Thesis (M. Arch.)--University of Hong Kong, 1999. / Includes special report study entitled: Interactive circulation space for elderly. Includes bibliographical references.

Thesis (M.S.W.)--University of Hong Kong, 1982.

Thesis (M.S.W.)--University of Hong Kong, 1981. / Typescript.

Thesis (M.S.W.)--University of Hong Kong, 1985.

Thesis (M.S.W.)--University of Hong Kong, 1981.

Findings released from recent pivotal clinical trials on hormone therapy (HT) benefits and risks have stimulated a growing trend towards lower doses and earlier discontinuation of HT for menopausal women. Yet, there is little knowledge regarding women's personal experiences with the resultant earlier and possibly abrupt withdrawal of HT. The purpose of this study was to explore postmenopausal women's vasomotor symptom experiences after discontinuing HT. The data for this study was collected from menopausal women who discontinued HT. The study questionnaire was created through an extensive review of the literature as well as an expert panel review. The questionnaire was also piloted with a small group of women prior to its use in this study. Data analysis consisted of descriptive analysis with means and standard deviations and/or frequency distributions with percentages for demographic data, health behaviors, factors influencing HT decisions, use of CAM and perceived efficacy. Chi-square analysis, Spearman Rho correlation, and logistic regression analysis were conducted for contextual factors and vasomotor symptom experiences. A McNemar test was performed to assess within group differences for vasomotor symptoms experiences pre and post HT. Questionnaires were received from 563 menopausal women throughout the United States. This study revealed that 80% of participants experienced vasomotor symptoms after discontinuing HT. The most common predictors which accounted for only 13% of variance in the occurrence of vasomotor symptoms were younger age, type of menopause and the occurrence of vasomotor symptoms prior to initiation of HT. Of the 563 women participating in the study, less than half reported the use of CAM to treat reemerging vasomotor symptoms. For the most part, less than half of the women felt their treatment choices were helpful in relieving their reemerging vasomotor symptoms Because a woman's experience of menopause can be highly individualized, an adaptation of Bronfenbrenner's ecological theory was used guide this exploratory study. The study findings supported the usefulness of the adaptation of Bronfenbrenner's ecological theory as a model through which to view the vasomotor experiences of menopausal women who have discontinued HT. / text

Too many elderly women suffer rapid aging decline, frailty and hypokinetic disease simply because of inadequate levels of physical activity. While the biopsychosocial benefits of regular exercise are now well-known, explanations are lacking for the reluctance of aging Canadian females to take up, or keep up, healthful forms of leisure-time physical activity. The purpose of this study was to examine and explain the variability of participation in health-promoting form sof exercise in elderly women. Several health behavior theories and personal attributes have shown promise in explaining exercise behavior, and thus, a second purpose of the study was to test the utility of a composite theoretical model. The composite model included ten personal and situational attributes as well as five cognitive beliefs about physical activity adapted from Social Cognitive Theory and a belief about personal control over one's health from Health Locus of Control Theory. A city-wide sample of 327 Vancouver women aged 70 and 98 years filled out survey questionnaires providing information on the 16 model variables in addition to kilocalorie estimates of exercise in the past week. Multiple regression analysis was used to explain late life exercise in three stages: 1) regression on the ten personal and situational attributes; 2) regression on the six cognitive beliefs; and 3) combined regression on all the significant predictors. From the life situational variables, health, childhood movement confidence, school location, and age were significant factors explaining 18% of the variability seen in current exercise level. From the cognitive variables, current self-efficacy to exercise and current social support to engage in physical activity were the only significant predictors (R2 = 22%). A full regression model was tested by including the four statistically important situational variables and the two cognitive variables from the previous analyses. The utility of the Composite Model was supported in that both situational variables and self-referent beliefs played significant and independent roles in explaining late life exercise (R2 = 26%). The main reasons that older women were physically active were: 1) they perceived high levels of social support to exercise (b = .239, p< .01); 2) they felt efficacious for fitness-types of activities (b = .185, p< .01), 3) they had satisfactory health (b = .174, p < .01), and 4) they were educated in foreign countries (b = -.125, p < .01). Health locus of control offered some explanation but was not able to demonstrate significance alongside other cognitive beliefs (b = -.106, p < .06). Education, socioeconomic status, work role, family size, and marital status were not able to explain late life exercise. This study found that health difficulties do indeed interfere with women’s activity patterns. However, women are also influenced by perceptions of declining social support, lower levels of movement confidence, and chronological age, to reduce their physical activity. Thus, regardless of their health situation, the explanation of exercise involvement in older women rests to a large degree on the amount of social encouragement they perceive from family, friends and physicians, their self-efficacy for fitness activity, as well as perceptions of age-appropriate behavior. Older women who were educated as children outside of Canada, Britain and the U.S. appear to be culturally advantaged for late life physical activity participation. Moreover, childhood movement confidence stands as a significant predictor among the situational variables. These findings suggest that participation in physical activity, and positive beliefs about exercise in late oo, are rooted in competencies and experiences acquired in childhood. Perceptions of inadequate encouragement appear to be limiting females, from childhood on, to develop and sustain confidence in their physical abilities that would promote a more active lifestyle into their oldest life stage.

