Abstract The global phenomenon of declining birthrate and aging society have provided promising prospects for the future development of smart robots (´¼¼z«¬¾÷¾¹¤H). In respond to this need, large amount of R&D, manufacturing and HR resources have been put in the training, technology and product development of smart robots. Not only should Taiwan accelerate the overall implementation strategy for this emerging industry, it should also understand the worldwide robotics industry development overview. This paper has organized worldwide R&D and educational implementation of smart robots for the past year along with conducting in-depth interviews with domestic experts and government agencies. These studies show different country¡¦s corresponding strategy on their own industry development, R&D personnel training, implementation into the education systems, and technology innovation applications for robotics industry. It will also analyze the necessity of promoting education on robot technology as suggested by domestic scholars and professionals. From the multiple perspective of international environment, changes in the domestic educational environment, national development objectives, to Dahan Co. Ltd strategies, we can conclude the promotion of education in robotics technology is beneficial in innovation and creativity. It is also necessary as it can help to encourage students to conduct research in this field. The purpose of this thesis is to provide a feasible proposal that creates a synergy between the developments of the robotics technology industry and also Taiwan¡¦s educational system.

This thesis examines how current demographics and evolving family dynamics act as a catalyst for the evolution of a building in response to how the elderly can successfully age in place. Through the design of a residential building in an inner city neighborhood of Calgary, Alberta, this thesis explores the potential for architecture to accommodate diverse families (such as singles, couples, single parent families, and the elderly) in one development, maintaining existing relationships, promoting social cohesiveness, and providing an informal network of support for the elderly. The project investigates how architecture might facilitate the integration of the elderly through ?exible relationships of building programme and unit variation.

<p> Canada's population is experiencing a change in its age structure which is increasingly becoming older. This has implications for many of the governments economic and social programs and society as a whole. As labour force participation among the elderly decreases, expenditures for social programs are increasing to supplement seniors relatively low income. The increased use of health services will also strain economies on the provincial level citing the need of increased community services.</p> / Thesis / Candidate in Philosophy

Abstract available in The Journal of Nutrition, Health, and Aging.

Made available in DSpace on 2014-06-11T19:27:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-09-19Bitstream added on 2014-06-13T20:36:20Z : No. of bitstreams: 1 mendes_bc_me_rcla.pdf: 1007216 bytes, checksum: 83d2499777113b28b5bb283713ed31eb (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Nas últimas décadas, o Brasil vem experimentando profundas transformações em seu padrão demográfico. Dentre estas alterações, destaca-se o aumento da participação dos idosos no total da população. Este fenômeno, conhecido como envelhecimento populacional, decorre principalmente da queda das taxas de fecundidade e mortalidade e, do aumento da longevidade. Diferentemente dos países industrializados, o envelhecimento populacional brasileiro surpreende por sua rapidez e, pela multiplicidade de questões que suscita. As particularidades do segmento idoso (declínio das funções sociais, econômicas, psico-biológicas), combinadas aos problemas socioeconômicos brasileiros (má distribuição de renda, desemprego, previdência social e sistema de saúde deficitários), representam desafios a serem enfrentados pelo poder público, sociedade, família e pelo próprio indivíduo. Dentre estes desafios, aqueles relacionados à micro-escala adquirem importância. Em primeiro lugar, porque o envelhecimento populacional brasileiro é espacialmente diferenciado, alguns espaços encontram-se em estágio mais avançado. Em segundo, porque os idosos vivem, convivem e demandam, predominantemente, em escala local. Esta pesquisa contemplou empiricamente o estudo do processo em um espaço local. Como o município paulista de Assis, tem registrado um envelhecimento populacional mais acentuado que o verificado no Estado de São Paulo e no Brasil, converte-se em um interessante objeto de estudo da problemática. / In the last decades, Brazil has been experiencing deep changes in its demographic pattern. Among these changes the increase of the proportion of elderly people in the population stands out. This phenomenon, known as aging population, occurs mainly due to the decline of fertility and mortality rates and the rise of life expectancy. Unlike the industrialized countries, the Brazilian aging population, surprises because of its speed and because of the multiple questions that involves it. The specific characteristics of elderly people (decline of social, economic and psycho-biological functions) combined with the Brazilian socio-economic problem (bad income distribution, unemployment, inefficient social and health care), represent challenges to be faced by the public sector, society, family and by the people themselves. Between these challenges, those related to the micro-scale, or local scale, acquire importance. First because the Brazilian aging population is spatially different, some spaces present higher levels of the process. Second, because elderly people live, relate and demand, largely, in micro-scale. Therefore, the empirical purpose of this study was to investigate the aging population of a local space. Assis city, where the process reaches higher levels than in the State of São Paulo and Brazil, becomes an interesting object of study of the problem involving the local govern, society and elderly people.

