studies were found. Three were with healthy elderly adults and four were with adults who had brain injuries. In regard to the healthy elderly adults, WM improvement was observed only after two years of cognitive intervention, with minimum of two sessions weekly. In contrast, the brain injured adult groups presented improvements in three months. The other study, the empirical, aimed to verify the effect of WM Training Program (WMTP) in healthy and independent elderly adults, through within and between groups comparisons of neuropsychological tests performance results, administered before and after intervention. The cognitive functions that presented significant differences in neuropsychological tests performances within-group analysis, were attention and visual-verbal episodic memory, which are directed related to WM. In between-group analysis, differences in performances were found in the verbal episodic memory and executive functions. These results suggest that the present WMTP, even though with short duration, could provide a transfer effect to other cognitive functions related to WM, thus showing that even in an indirect way this cognitive function could be improve. It is suggested to replicate this empirical study, extending the intervention period beyond three months and the session s frequency to at least twice a week, in order to verify if the WMTP will present directly any significant improvement in working memory.

Depression in the elderly population is a growing concern in the United States. A decrease in depression in the elderly could lead to greater quality of life and reduced cost of healthcare services. The Sense of Coherence Theory was utilized as the theoretical foundation for this study. The purpose of this study was to use archival data to analyze differences in depression scores by groups based on prayer (yes/no) and over time (wave 1/wave 2 of data collection) when controlling for amount of time spent in prayer by category, gender, and ethnicity. The data were retrieved from the National Archive of Computerized Data on Aging, which included interviews with adults aged 65 and over living in the coterminous United States. The first wave was collected in 2001 and consisted of 1,500 interviews. Wave 2 was collected in 2004 and consisted of 1,024 of the original participants. A mixed ANOVA was used to analyze the data. Results showed that change in depression over time differed depending on use of prayer after controlling for frequency of prayer. Comparisons of the 2 waves in the sample revealed that depression significantly decreased for people who prayed but not for people who did not pray. Implementing prayer as a supplemental form of treatment for depression may alter the way that some clinicians and providers conduct mental health treatment, reduce the emotional burden on families who are often the caretakers of the elderly, and become a cost-effective method of reducing depressive symptoms.

The calming effect of horses has been utilized in numerous therapies; however, few scientific data demonstrate the physiological benefits horses provide to humans. This study was completed to analyze some physiological effects Equine Assisted Learning (EAL) may have on adults above 55 years of age. The experiment examined how horses can affect the heart rate variability (HRV) in humans during a session of "Con Su Permiso", an interaction method to be explained later. Other effects, including immune system function and self-esteem, are analyzed as well. Human substitutes for horses were used as a control for this experiment. A total of 24 people participated in the experiment. The results for the interactions with the horse substitutes (humans) were that there was an increase in heart rate (HR) and HRV (SDNN). For the interactions with the horses, there was an increase in the HR and the percent very low frequency component of HRV (%VLF). Overall results suggest interactions with horses through EAL benefits elderly adults by stimulating their sympathetic system without stressing them. As for self-esteem and immune function, the results show that both horse and human interactions significantly increase self-esteem in participants but there is no significant change in immune system function.

The purpose of this study was twofold: (a) to determine the therapeutic effectiveness of group counseling with visually-impaired elderly adults, and (b) to provide information concerning the effectiveness of group counseling to practitioners in the field. The study reviewed the literature regarding aging and vision, psychosocial reactions to vision loss, and group counseling with the visually-impaired and the elderly. Twenty subjects, who were above age 65 and had recently experienced a severe loss of vision, were selected to participate in the study. Ten subjects were assigned to an experimental counseling group and 10 subjects were assigned to a no-treatment control group. The experimental group participated in 1-1/2 hour group sessions once a week for 10 weeks. Both the experimental group and the control subjects were administered pre- and post-tests. The tests measured depression, anxiety, self-esteem, and life satisfaction.

There is an acknowledged need for continual intellectual growth in older adults. This study describes the characteristics of learning practiced by a particular. group of well-elderly adults over the age of 75. Data were gathered self-reported learning experiences.A semi-structured interview was developed by the researcher to elicit responses in three areas that characterize learning: (1) decision to start to learn, (2) awareness of individual learning process, and (3) evaluation of their own learning processes. Fifteen members (n=10 women and n=5 men) of the Trinity United Methodist Church in Huntington, IN were interviewed.The data showed depth and comprehension in the learning experiences. The learning experiences ranged from skill acquisition to the writing of scholarly papers. The data indicated the group was homogeneous allowing it to be used for future research comparisons. Data for the three learning characteristics revealed that building on experience as a basis, the group was continually ready to learn. They had established wide resource networks, used a variety of printed, visual, and audio material, and readily sought expert advice. From the bases the participants to organized the material, evaluated the information, related the information to their situations, and then used the information to make decisions. All of the participants this process.
Department of Educational Leadership

Little is known about the interaction and channeling of motor and sensory information in the control of balance with aging. The aim of this thesis was to study the mechanisms of equilibrium control and its effects on aging when large head and gaze shifts are executed under varying postural conditions. In a first study, the postural strategies used by young and elderly subjects were compared during standing and walking tasks while subjects executed a large and rapid rotation of the head. Elderly subjects restricted their body motions and velocities, likely to minimize the ensuing perturbation. An important aspect of the head turning tasks is the redirection of gaze, which must be coordinated with postural responses. Thus, in a second study we aimed to determine the mechanisms of large horizontal gaze shifts (saccades) when submitted to a support surface perturbation, in young subjects. The findings from this study revealed a saccadic facilitation mechanism, when the visual target shift stimuli was closely followed by a motion of the supporting surface, providing evidence for the need of a stable reference when all available sensors are perturbed. In a third study, the control of gaze shifts (pursuit and saccades) during surface perturbations (sequence of pseudo-random motions) and with aging was examined. As hypothesized, elderly subjects showed less precision in target tracking. As well, the surface perturbations resulted in increased tracking errors for both groups. However, gaze time lag in response to target was not affected by surface motions. This study provided evidence that gaze accuracy could be attributable for the segmental movement excursion restriction observed in elderly subjects of the first study. Moreover, the saccadic facilitatory mechanism observed in the second study is specific to the surface perturbation condition (discrete vs. sequence) and its timing relative to target shift. Therefore, the trainability of elderly subjects in executing complex tasks, as described in the present thesis, should be explored. Improved abilities in executing large head and gaze shifts under challenging postural conditions would be an important step in reducing the incidence of falls in the elderly and could guide rehabilitation interventions.

