Thesis (Ed.D.)--Boston University

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Each year the rate of slip and fall accidents increases among older individuals. Most falls among the elderly occur indoors rather than outdoors, and of the falls that occur in the residential home, over 600,000 are due to floor covering materials. In particular, carpet and vinyl are common floor coverings used in the home today as the elderly often transition from carpet to vinyl and vice versa. When transitioning between two different floor surfaces, older adults may adjust their gait to avoid a slip, trip, or fall. Many studies have assessed gait parameters of elderly individuals on either carpet or vinyl. Yet, few have studied the effect of transitioning between two different floor surfaces on the gait of older individuals. This study investigated the effect of transitioning between different floor coverings on the gait characteristics of the elderly. For this study, 14 elderly (65 years old and over) and 14 young (18 to 35 years old) individuals participated. All participants walked on different transitional floors, namely carpeted floors, vinyl floors, and floors covered with both vinyl and carpet. While the participants were walking on the walkway, different gait parameters were measured, including the required coefficient of friction, stride length, transitional acceleration of the whole body center-of-mass (COM), heel velocity at heel contact, perception of slipping/tripping, and toe clearance. It was hypothesized that older participant's gait parameters would be different from their younger counterparts. Also, the older participant's gait adaptation would increase the likelihood of a slip and trip propensity while transitioning between different floor surfaces compared to the younger participants. More specifically, for the elderly, transitioning from carpeted floor surfaces to vinyl floor surfaces would increase the slip propensity and transitioning from vinyl floor surfaces to carpeted floor surfaces would increase trip propensity, and therefore increase the likelihood of fall accidents. In the present study, it was found that elderly individuals had greater toe clearance than their younger counterparts. Also, the elderly individuals had smaller toe clearance on the carpet than on the vinyl, which would increase the probability of a trip-induced fall when walking on the carpet. Further, the propensity of a slip-induced fall accident increased on the vinyl shortly after transitioning from the carpet to the vinyl due to the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase of the gait cycle, rather than heel contact phase of the gait cycle. In addition, it was also found that an increase in heel contact velocity and step length increases the propensity of a slip-induced fall accident. Furthermore, this propensity is greater while transitioning from a carpet to a vinyl floor surface, especially for elderly individuals. The results of the present study indicate that transitioning between different floor surfaces changes the biomechanical parameters of gait, especially for the elderly individuals. Although the increased likelihood of a slip or trip accident was found throughout the changes in biomechanical gait parameters, the elderly individuals who participated in this study did not perceive of slipping and tripping much. Therefore, elderly individuals should be made aware of / Master of Science

An environment strongly influences the behavior of individuals with dementia. A well designed physical environment can maintain and enhance the ability to function and improve quality of life. My thesis uses a residential environment for people suffering from dementia as the basis for therapeutic intervention. Understanding the physical and psychological effects of architecture on a person with dementia is an important tool in slowing the progression and effects of the disease. The competence of an individual can effect how he or she experiences a space and can make them respond more intensively to the immediate environment. Building orientation, color, lighting, and access to nature can affect the psyche of a resident and can help stabilize and reduce the effects of the disease. / Master of Architecture

The vitality of the city is substantially dependent upon the coexistence of old and new-buildings and people. A lot can be learned from the history and/or the potential of different generations; in the city this exchange is inevitable. The quality and arguably, quantity, of life are inextricably tied to both diversity and community. Human interaction, sense of belonging and dependence on others, make urban living desirable. The built environment of the city, similarly, tolerates the vernacular and its deviations over time. The challenge for designers is the recognition of the impact one building can have--just as no actions are neutral, no building exists without its particular and broader context. This is not only a source of inspiration, an opportunity for thoughtful, responsive design, but an imperative. / Master of Architecture

<p>Major changes have occurred in South Africa over the past twelve years. The delivery of health care changed significantly. Community Health Centres (CHCs) became the main service delivery sites within districts. Due to socio-economic changes in the country, the care of dependants, particularly children and the aged, became problematic to families where most of the adult members have to work to secure an income. A focused literature search indicates that informal carers are ill prepared for their task, that there is a need to include these carers in the discharge planning of the dependants and that the carers need to be supported within their families and communities. The aim of this study was to explore the experiences of informal carers during the transition of their elderly dependants from hospital to home, within the home and across different social groupings in the metropolitan area of Cape Town, South Africa. In addition, the involvement of informal carers in the rehabilitation of the elderly was explored.</p>

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