Chapter 1: Interregional Transfers through Public Pension in Canada- In this chapter, I build a regional computable general equilibrium model with an overlapping generations (OLG) structure of the Canadian economy to analyze population aging dynamics and public pensions. Canada is divided into three regions: Atlantic, Quebec and Rest of Canada (ROC). The impact of population aging is investigated on each of three regions' pension systems. The results confirm that as a result of aging all regions are affected negatively if they choose to have an independent pension system. Under a joint pension system most of the pressure of the provision of the pension system is on the ROC. Atlantic region benefits the most from a joint pension plan as the implicit funds ow from ROC to Atlantic region. Quebec benefits from having its own program, but the benefits disappear slowly in future years. Chapter 2: Age-Variable Rate of Time Preference in CGE-OLG Model- Contrary to the mainstream studies in the area of intertemporal optimization that assume a constant rate of time preference over individuals' life cycles, in this chapter I propose a new approach to measure the rate of time preference by assuming that the rate of time preference evolves by age. I construct an overlapping generations model (OLG) and calibrate rate of time preference. The age-variable rate of time preference would permit to capture many other elements that affect the life cycle profile of consumption as observed in the data. The results show that rate of time preference exhibits three phases and is different for young versus old. Chapter 3: Computing Demographic Change Simulation under Constant and Age-variable Rate of Time Preference - This chapter simulates the impact of an aging population on various macroeconomic variables and calculates the cohort welfare as well as social welfare. The outcomes from simulations are dependent on the choice of rate of time preference as well as the structure of the model. The results in this chapter provide a new approach to determining the impact of aging population. The choice of a realistic rate of time preference, which allows its variability by age, affects the cohort welfare noticeably.

Orientador: Odeibler Santo Guidugli / Banca: João Francisco de Abreu / Banca: Solange Terezinha de Lima Guimarães / Título da capa: Envelhecimento populacional : desafios de uma nova conjuntura demográfica para o município de Assis - SP / Resumo: Nas últimas décadas, o Brasil vem experimentando profundas transformações em seu padrão demográfico. Dentre estas alterações, destaca-se o aumento da participação dos idosos no total da população. Este fenômeno, conhecido como envelhecimento populacional, decorre principalmente da queda das taxas de fecundidade e mortalidade e, do aumento da longevidade. Diferentemente dos países industrializados, o envelhecimento populacional brasileiro surpreende por sua rapidez e, pela multiplicidade de questões que suscita. As particularidades do segmento idoso (declínio das funções sociais, econômicas, psico-biológicas), combinadas aos problemas socioeconômicos brasileiros (má distribuição de renda, desemprego, previdência social e sistema de saúde deficitários), representam desafios a serem enfrentados pelo poder público, sociedade, família e pelo próprio indivíduo. Dentre estes desafios, aqueles relacionados à micro-escala adquirem importância. Em primeiro lugar, porque o envelhecimento populacional brasileiro é espacialmente diferenciado, alguns espaços encontram-se em estágio mais avançado. Em segundo, porque os idosos vivem, convivem e demandam, predominantemente, em escala local. Esta pesquisa contemplou empiricamente o estudo do processo em um espaço local. Como o município paulista de Assis, tem registrado um envelhecimento populacional mais acentuado que o verificado no Estado de São Paulo e no Brasil, converte-se em um interessante objeto de estudo da problemática. / Abstract: In the last decades, Brazil has been experiencing deep changes in its demographic pattern. Among these changes the increase of the proportion of elderly people in the population stands out. This phenomenon, known as aging population, occurs mainly due to the decline of fertility and mortality rates and the rise of life expectancy. Unlike the industrialized countries, the Brazilian aging population, surprises because of its speed and because of the multiple questions that involves it. The specific characteristics of elderly people (decline of social, economic and psycho-biological functions) combined with the Brazilian socio-economic problem (bad income distribution, unemployment, inefficient social and health care), represent challenges to be faced by the public sector, society, family and by the people themselves. Between these challenges, those related to the micro-scale, or local scale, acquire importance. First because the Brazilian aging population is spatially different, some spaces present higher levels of the process. Second, because elderly people live, relate and demand, largely, in micro-scale. Therefore, the empirical purpose of this study was to investigate the aging population of a local space. Assis city, where the process reaches higher levels than in the State of São Paulo and Brazil, becomes an interesting object of study of the problem involving the local govern, society and elderly people. / Mestre