Background: In the United States, 30-60% of older adults fall each year; 10-20% of these falls result in injury, hospitalization, or even death. Better prevention of falls in this population may be facilitated by broader identification of risk factors. The use of statins has emerged as a potential risk factor, but the data provide conflicted results. Purpose: To examine the relationship between statin use and falls among community-dwelling older adults. Methods: We evaluated the patient registry of a Level 1 trauma center. All patients aged > 50 years who were admitted for falls in 2015 were included (n=615). Many of these patients had been previously admitted for falls and many were later readmitted for falls. We analyzed predictors of both prior admission and readmission with linear regressions. Independent variables were self-reported balance problems, diagnosis of dementia, and the use of statins. Results: On average, patients admitted for falls were 79.9 + 9.3 years old and 28% (n=173) were taking statins. Our collection of predictors explained 14.2% of the variance in the number of prior admissions (p<0.001). In this model, the use of statins significantly predicted the number of previous fall-related admissions (95% CI: 0.07–0.50, p=0.010). This same model maintained its significance when predicting admissions for future falls (p<0.001) and the use of statins continued to predict a greater number of readmissions (95% CI: 0.04–0.36, p=0.015). Conclusion: More than 25% of all Americans age > 40 years are taking cholesterol-lowering medication; 93% of those medications are statins. Although evidence is conflicted, these data support the finding that statin therapy increases the risk of falls in older adults. Incorporating exercise training as a prophylactic measure: enhancing lipid profiles and decreasing the need for statins while also improving balance, coordination, and mobility, may reduce fall-related injuries.

A longevidade pode ser acompanhada por diversas comorbidades, entre elas o declínio cognitivo.Indivíduos que evidenciam declínio no desempenho cognitivo superior ao esperado para a idade, usualmente demonstrado em anormalidades nos testes neuropsicológicos, mas não atingindo o diagnóstico de demência, e que preservam as atividades de vida diária recebem o diagnóstico de portadores de Comprometimento Cognitivo Leve (CCL). A identificação de casos de declínio cognitivo abre espaço para intervenções que visem prevenir as demências, entre elas o treino de memória. Foi realizado um ensaio clínico randomizado, controlado e cego, com objetivo principal de verificar a eficácia do treino de memória em controles normais (CN) e em idosos com Comprometimento Cognitivo Leve (CCL) que realizaram uma bateria de testes cognitivos. Os idosos que atenderam aos critérios de inclusão (n=112) foram classificados nos seguintes perfis cognitivos: controles normais (n= 65) e CCL (n=47), segundo os critérios de Gauthier e Touchon (2005). Os participantes foram aleatoriamente reunidos em três grupos de intervenção: treino de memória (TM), grupo de intervenção educativa (IE) e grupo controle (GC). O TM realizou oito sessões, foram trabalhadas estratégias mnemônicas em tarefas ecológicas e oferecido conteúdo educativo sobre memória e envelhecimento. O IE realizou o mesmo número de sessões, com a mesma duração do TM, porém foram trabalhados apenas os conteúdos educativos. O GC realizou apenas o pré e o pós-teste. Os resultados apontaram para uma melhora no perfil cognitivo dos idosos com CCL. Após o treino de memória os participantes com CCL exibiram desempenho característico de idosos sem comprometimento cognitivo, mostrando a presença de plasticidade neural.Sendo assim, o treino de memória mostrou ser uma possibilidade de intervenção educativa de baixo custo e fácil viabilidade, capaz de agregar qualidade de vida à longevidade.
The longevity can be accompanied by several affections, between them the cognitive decline. Mild cognitive impairment defines individuals with objective evidence of memory impairment in relation to age; largely intact general cognitive functions; essentially preserved activities of daily living and absence of dementia. The identification of cognitive impairment raises the opportunity to act with the aim of preventing dementia. One potential measure is memory training. A randomized and controlled double-blind clinical trial was done with the objective to test the memory training effect in aged individuals previously diagnosed with Mild Cognitive Impairment (MCI). The aged individuals were recruited by means of the local media. Afterward they were submitted to a battery of cognitive tests. The aged individuals attending the inclusion criteria (n=112) were classified into cognitive profiles as follows: normal controls (n= 65) and MCI (n=47). Gauthier and Touchon’s criteria (2005) were used for performing this classification. The study sample was randomly distributed into three different intervention groups: memory training group (MT) educational intervention group (EI) and control group (CG). The MT received eight interventional sessions working in mnemonic strategies using ecological tasks. In these sessions was also offered educative content on memory and aging. The EI did the same number of sessions with the same time extension as MT. However, only the educative content was worked. The CG did only a pre and a post testing evaluation. The results show an improvement in the cognitive profile of aged individuals with MCI. Moreover, after the memory training the individuals with MCI exhibited a performance typical of aged individuals without cognitive impairment. Conclusion: The memory training is a low cost and feasible intervention in cognitive impairment. It can improve quality of life in ageing.

In the world today, the portion of aging people grows continuously. Due to successfulof healthcare services, people are living longer and the number of newborn isdecreasing. This can imply that the population of young and working people isdecreasing in many countries. This leads to the mean value incrementing of the meanworld population’s age value in the whole world. It has become more and moreimportant to consideration human factors of elderly people in many businesses.Software companies have to consider design of software concerning of usability forageing people. Currently, most of the software is designed to support younger users.To support elderly users, we have to consider more on age-related differences. Thisthesis presents a literature survey, and related theories used in designing graphic userinterface for ageing people. Besides, criteria for designing software for older users arealso discussed and suggested as guidelines for future studies and development. Thepurpose is to improve older users’ potential in using information technologies, and topotentially allow older users to gain more benefit from using of computer software.A case study for software design for elderly users was implemented to verifysuggested guideline and gain deeper design understanding. The elderly volunteerswere involved in design evaluation process. The results from case study have showneffectiveness of the design guideline approach.

