Project (M.A.) - Simon Fraser University, 2005. / Project (Dept. of Gerontology) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 134-140). Also available on the Internet.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Background: The worldwide ageing demographic trend has resulted in a growing number of frail elderly who are in the last stages of autonomous living. Oral nutritional interventions for the frail elderly address the body’s natural weight loss, sometimes reversing weight loss, though the literature is not of one accord. No review of nutritional interventions has been conducted for community-dwelling frail elderly, who are most likely to benefit from these interventions and delay adverse outcomes. Objective: (i) This systematic review analyzes results from randomized controlled trials of oral nutrition interventions for the community-dwelling frail elderly to determine their efficacy in making gains in nutritional and functional status. (ii) The secondary objective is to analyze the quality of the studies in this review and draw conclusions for further areas of development in the field of nutrition in elderly care. Methods: Randomized controlled trials of oral nutritional supplements were searched in The Cochrane Library and PubMed, and hand searched in reference lists of systematic reviews. These interventions targeted protein-energy deficiency and included oral supplementation or supplementation paired with exercise compared to a placebo or usual practice. Community-dwelling frail elderly not institutionalized or hospitalized were eligible. Studies targeting disease-specific elderly were excluded. Results: Out of 120 search results, six trials were included in this review. A small weight gain from oral nutritional interventions among frail community-dwelling elderly was reported in five out of six studies. Functional status did not improve significantly with the interventions. Studies used unstandardized definitions and different ways to measure outcomes, resulting in heterogeneity. Conclusions: The few and poor quality of studies demonstrates the need for more studies of better quality and homogeneity assessing oral nutritional interventions for nutritional and functional gain in frail elderly who are not yet suffering from adverse outcomes. / published_or_final_version / Public Health / Master / Master of Public Health

This study investigated the relationship between seniors' travel behaviors and living environments and the ways they successfully adapt to the environments, using a sequential mixed method in which qualitative methods follow quantitative analyses. The data were collected from the members of social clubs who regularly visit a community center for the elderly in a mid-size city in Osaka prefecture, Japan. One hundred ninety three seniors participated in the questionnaire survey asking about their daily travel patterns, personal backgrounds, social relations, and environmental information. Twenty-one seniors shared their perceptions of the city and the ways in which they get around through face-to-face interviews, sketch mapping, and one-week travel diary. The findings highlighted cultural and gender influences on seniors' mobility and the proactive nature of their travel behaviors. The participants were relatively healthy and active seniors who travel primarily by bicycle. The statistical analyses indicated that gender did not determine overall or average travel frequency but did identify factors related to high travel frequency. Living near a bus stop and the perception of going out more often than in the past predicted men's high travel frequency (going out every day), while women's high travel frequency was predicted by travel modes (bicycling and walking), sidewalk safety, chores (grocery shopping), and social network (seeing friends and having fewer relatives). Furthermore, the results of qualitative analyses revealed that seniors invented, modified, and applied various adaptive strategies to maintain or enhance their mobility. The positive perceptions of their communities such as favorable memories and beautiful scenery fostered seniors' familiarity and sense of belonging. Seniors used and modified social and environment resources to ensure travel safety. In addition, changes in senior's life stages and travel means manifested gender differences in their adaptive strategies. Men tended to focus on maintaining good health to keep their driver's license, representing their social role as a provider, while women's adaptations related to adjustment to widowhood and travel safety.

As the population trends continue to demonstrate the growth of the aging generation, it is apparent that this group of people are an increasingly important demographic. The elderly traveller is steadily showing increased interest in air travel. As such, designing travel spaces that support the needs and requirements for the security, comfort, and navigation of the senior population is necessary. The airport environment can be understood as a transitional space that is associated with stress and discomfort because it tends to be unrefined and poorly planned, and is generally regarded by the general public as an area of less importance. This interior design practicum seeks to address this issue through the design of an airport facility that re-evaluates the role of transitional spaces by creating a spatial narrative that connects people and spaces together on a physical and emotional level while addressing concerns of comfort and security that travellers encounter on their travels. The resulting proposed design for the Winnipeg Airport incorporates vibrant colours in a calming space to address wayfinding strategies, reclaimed and local materials that reflect the Manitoban landscape, and repetitive spatial elements that occur on each level both horizontally and vertically to make the space a place.

As the population trends continue to demonstrate the growth of the aging generation, it is apparent that this group of people are an increasingly important demographic. The elderly traveller is steadily showing increased interest in air travel. As such, designing travel spaces that support the needs and requirements for the security, comfort, and navigation of the senior population is necessary. The airport environment can be understood as a transitional space that is associated with stress and discomfort because it tends to be unrefined and poorly planned, and is generally regarded by the general public as an area of less importance. This interior design practicum seeks to address this issue through the design of an airport facility that re-evaluates the role of transitional spaces by creating a spatial narrative that connects people and spaces together on a physical and emotional level while addressing concerns of comfort and security that travellers encounter on their travels. The resulting proposed design for the Winnipeg Airport incorporates vibrant colours in a calming space to address wayfinding strategies, reclaimed and local materials that reflect the Manitoban landscape, and repetitive spatial elements that occur on each level both horizontally and vertically to make the space a place.

No description available.

The elderly form a physiological heterogeneous group. This thesis is concerned with the activity of plasma aspirin esterase and several other plasma esterases in the fit, community-dwelling and frail hospitalized elderly. I, Several studies have produced evidence to suggest that drug metabolism is altered in the frail elderly and some of this work has centred around the plasma esterases. Kinetic analysis of plasma from young people, and fit and frail elderly people showed that the reduced plasma aspirin esterase in the latter group was most likely due to a reduced amount of cholinesterase enzyme (a reduced maximal activity) rather than that of a compromised affinity of the enzyme (increased Km). Purification of whole plasma achieved the removal of 97% of the albumin component of plasma aspirin esterase. Subsequent kinetic analysis confirmed that there was no change in the Km value of plasma aspirin esterase in the three groups as a result of isolating the cholinesterase enzyme. Following this, it was postulated that the reduced activity of several plasma esterases in the frail elderly may be due to their often poor nutritional status. A group of frail elderly people were randomised and half received a supplemented hospital diet. Plasma aspirin esterase, cholinesterase, paraoxonase, phenylacetate esterase, red blood cell intracellular esterase and red blood cell acetylcholinesterase in addition to anthropometric measurements were measured at 0,4 and 8 weeks of the study period. The control group did not gain weight whereas the group who received a supplemented diet gained an average 1.3Kg (non-significant). The post study weight and TSF measurements between the fed and control groups differed signifcantly at p<0.05. There were no significant changes in any of the esterases at 8 weeks however plasma cholinesterase did show a significant increase in activity at 4 week (p < 0.05) and plasma paraoxonase showed a trend towards an improved activity.

No description available.