Against the backdrop of successful family planning in China, the aging of the society’s population is increasing. With the increasing number of older adults, the support of the elderly has become a significant issue for society. Filial piety and respect for the elderly are the fundamentals of Chinese society and its long history. One aspect of filial piety focused on the responsibilities of the family in eldercare. It advocates that the elderly need not only material help but also spiritual comfort and emotional support. This culture of filial piety in a traditional Chinese society illustrates a path for responding to problems of the aging population. However, with the advent of an industrialized society, China’s family structure has undergone fundamental changes. There is an increasing trend of families choosing to send the elders to long-term institutional care rather than home or community care. This has led to conflict between traditional filial piety principles and the new model of aging healthcare. As a result, it is important to understand whether the new institutional care in China will meet the material and spiritual needs of the elderly. This paper aims to examine how Chinese values connect with eldercare treatments nowadays with the interplay of filial piety Confucian familism. More specifically, this paper discusses how Confucian values play in the relationship among eldercare locations, accessibility to care, and how filial piety has been expressed in the senior home before and during the COVID-19 pandemic in China. Also, since the available data on service and quality in nursing homes in China is limited, it is important to understand what administrators and caregivers are experiencing as a first step. This paper examines the following issues during the COVID-19 outbreak. 1. To what extent does Filial-piety Confucian familism play a role in young and elder generation’s attitudes regarding elder health care? 2. What challenges do the nursing homes face before and during the pandemic? 3. How was filial-piety expressed in the nursing home before and during the pandemic? Methodology and Methods This project conducted a total of 15 in-depth interviews with selected interviewees, including both selected administrators and caregivers in five nursing homes in Shanghai, China. As the researcher was born and raised in Shanghai, the insights for this research came partially from the real-life experience and a personal understanding of Chinese culture. The researcher conducted this qualitative study in Shanghai during the time when there were restrictions on travel and interaction due to COVID-19. Regarding the location specialty, the researcher was able to conduct interviews in Shanghainese and observe the cultural rituals inherent in the region. The interviews were conducted to observe examples of experiences that administrators and caregivers observed or participated in. As such, the results are based on examples more so that opinions or attitudes. All interviews were recruited through email exchanges and discussions were over WeChat (a Chinese communication app) and phone calls due to the pandemic restrictions. Key Findings This study found that numerous young people in China chose to place their parents in nursing homes due to busy work schedules, house demolitions, and the need for long-term medical care for their parents. However, senior care institutions are still in the stage of exploration and standardization. Inevitably, there are some problems, including a shortage of professional medical staff and a limited level of medical services that can be provided. It was found that this new and flourishing model of elderly care is also facing a series of problems that are prevalent around the world, such as high bed vacancy rate, endless psychological problems of the elderlies, and increased operating costs of nursing homes. This information has led us to question whether the elders are living well and to try to understand views of nursing homes and filial piety. We found that most elders have gradually changed their traditional concept of filial piety to a more modern one. The administrators and caregivers we interviewed said that “filial piety” is a respect from the heart, a mutual emotional exchange and understanding. It possesses equality and democracy between two generations. Their comments suggest that more elderly people living in nursing homes have low attachment to traditional notions of filial piety. In contrast, more children have a solid attachment to traditional filial piety because they struggled mentally before sending their parents to a nursing home. In addition, the study found that filial piety was expressed differently before and during COVID-19. Prior to the pandemic, the administrators and caregivers suggested that individuals were more inclined to fulfill practical obligations and compassionate reverence needs. Whereas, during the pandemic, filial piety was expressed less practically and more emotionally due to the closure of institutions. Future Research Further studies should expand the sample size by including more nursing homes in various districts of Shanghai. It would be helpful if researchers can interview the caregivers and administrators in person and visit some of the care homes to gather other information on the unique needs of clients and families. Further studies could seek to discover how filial piety plays a role in the nursing home after the pandemic has passed. The challenges of the aging models can be further analyzed and recognized through exploring public policies and the needs of China’s overall society. For example, China's future pension system might need to respond to how filial piety evolves. A comprehensive pension security system based on current filial views could be established where children might play different roles in the older adults' material life, care, and spiritual comfort. This research offers suggestions to consider in future research relating to finding a role for elderly care homes in society in reducing some of the negative perceptions of these homes, developing a model that meets the needs of elderly and children, and training and developing staff. Firstly, research might seek to understand how to address some of the negative perceptions of the nursing homes and, possibly, change the view that nursing homes do not mean an abandonment of the elderly. Rather, research might seek to illustrate ways that nursing homes might implement a modern version of filial piety which provides a way that elderly can live in a care home as well as participating with their children in their family homes. Secondly, the study might get input into a template or model for designing nursing homes to recognize the evolving changes and pressures on traditional views of filial piety. As needs of children and elderly in a society have changed, so have their expectation of filial piety and, given these changes, how do we develop elderly institutions to respond to the economic needs of children and society at large? Thirdly, the research might investigate the response to the concerns raised from administrators about the shortage of trained staff. This might involve identifying needs of qualified care professional and encouraging their training and developing in colleges, vocational and technical colleges, secondary vocational schools, and county vocational education centers. / Graduate