Health, housing and much more recently, assistive technology, are key determinants of elderly independence in British Columbia. This thesis discusses these three determinants in some detail, and also stresses their interrelationship with each other. Throughout the entire thesis, the elderly's preference to age-in-place (Blackie, 1986; Wheeler, 1982) is stressed. In the issue of health, the current community-based health care delivery system of the British Columbia Ministry of Health's Continuing Care Division is compared and contrasted with a "counterpart" in the United States: the On Lok Health Services System in San Francisco, California. On Lok is discussed to highlight its effectiveness in delivering a community-based holistic health care system for a group of aging-in-place elderly in need of long term care with relatively low cost. In the issue of housing, the thesis investigates three avenues in which architects can apply their skills to maximize aging-in-place possibilities for our elderly in the context of British Columbia. Constraints by building codes, health care regulations, real estate market expectations and the aging characteristics of British Columbia's elderly are also highlighted to bring context to the discussion. In the issue of assistive technology, given the huge range of product development, the thesis focuses on one particularly interesting communication device - the Videophone. The Videophone is discussed to explore its potential impact for elderly independence, especially for the future.

Background and hypothesis. Edentulous patients may be at risk for malnutrition and cardiovascular disease even with well made dentures. Improvements in methods used to assess nutritional status suggest that functional biomarkers such as plasma homocysteine (tHcy), in addition to traditional methods, will provide a better quality assessment. The hypothesis is that there is an association between functional biomarkers of nutritional status and traditional cardiovascular disease risk factors in a community dwelling edentulous elderly population. / Methods. This was a cross-sectional study of the baseline characteristics of a convenient sample of 254 edentulous community dwelling elderly over 65 years. Measurements included anthropometric, body composition, homocysteine, vitamins and relevant blood components. Correlations, multiple regression models and Adjusted Odds Ratios (AOR) for tertiles were used to assess the relationship between vitamins and other parameters with hyperhomocystenemia, defined as THcy value of &ge; 14mmol/L. The independent effect of edentulism on hyperhomocysteinemia was sought using the NHANES III data. / Results. The prevalence of hyperhomocysteinemia was 49.2%. Effect of folate on hyperhomocysteinemia was significant (p = 0.037). Low folate tertile group had a 2.45 times higher odds (CI: 1.23, 4.87) of hyperhomocysteinemia than patients in the higher tertile (p = 0.019). Groups with normal folate did not have higher odds of hyperhomocysteinemia regardless of levels of vitamin B6 or B12. AOR for vitamin B12 tertiles in relation to hyperhomocysteinemia were 2.36 (CI: 1.18, 4.75) and 2.12 (1.07, 4.22) for lower vs. high. A weak inverse relationship existed between tHcy and vitamin C (r= -0.11, p= 0.045). A borderline negative correlation existed between HDL and THcy adjusted for age (r = - 0.12; P = 0.05). Significant correlation existed between THcy and BMI (r = 0.15, P = 0.02), small waist circumference (r = 0.22; p = 0.0004) and waist/hip ratio (r = 0.23, p = 0.0003). In a multivariate analyses, edentulism was associated with hyperhomocysteinemia (p = 0.012). / Conclusions. In this sample, homocysteine levels appeared much higher than one would expect with folate fortification, and were related to several cardiovascular risk factors. Using data from NHANES III, edentulism was found to independently predict hyperhomocysteinemia. The inverse relationship between homocysteine and vitamin C and the effect of folate on hyperhomocysteinemia suggests that increasing dietary intake of fruit and vegetables in edentulous individuals might be beneficial. Furthermore, the latter are at risk of developing hyperhomocysteinemia, a condition associated with cognitive impairment, dementia and coronary artery disease risk.

Introduction: Stroke is associated with a high prevalence of dysphagia in the elderly population. Hence, dysphagia evaluation and management are key issues in stroke rehabilitation. The McGill Ingestive Skills Assessment (MISA) is a recently developed mealtime observational tool aimed at evaluating the functional aspects of the oral phase of ingestion. Objective: To determine the discriminative validity of the MISA by assessing known/extreme groups of elderly individuals presenting with stroke, who have been admitted to an acute-care-hospital or a rehabilitation center. Participants were allocated to one of two groups: 1) individuals with stroke and no dysphagia, who are on a regular diet and 2) individuals with stroke and dysphagia, who are permitted only purees. Methods: Participants were evaluated with the MISA and a comprehensive chart review was conducted. Analysis: Groups were compared on socio-demographic and clinical characteristics. Univariate tests were performed to test the significance of between-group differences. Conclusion and significance: The results of the study are satisfactory, and enhance the clinical usefulness of the tool for dysphagia management. These results also support future studies addressing the responsiveness of the MISA.