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Partindo da premissa da educação enquanto direito constitucional e humano no Brasil, não restrita à escolarização ou à Educação Básica, mas que envolve processos formais, não-formais e informais, o presente estudo discute a concepção de educação permanente baseada no princípio da formação múltipla e integral, definindo como campo de investigação a Educação de Jovens, Adultos e Idosos (EJAI) por apresentar elementos convergentes. Assim, levantou-se o problema de investigação: quais as relações entre as políticas educacionais para EJAI e a educação permanente? O objetivo geral é analisar as relações entre a educação permanente e as políticas educacionais da EJAI a partir da perspectiva do direito constitucional e humano à educação. Como objetivos específicos, estabeleceram-se: Contextualizar a educação como direito no Brasil, a partir das Constituições e da Declaração Universal dos Direitos Humanos; Conceituar a educação permanente a partir das diferentes abordagens existentes, estabelecendo suas relações com as políticas educacionais para a Educação de Jovens, Adultos e Idosos; Investigar a relação que se estabelece entre educação permanente, Educação de Jovens, Adultos e Idosos e direitos humanos; Analisar a relação entre as políticas educacionais para Educação de Jovens, Adultos e Idosos e a educação permanente, evidenciando seus limites e possibilidades. A metodologia utilizada está pautada pela abordagem crítica e os principais referenciais teóricos utilizados para debater o problema, são Arroyo (2017) Barros (2013), Furter (1976, 1984), Freire (1982, 1987, 1992, 1996), Gadotti (1992, 2007, 2009, 2011, 2016), Lima (2007), Paiva (1983, 2003), Paiva (2009), Pinto (1987), Requejo Osorio (2003), Ribeiro (2005), Romão (2007, 2011), Oliveira (1999, 2013) e Scortegagna (2010, 2013, 2016). Os procedimentos metodológicos partiram do estado do conhecimento, seguidos da pesquisa bibliográfica e pesquisa de campo qualitativa. O campo de investigação foi uma instituição de ensino privada de Curitiba que oferta a EJAI no ensino Fundamental e Médio com a aplicação de um questionário com questões abertas e fechadas para a equipe pedagógica e docente, composta por uma pedagoga e 12 professores. Entre as conclusões obteve-se que 75% dos professores conhecem a educação permanente e a relacionam com a EJAI, declarando que, enquanto política pública, esta modalidade é considerada uma forma de educação permanente, evidenciando que as políticas educacionais podem ser consideradas o elo de articulação entre ambas. Além disso, foi possível evidenciar que não existem políticas educacionais específicas para a educação permanente, que o Plano Nacional de Educação é a política educacional mais conhecida do público pesquisado e que todas as políticas educacionais que contemplam a EJAI estão relacionadas com educação permanente, pois a EJAI é parte da concepção de educação permanente.
Based on the premise that education is a constitutional and human right in Brazil and it’s not restricted only to schooling or Basic Education, but also involves formal, nonformal and informal processes, this study discusses the concept of permanent education based on the principle of multiple and integral, defining Youth and Adult Education and Education for the Elderly (known in Brazil by the portuguese acronym – EJAI) as a research field since it presents some convergent elements. Thus, the research problem raises the following question: what are the relationships between educational policies for EJAI and lifelong education? The general objective is to analyze the relationship between lifelong education and EJAI educational policies from the perspective of constitutional and human rights to education. As specific objectives, we’ve established: Contextualized education as a right in Brazil, based on the Constitutions and the Universal Declaration of Human Rights; To conceptualize lifelong education based on the different existing approaches, establishing its relations with educational policies for the Education of Youth, Adults and Elders; to investigate the relationship between permanent education, Youth and Adult Education and Education for the Elderly and human rights; to analyze the relationship between the educational policies for Education of Young people, Adults and Elders and the permanent education, evidencing its limits and possibilities. The methodology that was applied is based on the critical approach and on the main theoretical references used to discuss the problem. they are Arroyo (2017) Barros (2013), Furter (1976, 1984), Freire (1982, 1987, 1992, 1996), Gadotti (2007), Paiva (2009), Pinto (1987), Requejo Osorio (2003), Ribeiro (2005), Romão (2007, 2011) Oliveira (1999, 2013) and Scortegagna (2010, 2013, 2016). The methodological procedures were based on the state of knowledge, followed by bibliographical and qualitative research. The research location was a private institution of Curitiba that offers the EJAI in the Fundamental and Middle levels and it counted with the application of a questionnaire contained open and closed questions for the pedagogical and teachers team, composed by a pedagogue and 12 teachers. Among the results, 75% of the teachers have knowledge about continuing education and are able to relate it to EJAI, declaring that, as a public policy, this modality is considered a way of permanent education and it evidences that the educational policies can be considered the connection between them. In addition, it was possible to present that there are no specific educational policies for lifelong education, that the National Education Plan is the most well-known educational policy of the public surveyed and that all educational policies that contemplate the EJAI are related to permanent education. EJAI is part of the concept of permanent education.

In der vorliegenden Arbeit wurde die prädiktive und reaktive Anpassungsfähigkeit älterer Personen auf unerwartete Gangstörungen untersucht. Direkt nach der ersten unerwarteten Störung zeigten junge und ältere Personen eine ähnliche Erhöhung ihrer dynamischen Stabilität im folgenden Gangversuch zum Zeitpunkt kurz vor der erwarteten Gangstörung im Vergleich zu normalem Gang. Ältere Personen können also ihre Fähigkeit zur schnellen prädiktiven Anpassung der dynamischen Stabilität als Reaktion auf Gangstörungen beibehalten. Wiederholte unerwartete Gangstörungen wurden ebenfalls bei beiden Altersgruppen mit einem verbesserten Stabilitätszustand bewältigt. Ältere Personen zeigten allerdings tendenziell eine geringere reaktive Adaptation verglichen mit den jüngeren. Mittels einer Interventionsstudie wurde weiter untersucht, ob ältere Personen lernen können, auf Stabilitätsstörungen besser zu reagieren. Zwei Trainingsgruppen (ST, MT) trainierten zweimal wöchentlich für 14 Wochen und führten Übungen durch, die Mechanismen der dynamischen Stabilität enthielten. ST trainierte diese Übungen für jeweils 90min, während MT diese nur für 45min ausübte und in der verbleibenden Zeit noch Krafttraining für die unteren Extremitäten durchführte. Die Kontrollgruppe führte kein Training durch und zeigte auch keinerlei Stabilitätsveränderungen im Vergleich prä- zu post-Messung. Nach der Intervention war für ST die Stabilität nach der Gangstörung signifikant erhöht im Vergleich zum Stabilitätszustand vor der Intervention. Die Unterstützungsfläche nach der Gangstörung wurde bei beiden Interventionsgruppen als Folge der Intervention vergrößert. Signifikante Unterschiede waren hier allerdings nur bei ST zu finden. Das Üben von Mechanismen der dynamischen Stabilität kann also zu einer verbesserten Anwendung dieser Mechanismen nach einer Gangstörung führen. Zusätzliches Krafttraining zeigt allerdings keine Vorteile gegenüber dem ausschließlichen Üben von Mechanismen der dynamischen Stabilität.
This thesis aimed to gain knowledge about the preservation of predictive as well as reactive adaptability in old adults during locomotion. Young and old subjects similarly increased their dynamic stability at touchdown of the disturbed leg (prior to the perturbation) in the trial following an unexpected perturbation compared to unaffected normal gait. This suggests that older adults preserve the ability to show fast predictive adaptations in their dynamic stability in consequence to perturbations during walking. In the course of repeated unexpected perturbations, both age groups showed an increase in their dynamic stability state after the perturbation. Older adults, however, showed a tendency towards a lower reactive adaptation magnitude compared to young adults. Furthermore, by means of an intervention study, it was investigated if older adults preserve their ability to learn improved postural reactions in consequence to perturbations in general. Therefore, two training groups (ST, MT) participated for 14 weeks, twice a week, in a training program. ST practiced exercises which included mechanisms of dynamic stability for 90min and MT for 45min whereas MT further performed 45min of strength training for the lower extremities. The control group performed no training and showed no differences in the stability between pre and post measurements. Post-intervention, dynamic stability state was significantly increased for ST compared to pre-intervention after the unexpected perturbation during walking. Both intervention groups increased their base of support of the recovery step in consequence to the perturbation after the intervention, showing significant differences only in ST. It can be concluded that exercising the mechanisms of dynamic stability may lead to a better application of these mechanisms after an unexpected gait perturbation. A mixed training program, however, shows no advantages compared to the exclusive training of the mechanisms of dynamic stability.