Healthcare services for the aging population in the United States are a complex configuration of acute healthcare organizations, and post acute nursing facilities, home healthcare, and community based services. The system encompasses all services that imply the need for clinical, medical, or professional judgment (Baldrige National Quality Program, 2006). Most Americans believe the system exists to provide preventive services, management for chronic conditions, and health care services to meet the needs of the people (National Committee for Quality Assurance (NCQA), 2004). However, the healthcare delivery system is fragmented across a broad array of settings (Coleman, Smith, Frank, Min, Parry, & Kramer, 2004), plagued by gaps in quality of care, and does not provide optimal care to the majority of American citizens (NCQA, 2004). As a result, national efforts are focused on the identification of quality indicators, performance measures, and the driving need for consensus standards across a multiplicity of providers, payers, and stakeholders. The overarching focus of this effort is to bridge the gaps in health care quality, and reduce documented disparities for vulnerable populations (National Quality Forum (2004). Healthcare transitions occur as patients receive a broad range of services across a multiplicity of providers, payers, and settings. Aging patients > 65 are most vulnerable during these transitions. A poorly executed transition can result in complications for the patient, duplication of tests and services, discharge delays, increased lengths of stay, early readmissions to the acute care setting, frustration for families and care givers, and dissatisfaction with overall services. Management of care and accountability across settings is limited and patients are falling through the cracks in the foundation of the healthcare system (Covinsky, 2003). The intent of this research was to examine healthcare transitions for patients > 65 admitted to a large acute healthcare system, and to identify measurable quality indicators for an innovative delivery model designed to optimize early discharge from the hospital through rapid rehabilitation. This was a quasi-experimental, cross-sectional design measured at the patient level. The research included a total sample of 250 patients representing both the intervention and the control group. The intervention group consisted of 100 patients who were rapidly discharged to a transitional care facility in the community, and 150 patients randomly selected to a control group that did not transition to rapid rehabilitation. The groups were matched as closely as possible by age, gender, race, primary diagnoses, and the complexity of case. Inefficiency was measured by 3 indicators (1) length of stay, (2) total expenses before contractual allowances, and (3) discharge delays from the hospital. Ineffectiveness was measured by 3 indicators: (1) readmission within 30 days, (2) patient safety with falls serving as the proxy, and (3) overall patient satisfaction. Descriptive analysis was performed utilizing SPSS 15.0. Path analysis was method of choice for data analysis and AMOS 7.0 was utilized for the measurement model. Descriptive analysis found a broad range of diagnosis related groups across 183 women and 67 men with a mean age of 80 for both groups. Initial analysis found the intervention group had a mean length of stay of 9.17 days, and experienced 20 readmissions. The control group had a mean length of stay of 6.77 days, and 30 readmissions. The statistical analysis suggested length of stay and cost of healthcare services are statistically significant indicators at the 0.05 or lower level and that patient safety has the potential to be developed as an indicator for effective outcomes. The identification of quality indicators, measurement of efficiency and effectiveness, and establishing predictors for successful healthcare transitions is dependent on the quality and integrity of data abstracted from hospital information systems, accuracy of information in patient records, and the consensus of standards and definitions across a multiplicity of stakeholders. Further research and collaboration is necessary to ensure that patient transition to innovative care programs such as rapid rehabilitation is based on well-defined patient selection criteria. The intent of the methodologies and quality indicators explored in this research supports the increasing need to ensure that inferences and quality measurements drawn from healthcare information is based on valid, reliable, and well defined data sources (Pan, Fergusson, Schweitzer, & Hebert, 2005). This research suggests hospitals are making steady progress to overcome challenges to safe, quality health services as outlined by the Institute of Medicine (2001) for system redesign, but finds specific implications for hospital leadership. There is a need to thread evidence based practice initiatives into hospital and clinical structures to accommodate new delivery models, processes, and case management. Health services information needs to be housed in a central repository or data warehouse to increase transparency of reportable information across systems and to ensure that valid and reliable information is utilized to draw inferences about performance of hospital systems (Selden & Sowa, 2004) and that quality measurements are established to ensure a scientific foundation for the management of healthcare services (Wan, 2002).