The goal of this research project was to determine if introducing intergenerational interactions would supplement or detract from the use of horticulture as a therapeutic tool when working with elderly adults and preschool children. The program was set up to compare independent group activities with intergenerational activities. A group of elderly adults in the University Adult Day Service and a group of preschool children in the University Child Development Laboratory School took part in both separate age group and intergenerational activities. There were three sessions each week: one for the children's group, a second one for the elderly adults' group, and a third one that combined both groups. The same activity was done during all three sessions each week, with modifications to make the activity appropriate for each age group and to make it more interactive for the intergenerational group. These activities took place in the campus building where the day care centers are located. Four volunteers assisted with the activities. Two worked with the children's group both during separate and intergenerational activities, and two volunteers similarly assisted with the elderly adult group. Video cameras were used to record each session. These videos were viewed and evaluated after the 10-week horticulture therapy program was completed to score attendance and participation during separate age group activities, and attendance, participation, and interaction between the two groups during intergenerational activities. This data was used to determine if introducing intergenerational interactions affected the individual's attendance or participation, and to determine if the interactions between the two groups showed any change over time. Several variables were shown to affect the outcome of research. The first variable discussed is the effect of the staff, volunteers, or administration on the participants and the activities. Staff and volunteers can greatly affect intergenerational interactions by: 1) failing to encourage participation from participants of all ages, 2) lacking experience or having discomfort in working with special populations, 3) failure to establish adequate communication with the researcher or with each other, or 4) demonstrating a negative attitude towards the project. The second variable in research is the limitation introduced by data analysis using video. While video recording is useful in evaluating data, it can cause problems due to a limited viewing area, limited viewing angles, blocked screens, or unfamiliarity with recording equipment. Videos were used to assess participation and interaction. Participation scores include three categories: "no participation" for present but inactive participation, and "working with direct assistance" or "independent participation" for active participation. Participation was affected by the horticulture activities' set up, difficulty level, and availability of assistance from volunteers. Children's participation during separate group activities was affected mainly by the difficulty level and set up of activities. Elderly adult's participation during separate age group activities was affected mainly by each individual's abilities and availability of assistance. Children's intergenerational participation scores show an increase in the category of "working with direct assistance", while elderly adults' intergenerational scores show an increase in the categories of "no participation" and "independent participation". In part, the change in intergenerational participation was due to a decrease in the assistance available from volunteers for each individual. Lastly, the percentage of total interaction time between the generations during activities increased over time. However, the introduction of intergenerational interactions detracted from the use of horticulture as a therapeutic tool for elderly adults and preschool children. It is recommended that intergenerational programming may not be useful to fulfill specific horticulture therapy goals for these groups. At the same time, the intergenerational activities involving horticulture plant-based activities were more successful at increasing interactions than the craft-type activities. Therefore horticulture may be a useful activity for intergenerational programs with a goal of increased interaction and relationship development.
Master of Science

Although cognitive rehabilitation is not a new field of intervention, as it dates back to the treatment of brain-injured soldiers during World War I, the use of cognitive rehabilitation intervention therapies for individuals with dementia and mild cognitive impairment has yet to draw definite conclusions about its effectiveness. Based on the conceptual framework of biopsychosocial theoretical model, this study explored to what extend cognitive rehabilitation intervention was effective in improving the memory and mood functioning of elderly adults with mild cognitive impairments. An archived data set of 216 elderly adults collected at a midwestern agency in the United States during the period of May 2012 through December 2013 was used. Wilcoxon matched pair tests were used to assess elders' changes in memory and mood functioning. Results indicated that there were no significant changes in memory skills or mood functioning found after the elderly individuals participated in the cognitive rehabilitation program within the 18-month period of continuous intervention training. Several limitations could explain these results including a small sample size of 88 participants that finished the 18-month program; the quality of the assessment process; and the lack of further information on the archived data such as demographics, patients' medication regimen, or type of family support. Health care professionals, families, and caretakers may use these results to understand the importance of closely monitoring the training and checking for positive results and adjusting the intervention as needed. Results of the study also highlighted the importance of focusing on promoting a take-charge collaborative approach to awareness and life satisfaction which is a salient implication for positive social change.

The purpose of this study is to identify the pivotal factors contributing to programmatic success of arts programs for people, age sixty-five and older, in the United States. This study examines select programs within five arts disciplines: Elders Share the Arts (theatre), Museum One (visual art), Liz Lerman Dance Exchange (dance), New Horizons Music (music), and Arts for the Aging (writing/literature). The selected programs serve a heterogeneous population of older adults and exist independently of larger, non-arts institutions, such as hospitals, nursing homes, or senior care facilities. Success factors were determined by three methods, including: (1) direct questioning of program staff members about what they believed made their programs successful, (2) observations of program delivery to determine success factors in action, and (3) research and review of literature. The conclusions of the aforementioned methods result in six universal factors among successful programming within arts programs. These common factors are:

1. Reminiscence regularly occurs among individual participants. Older adults who have the opportunity to reflect, without inhibition, on events from their past tend to experience more self-satisfaction, a reinforcement of their identity, and a ready connection with other adults.
2. Programs establish and maintain a safe, non-threatening environment. Allocating a small amount of time for everyone to acclimate to the new environment allows older adults to feel more at ease, encourages their participation, and increases their enjoyment.
3. Teaching artists are personally committed to the context in which they work and exhibit patience when engaging with older adults. Teaching artists find a balance between activities that are aesthetically enjoyable and educationally and socially rewarding.
4. Another organization or venue serves as a host for the program. This reciprocal relationship sustains the arts program and increases the vitality of the host organization by providing a wide range of programs.
5. The organization's leader is enthusiastic and mindful of both challenges and opportunities in the field. A single person in a highly-placed administrative position is identified as an essential driving force behind successful programs.
6. Teaching artists demonstrate loyalty by committing several years to the programs. The long-term retention of all teaching artists ensures consistent, reliable, and quality programs.
   Master of Fine Arts

The present study attempted to investigate the effects of extinction on the behavior of older adults with moderate to severe dementia. A touch screen computer displaying four large colored buttons was employed. Participants were exposed to three conditions: baseline, intervention, and a reversal. The target response (pressing green after yellow) resulted in a video stimulus in the intervention condition, and then the videos were withheld during the reversal condition. Data on button-pressing and vocal-verbal statements were visually analyzed to determine the effect of the videos on responding; however none of the participants acquired the task. Therefore, a discussion of extinction responding was not possible. Interesting findings in terms of reinforcement and implications for the treatment of problem behaviors in older adults with dementia are discussed.

Elderly adults (N = 116; average age = 73 years) were randomly assigned to one of four treatment groups varying in the amount of training and testing on fluid intelligence tests. They were compared before and after treatment on self-efficacy and utility beliefs for intelligence tests and everyday competence. Although both ability training and extended retest practice resulted in significant gains in objective test performance (Baltes, Kliegl, & Dittmann-Kohli, 1988), only ability training resulted in positive changes in self-efficacy. However, these changes were restricted to testrelated self-efficacy. Training had no impact on perceived utility or on everyday self-efficacy beliefs. Implications of the results are discussed with regard to interventions to increase intellectual self-efficacy in elderly persons.

The population of the oldest old (aged 85 years and over) is growing. It is estimated that 30% of the adults over the age of 65 years experience falls at least once a year. This figure rises to 50% per annum for adults over 80 years living either at home or in care home. Currently older people are the fastest growing segment of the population. In the UK alone, the proportion of people aged 85 years old has increased from 2% to 4% in the past six decades. This marked increase in growth of population aged over 85 years is expected to have substantial impact on overall falls rate and pose serious issues to meet care needs for social and health care departments. In the light of such negative consequences for the faller and the associated costs to society, simple and quantitative techniques for falls risk screening can contribute significantly. This study describes a semi-automated technique to estimate falls risk of community dwelling elderly adults (aged 85 and over). This study presents the detailed analysis of tri-axial accelerometer movement data recorded from the right wrist of individuals undertaking the Timed Up and Go (TUG) test. The semi-automated assessment is evaluated here on 394 subjects’ data collected in their home environment. The study compares logistic regression models developed using accelerometer derived features against the traditional TUG measure ‘time taken to complete the test’. Gender based models were built separately across two groups of participants- with and without walking aid. The accelerometer derived feature model yielded a mean sensitivity of 63.95%, specificity of 63.51% and accuracy of 66.24% based on leave one-out cross validation compared to manually timed TUG (mean sensitivity of 52.64%, specificity of 45.41% and accuracy of 55.22%). Results show that accelerometer derived models offer improvement over traditional falls assessment. This automated method enables identification of older people at risk of falls residing both at home and in care homes and to monitor intervention effectiveness of falls management.

Background: Self-rated health is an important predictor of adverse health outcomes (e.g. mortality) and health service use. While intergenerational family capital has been considered as one of the most important social determinants of self-rated health, the role of grandparent-grandchild dyads in self-rated health has not been fully investigated. Further, little is known about the patterns of change in trajectories of the self-rated health of older rural Chinese adults, who constitute the largest ageing population in the world. Objectives: This study investigated the association between grandparent-grandchild family capital and the self-rated health of older adults in rural China, as well as the mediation role of the grandparent-parent relationship in the association between grandparent-grandchild family capital and self-rated health. The present study also examined the development trajectories of the self-rated health of older rural Chinese adults from the point of view of intergenerational relationship and socio-economic status. Methods: Data for this study are derived from the Well-Being of the Elderly in Anhui Province survey. A random sample of 1,715 adults aged 60 and older were interviewed in the rural Chaohu region in 2001. A total of 1391 and 1067 respondents participated in the 2003 wave and 2006 wave respectively. New respondents were recruited for the 2009 wave and 1224 respondents were interviewed in 2009. Based on the 2009 wave of the Chaohu survey, structural equation modeling was used to examine the direct effect of grandparent-grandchild family capital on the self-rated health of older adults and the mediation role of the grandparent-parent relationship. Based on the 2001, 2003 and 2006 waves of the Chaohu survey, general growth mixture modeling was used to examine the multiple underlying trajectory patterns of self-rated health as well as the antecedents of the latent class memberships. Results: The results showed that grandparent-grandchild family capital had a direct effect on the self-rated health of older adults in rural China. The results also showed that the grandparent-parent relationship played a partial mediation role in the association between grandparent-grandchild family capital and self-rated health. Further, a two-class model was chosen to interpret the underlying trajectory classes. The two trajectories were labeled “good but declining SRH class” and “poor and declining SRH class”. Discussion: The findings enriched our theoretical understanding of intergenerational family capital and its effects in a cultural context that emphasizes collectivism and intergenerational exchanges. The mediator role of the grandparent-parent relationship was also highlighted in the findings, which confirmed “grandchild-as-linkage” theory. Further, there are underlying multiple trajectory patterns of the self-rated health of rural older adults. Intergenerational relationship was an important antecedent of the latent classes of self-rated health trajectories in rural China.
published_or_final_version
Social Work and Social Administration
Doctoral
Doctor of Philosophy