The Triratna/FWBO Buddhist movement has been associated with younger people and a lifestyle in which single sex residential communities and work projects (TBRLs) have been prominent. There is now a trend towards a wider range of lifestyles including fewer people living communally. Demographic changes include 50+ average age for ordained members and some people developing Long-Term Care (LTC) needs, with limited family and financial support. This raises questions as to the extent to which ‘Buddhist identity’ can be supported in LTC situations, with informal care, mainstream LTC services and possible care-based TBRLs all relevant.Data-gathering was initially on the basis of a general investigation of LTC issues in Triratna/FWBO using an eclectic, primarily qualitative design which had features of both a case study and a cross-sectional survey. 17 interviews included participants with current LTC needs, others asked to anticipate future care preferences, and people with relevant expertise. A questionnaire was formulated to explore attitudes to possible care-based TBRLs, with 107 participants and numerous additional comments. There was a strong consensus that Buddhist-based LTC services would, for example, provide better vegetarian diets and have an understanding of Buddhist names taken at ordination. These features were included in a conceptualisation of Buddhist identity which contrasted ‘Buddhist’ and ‘Non-Buddhist’ life, and noted ‘Dreams’ and ‘Nightmares’ as to LTC. Effective basic care was seen as essential to the general level of well-being needed for Buddhist practice, whilst a higher level of support might facilitate access to Buddhist ‘life goods’, and assist people in self-verifying themselves as committed Buddhists through ongoing practice. Informal support from fellow Buddhists was available in many contexts, but not at levels of intensity and duration characteristic of some family-based care, and it was seen as modulated by perceptions of burden, ‘busy-ness’ and other factors. There was a ‘legacy of suspicion’ of mainstream LTC, mainly focussed on residential care, with acknowledgement of some good/respectful carers and care services. TBRLs in LTC were generally welcomed, being seen as suitably altruistic work which might feature an atmosphere of ‘mutuality’ between staff and clients who were Buddhist or of Buddhist sympathy. Comparative material was used here from Methodist, Jewish and Lesbian/Gay/Bisexual/Transgender (LGBT) communities in LTC contexts, with the last of these conceptualised as comparable to the Western Buddhist community as a currently emerging identity in terms of later life services. Practicality and feasibility were discussed with reference to existing TBRLs, and experience of paid-for care input between Buddhists. The latter appeared supportive of Buddhist identity and readily linked to the personalisation agenda in social care. Buddhist-friendly services were seen as a possible context for generativity, and the concept of ‘a natural part of life’ was explored in terms of the emergence of LTC in the Triratna/FWBO movement, and of Buddhism as a gradually more familiar identity which might be encountered in the sphere of LTC.