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Financiadora de Estudos e Projetos
According to the Brazilian Institute of Geography and Statistics (IBGE), population aging integrates our current context and occurs extensively in Brazil, which makes it worth considering by public social policies. On this account, it is important to understand that aging is a heterogeneous process marked by losses and gains as some of our cognitive functions tend to decline while others remain and are enhanced over time, especially those connected with cultural stimuli. In this sense, education towards the elderly is of great importance and it must be conceived from continuing education, linked to the concept of lifelong education. As the Youth and Adult Education (EJA) is one of the actions promoted by lifelong education as well as one of the educational spaces having the presence of the elderly, it is important to understand who they are, the ones integrating this type of basic education, in order to provide them with appropriate service regarding their specificities and interests so that their right to quality education is guaranteed as it is established by the national legislation. This research was based on the analysis of articles of the Brazilian journal of Psychology - Psychology: Reflection and critique - in order to identify elements that can collaborate with the service provided to the elderly while subjects composing the EJA. Therefore, a bibliographical research was carried out in which 40 articles of the journal in question were selected, between the years 2000-2012, having the following keywords as the criteria: aging, old age, the elderly, elderly men, elderly women. To perform the analysis of the articles the technique of content analysis was employed. From the analysis of the articles it was possible to organize nine elements that contribute to the reflection and action towards the service provided to the elderly in the EJA: 1) meet the specificities, needs and interests of the elderly seeking the EJA, thus understanding the heterogeneity of aging; 2) understand that the cognition of the elderly involves gains and losses and a favorable cultural environment can offset losses and promote cognitive gains; 3) stimulate the high sense of self-efficacy of these elderly subjects; 4) understand that the processes of teaching and learning can be enhanced with the collective environment of intergenerational interaction of the EJA; 5) seek to overcome stereotypes, prejudices and negative beliefs about old age; 6) understand that the tools and knowledge provided by schooling are relevant to the autonomy, citizenship and social inclusion of the elderly in the present society; 7) value the knowledge and life experience that the elderly carry; 8) provide educational materials which are adequate for the reductions of some sensory abilities, such as vision and hearing; 9) conceive the perspective of development throughout life (life-span). In this sense, we suggest the social and academic relevance of the theme of the elderly in the EJA and the furtherance of new studies and research in order to increase scientific production in education and consolidate the knowledge about the educational practice for this population.
Segundo dados do Instituto Brasileiro de Geografia e Estatística (IBGE), o envelhecimento populacional integra o nosso contexto atual e ocorre intensamente no Brasil, devendo ser considerado pelas políticas públicas sociais. A partir disso, é importante entender que o envelhecimento é um processo heterogêneo, marcado por perdas e ganhos, sendo que algumas funções cognitivas tendem a declinar e outras a se manter e a se aprimorar com o passar do tempo, principalmente aquelas que estão vinculadas a estímulos culturais. Nesse contexto, a educação voltada aos idosos possui grande importância e deve ser concebida a partir da educação permanente, vinculada ao conceito de educação ao longo da vida. Sendo a Educação de Jovens e Adultos (EJA) uma das ações impulsionadas pela educação ao longo da vida e um dos espaços educativos que possui a presença de idosos, é preciso compreender quem são os sujeitos idosos que integram essa modalidade da educação básica, a fim de fornecer-lhes atendimento adequado às suas especificidades e aos seus interesses, buscando garantir-lhes o direito à educação de qualidade, estabelecido pela legislação nacional. A presente pesquisa se pautou na análise de artigos do periódico brasileiro da Psicologia - Psicologia: reflexão e crítica - a fim de levantar elementos que podem colaborar com o atendimento de idosos enquanto sujeitos que compõe a EJA. Para tanto, realizamos uma pesquisa bibliográfica, selecionando 40 artigos do periódico em questão, entre os anos 2000 a 2012, utilizando como critério as palavras-chave: envelhecimento, velhice, idoso, idosos, idosa, idosas. Para realizar a análise dos artigos utilizamos a técnica de análise de conteúdo. A partir da análise dos artigos foi possível organizar nove elementos que colaboram com a reflexão e a ação voltada ao atendimento aos sujeitos idosos na EJA: 1) conhecer as especificidades, necessidades e interesses dos idosos que buscam a EJA, entendendo a heterogeneidade do envelhecimento; 2) entender que a cognição dos idosos envolve ganhos e perdas e um ambiente cultural propício pode compensar perdas e promover ganhos cognitivos; 3) estimular o alto senso de autoeficácia desses sujeitos idosos; 4) entender que os processos de ensino e de aprendizagem podem ser potencializados a partir do ambiente coletivo de convívio intergeracional da EJA; 5) buscar a superação de estereótipos, preconceitos e crenças negativas em torno da velhice; 6) entender que os instrumentos e conhecimentos fornecidos pela escolarização são relevantes para a autonomia, o exercício da cidadania e inserção social dos sujeitos idosos na sociedade atual; 7) valorizar os conhecimentos e as experiências de vida que os sujeitos idosos possuem; 8) fornecer materiais didáticos adequados às diminuições de algumas capacidades sensoriais, como por exemplo, a visão e a audição; 9) conceber a perspectiva de desenvolvimento ao longo da vida (life-span). Dessa forma, sugere-se a relevância social e acadêmica da temática dos idosos na EJA e o fomento de novos estudos e pesquisas, a fim de potencializar a produção científica na área da educação e fortificar o conhecimento sobre a prática pedagógica voltada a essa população.

The purpose of this study was to examine the impact of (a) respondent age, (b) age and gender of perpetrator and victim, and (c) history of experienced violence on perceptions of elder abuse. Two-hundred and one (N = 201) middle-aged adults and 422 college students were assessed. Measures included adaptations of the Severity of Violence Against Women Scale and Elder Abuse Attitudes and Behavioral Intentions Scale-Revised. Middle-aged respondents viewed psychological behaviors more harshly than young. Middle-aged females and young males were less tolerant of middle-aged perpetrators. While past performance of elder abuse was predictive of future elder abuse, history of childhood abuse was not. Exploratory analyses examined middle-aged respondents' judgments of abusive behaviors and perceptions based on age of perpetrator. Middle-aged and young adults' willingness to respond to dimensions of quality, severity, and reportability were also examined.

xiii, 109 p. : ill.
Falls are a significant source of physical, social, and psychological suffering among elderly adults. Falls lead to morbidity and even mortality. Over one-third of adults over the age of 65 years will fall within a calendar year, with almost 10,000 deaths per year attributed to falls. The direct cost of falls exceeds $10 billion a year in the United States. Fall incidents have been linked to multiple risk factors, including cognitive function, muscle strength, and balance control. The ability to properly identify balance impairment is a tremendous challenge to the medical community, with accurate assessment of fall risk lacking. Therefore, the purpose of this study was to assess balance control during gait among young adults, elderly adults, and elderly fallers; determine which biomechanical measures can best identify fallers retrospectively; demonstrate longitudinal changes in elderly adults and prospectively assess fall risk; and provide a method for mapping clinical variables to sensitive balance control measures using artificial neural networks. The interaction of the whole body center of mass (CoM) in relation to the base of support (BoS) assessed static and dynamic balance control throughout gait. Elderly fallers demonstrated reduced balance control ability, specifically a decreased time to contact with the boundary of the BoS, when compared to young adults at heel strike. This decreased time might predispose older adults to additional falls due to an inability to properly respond to perturbations or slips. Inclusion of these balance control measures along with the Berg Balance Scale and spatiotemporal measures demonstrated sensitivity and specificity values of up to 90% when identifying 98 elderly fallers and non-fallers, respectively. Additionally, 27 older adults were followed longitudinally over a period of one year, with only the interaction of the CoM with the BoS demonstrating an ability to differentiate fallers and non-fallers prospectively. As the collection and analysis of these biomechanics measures can be time consuming and expensive, an artificial neural network demonstrated that clinical measures can accurately predict balance control during ambulation. This model approached a solution quickly and provides a means for assessing longitudinal changes, intervention effects, and future fall risk. This dissertation includes both previously published and unpublished co-authored material.
Committee in charge: Dr. Li-Shan Chou, Chair; Dr. Andrew Karduna, Member; Dr. Marjorie Woollacott, Member; Dr. Ronald Stock, Member; Dr. Arthur Farley, Outside Member

Background: Older adults walk more slowly than healthy young adults at fast and normal walking speeds. These age-associated changes in mobility impact upon daily function. A slower gait, for example, may reduce the older adult’s ability to safely cross at traffic intersections due to the time restriction. Recent research has demonstrated whole body vibration (WBV) can improve the strength and power (Roelants, Delecluse & Verschueren, 2004; Russo et al., 2003; Verschueren, Roelants, Delecluse, Swinnen, Vanderschueren & Boonen, 2004) of community dwelling elderly females, and the mobility of nursing home residents (Bautmans, Van Hees, Lemper & Mets, 2005; Bruyere et al., 2005). To date, no published research has examined the impact WBV has on the gait parameters of community dwelling elderly females. The research was conducted in three phases. Phase One – Development of a WBV Platform: This phase outlines the development of a WBV platform (ACUWBV) that was designed and built for this research. A unique aspect of the ACUWBV was the method of adjusting WBV amplitude and therefore intensity. Current WBV technology, using tilting oscillations, requires the individual to increase their stance width. The ACUWBV allowed for the adjustment of WBV amplitude while maintaining the same stance width. The reliability and accuracy of the ACUWBV eccentric cam was measured during this phase of the research. Although an intraclass correlation coefficient of 0.4 was calculated and is considered an indication of low reliability, calculations of typical error (TE -95% error range) for each amplitude indicated the error to be small in the overall precision of the instrument. Specifically, at a frequency of 20 Hz, the expected WBV acceleration ranges for amplitudes of 0.5 mm and 1.0 mm were 7.58 m.s-2 to 8.85 m.s-2 (TE = 0.02 mm) and 16.90 m.s-2 to 17.53 m.s.-2 (TE = 0.01 mm), respectively. Phase Two – Pilot Study: This phase established the response of elderly community-dwelling female fast gait to WBV. Seven elderly female participants attended three WBV sessions per week for three weeks. Participants performed fast walks over an electronic walkway (GAITRite) at the end of each WBV session. A time-series graph displayed a linear increase in stride velocity over the three week intervention period. Conversely, stride time, stance time and double support time exhibited linear decreases. However, stride time (p=0.04) and stance time (p=0.04) were the only variables that exhibited a significant difference. It was concluded that the linear changes in stride velocity, stride time, stance time and double support time warranted further investigation with a larger sample size within a longer intervention period. Phase Three – Major Study: Phase three was an extension of phase two. This WBV intervention study was performed over a twelve week period. Twenty-two elderly female participants were placed in one of two groups. Group one (placebo/WBV; Group; n=12) was exposed to a placebo intervention for the first six weeks followed by a six week WBV intervention. Group two (Group WBV/placebo; n=10) was exposed to WBV for the first six weeks and a placebo intervention for the following six weeks. Group placebo/WBV exhibited no change in stride velocity during the placebo period, but a seven per cent increase during the six week WBV period (p=0.005). The changes in stride velocity coincided with increases in stride length (p=0.017), and reductions in stride time (p=0.007), stance time (p=0.001) and double support time (p=0.001). Group WBV/Placebo demonstrated stride velocity to increase by five per cent during the WBV period. Although the time-series graphs demonstrated improvements in stride velocity to be associated with decreases in stride time, stance time, and double support time, the changes failed to reach significance. Single support time and stride length showed no change over the WBV period. The improvements shown by group WBV/placebo from the first six weeks of WBV were maintained during the six week placebo (detraining) period. In summary, WBV was an effective intervention for enhancing the walking speed of community dwelling elderly female gait. This form of exercise may have positive outcomes on the daily function of elderly females, which in turn may improve their quality of life.

The relationship of culture and healthcare plays an important role in the success of health care access for everyone. In recent decades, the United States has opened its door to welcome not only refugees and immigrants from Europe, but also from other countries all over the world. Coming to the United States, these ethnic groups must overcome many problems to adjust to the American healthcare system. Meanwhile, American health providers not only misunderstand their refugees and immigrant clients' culture, but also want them to conform to the requirement of purely biomedical treatment. The result is that access to healthcare for immigrant groups in the United States is likely to be difficult because of significant cultural differences between the clients and healthcare provider. This research used in depth-interviews, participant observations, and a case study to explore the interaction between culture and healthcare for Vietnamese refugee and immigrant adults and elderly living in the Greater Springfield, Massachusetts area; the level of their involvement in the American healthcare and in traditional healthcare; the extent of integration of American healthcare and traditional healthcare; the obstacles they face in accessing and using American healthcare; and the importance of health education in successful healthcare access. Theories of acculturation, such as Models of Acculturation (Padilla, 1980) and Health Care System Model (Kleinman, 1978a) were used to process the study data to determine the extent of the influence of culture on the effectiveness of healthcare. Finally, based on data analysis, I explain how Vietnamese refugee and immigrant adults and elderly acculturate to the American healthcare system, and make recommendations for improving healthcare for them, as well as for other ethnic groups throughout America.

碩士
長庚大學
護理學系
99
A common problem existing among elderly population is tripping and falling down. Elderly people who are 65 years of age and older, and live at nursing homes have three times higher probability of having this accident as compared with those at similar ages in community. Such accident although is probably not lethal can cause a great impact to their health and psychology. Some elderly people who have not had this experience are afraid of tripping and falling down, and therefore restrict themselves from physical activities. The consequences will be gradual decline of their physical functions, and higher morbidity rates, hospitalization rates and death rates. The demands for social care, waste of medical resources, and burden of family or caregivers will increase. These elderly people will have lower self-efficiency, avoid physical activities, lose confidence, and get socially isolated. They will also have depression and poorer living satisfaction and living quality. This study aimed to develop and prove preventive measures against tripping and falling down - effects of health education and exercise, and predict risk factors of tripping and falling down for elderly people living at nursing care institutions. True-experimental design was adopted to select 62 residents at the nursing home affiliated to a medical center in North Taiwan. These subjects were 50 years old and older, and divided into two groups, the control group (N= 31) and experimental group (N = 31). The former was not given any interventions whereas the later was given health education and exercise for upper and lower limbs for eight weeks. Two tests were conducted immediately and one month after completion of the interventions. Measurement: demographical, fall times record , Geriatric fear of falling measure (GFFM), Fall Efficacy scale (FES), Tinetti mobility scale, Taiwanese Depression Questionnaire (TDQ), Short-Form-36 (SF-36), muscle strength record, risk factor assessment tool in the elderly residents in a long-term care facility. Results: Mixed model significant showed, Physiological: mobility function (F=13.672, p&lt;.001), falls(F=10.505, p&lt;.001), left anterior deltoid (F=14.205, p&lt;.001), right anterior deltoid (F=9.621, p&lt;.001), left biceps brachia (F=16.983, p&lt;.001), right biceps rachia ( F=12.841, p&lt;.001), left quadriceps femoris (F=24.944, p&lt;.001), right quadriceps femoris (F=23.357, p&lt;.001), left psoas major (F=18.530, p&lt;.00), right psoas major (F= 15.612, p&lt;.001); psychology: FES (F=2.598, p&lt;.001), GFFM (F=27.578, p&lt;.001), TDQ (F=37.275, p&lt;.001), Aware state of health (F=45.074, p&lt;.001), QOL (F=19.652, p&lt;.001), fall risk factor assessment (F=3.137, p&lt;.01). Significant differences were found for all variables. It was suggested to make preventive health education and exercise into a film, and include it into institutional routines. Family members or other important people of elderly people should also be included in the preventive plan against tripping and falling down. Interventions in this study took only a short period of time, but were found very effective. However, it is necessary to obtain more evidences about the effects in a long period of time. Future studies could focus on exercise time and frequency, in order to obtain the best effects. This study also found out that exercise can reduce depression, which is an important issue of elderly people at nursing homes, and should draw attention in future studies.

碩士
國立台北護理學院
醫護教育研究所
96
This study is to understand the fall prevention behaviors of institutionalized elderly adults with hypertension and the relevant factors that influence such behaviors within the framework of the PRECEDE model. Study design: A cross-section survey was designed with a total of 108 randomly selected elderly from three institutions in Taipei as the subjects. The study tools used were structured questionnaires including personal profiles and scales for the following: knowledge of fall prevention, health beliefs of fall prevention, self-efficacy for fall prevention, social support of important others for fall prevention and behaviors concerning fall prevention. Questionnaire data was analyzed with SPSS15.0 statistical software and several statistical methods including frequency, percentage, standard deviation, mean, ANOVA and stepwise multiple regression. The study findings indicate the following. (1) Markedly relevant factors for fall prevention behaviors are: frequency of falls, self-efficacy for fall prevention, support of important others for fall prevention, obtainment of information about fall prevention and regular exercise behaviors. (2) There is no marked relevance between fall prevention and these factors: gender, age, conditions of being afflicted by chronic disease, types and amounts of medicine taken, conditions of depression, conditions of orthostatic hypotension, balance, knowledge of fall prevention and health beliefs of fall prevention. (3) The results of stepwise multiple regression reveal that the support of important others for fall prevention, self-efficacy for fall prevention and exercise conditions in last six months are forecast factors for the fall prevention behaviors of institutionalized elderly adults. These can explain up to 25.5% of variance and among them, the support of important others for fall prevention has the greatest explanatory power(R square=.255, F＝11.795，P<.05). Conclusion: Forecast factors for the fall prevention behaviors of institutionalized elderly adults are self-efficacy for fall prevention, the support of important others for fall prevention and exercise conditions in last six months. The findings of the study may be used as basis for health promotion planners in devising fall prevention plans for the elderly.

碩士
國立中正大學
高齡者教育研究所
101
This study investigated the purposes of and effects experienced by elderly adults who were deprived of education early in their childhood by evaluating their life histories. The 3 purposes of this study are as follows. 1. To investigate the learning and life development experiences of elderly adults who were deprived of education. 2. To investigate the learning motivations and meanings of elderly adults who were deprived of education. 3. To analyze the factors that affected participants’ participation in learning. In this study, in-depth narrative interviews were used to investigate the learning-participation experiences of elderly adults who were deprived of education. Six elderly adults (4 women and 2 men) were interviewed. This study analysed the participants from a life course perspective by compiling life outlines, which involved current lives, life histories, and learning experiences. Second, the learning development and learning context of these participants were analysed. The educational development of these elderly adults is described as follows. 1.The participants were deprived of education early in their childhood for the following 4 reasons: transfers of political sovereignty, poverty, lack of compulsory education and, regarding the women, a necessity to stay at home and maintain the household. 2.The participants were affected in the following 3 manners by a lack of education: job restrictions, feelings of self-abasement, and inadequate life skills, which required them to rely on other people. 3. They were motived to participate in education for the following 3 reasons: They received encouragement from others, wished to achieve educational goals that they were unable to attain previously, and participate in social services. 4.Participation in learning conveyed the following meanings for these participants: learning increases knowledge, learning facilitates forming friendships, learning engages the brain and delays the effects of ageing, and learning promotes self-realization and self-actualization. 5.Factors that affected the participants regarding learning were work, teaching, social support, and ageing. The 4 main parts of the life course perspective were used to analyse the learning contexts of elderly adults who were deprived of education early in their childhood. Regarding timing, the participants lost compulsory education opportunities because of the formulation and execution of governmental policies, historical transitions, and unstable socio-economic factors. Their location in time and place was later affected after the participants were deprived of education early in their childhood. Concerning human agency, the participants established their own purposes and methods of learning. Regarding linked lives, the strongest effects on their willingness to learn were derived from social support and the advances of informal and formal education. Finally, we present a comparison of the learning contexts of elderly adults who were deprived of education early in their childhood. We derived 5 recommendations based on the results, which involve recommendations to government agencies, advanced-age agencies, teachers who teach elderly adults, and the methods of and participants in subsequent research. Keywords: the elderly adults who were deprived of education early in their childhood, life courses, learning participation

The diploma thesis focuses on education of older adults in relation to quality of life. The aim of the thesis is to identify the association between the participation of the elderly in education and their subjective quality of life. The study focused on identification of the association between quality of life and education at the university of the third age is designed based on theoretical and empirical findings. The quality of life is assessed using the WHOQOL-BREF and WHOQOL-OLD instruments. Quality of life assessment scores of 645 participants of the university of the third age are compared with normative scores for older adults. The study also examines the association between selected aspects of participation in the university of the third age, participation in other educational activities and quality of life of the elderly. The results confirmed that the education at the university of the third age is associated with subjective quality of life. The results also display that participation frequency and the number of semesters attended is not associated with the quality of life and that the contact with other university members and participation in other educational activities has very weak association with quality of life. These findings are discussed according to the theoretical resources and...