published_or_final_version / Social Work / Master / Master of Social Work

One of the major issues concerning old age security is the adequacy of support systems for the aged population. Population aging and economic development in the People's Republic of China have raised the question about the ability of the family to take care of the elderly. Using the latest data collected by the Research Center on Aging in China of a national representative sample of the aged population, this study develops a model to examine the effectiveness of family support for the elderly during the current socio-economic transition of the society. The model also examines the adequacy and effectiveness of state welfare systems on the aged population and the effect of select socio-demographic factors on the well-being of the elderly in China. The investigation into the social, economic, and health aspects of the life of the elderly provides the background knowledge for understanding the support systems for the elderly in China. The multivariate analyses of the effects of the elderly support systems within the framework of shared functions of the primary groups, and the bureaucracy in achieving social goals, identify the important effects of the economic conditions of the family and the state income maintenance programs on the sense of well-being of the elderly. The findings lead to the conclusion that the cooperation of the family and the state is necessary to provide a secure life for an aged population. The patterns and trends of old age support in China are found to be constrained by the interplay of various social forces, among which the effect of politicalization of the social and economic conditions of the elderly is crucial. Policy recommendations include public assistance to the family, encouragement of the local effort, and national legislation on old age security.

Yu Sau Fung. / "October 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 389-460) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Faculty of Education and the Arts. School of Social Sciences. Includes bibliographical references (leaves 247-276)

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

This research investigated banner ads on the World Wide Web, specifically the types of messages used in those ads and the effectiveness of the ads as seen by their intended audience. The focus was on health-related banner advertisements targeting senior citizens. The study first sought to determine the frequency of appearance of those ads when classified into categories of compliance-gaining tactics provided by research scholars. Second, the study explored the relative perceived effectiveness among those categories. Two graduate students from a Central Texas university sorted text messages into predetermined compliance-gaining categories. Chi square tests looked for significant differences in the frequencies of banner ads in each category. Forty-five senior citizens from the Central Texas area completed surveys regarding the perceived effectiveness of a randomly ordered, randomly selected set of categorized banner ads. A repeated measures test attempted to determine whether some compliance-gaining strategies used in health-related banner ads were perceived as more effective than others. The hypothesis stated that there would be differences in frequencies of compliance-gaining strategies used among the compliance-gaining categories in health-related banner ads for senior citizens. The hypothesis was supported. The research question asked if some categories of compliance-gaining strategies used in health-related banner ads were perceived as more effective than others by senior citizens. There was no evidence that senior citizens perceived any compliance-gaining category as being more effective than any other. However, post hoc analyses revealed trends in the types of compliance-gaining messages senior citizens perceived as more effective. These trends provide a basis for directional predictions in future studies.

The problem of this study was to compare and evaluate two methods of teaching medication compliance to an elderly population with a variety of medical problems, cultural backgrounds, and educational levels. Eighty patients over 65 years old who were attending clinic at a county health care facility participated in the study and were randomly placed into two groups. The Medication Knowledge and Compliance Scale was used to assess the patients' medication knowledge and self—reported compliance. Group I (control) received only verbal teaching. Group II (experimental) received verbal teaching as well as a Picture Schedule designed to tailor the patients' medication schedule to their daily activities. Each patient was re—evaluated two to three weeks later. Medications were also counted at each visit and prescription refill records were examined. Knowledge and compliance did increase significantly among all 80 participants. Patients in Group II demonstrated a significantly greater increase in compliance than Group I but did not show a greater increase in knowledge. Patients in Group II also improved compliance as evidenced by their prescription refill records. This study demonstrates that even though significant barriers to learning exist, knowledge and compliance can be significantly improved when proper teaching techniques are utilized.

Standing and walking balance are complex tasks that involve detecting body motion andposition through sensory information from the visual, vestibular, and proprioceptive systems, integrating these inputs, and producing an appropriate neuromuscular response to maintain stability. Sensory information from these peripheral sensory organs, eyes, muscles, joints, and vestibular systems is integrated to create an accurate estimate of body movement and position. However, with age, injury, or disease, sensory input from these organs can become faulty or weakened, resulting in inaccurate perceptions of motion or rotational illusions that lead to dizziness, vertigo, instability, and falls. Testing and treatment of balance impairments in patients typically involve assessing functional impairment by evaluating postural balance during challenging static and dynamic environmental conditions, such as using unstable platforms, balance boards, or when visual fields are occluded, blurred, or distorted. While robotic systems have been developed to measure postural balance in standing tasks, there remains a lack of studies that measure gait responses during sensory alterations. Assessing and treating balance impairments in individuals with imbalance issues often involves evaluating postural balance under challenging static and dynamic conditions. These conditions may involve altering sensory input through unstable platforms while simultaneously occluding, blurring, or distorting visual fields. Although robotic systems have been developed to impose sensory perturbations and assess postural balance during standing tasks and treadmill walking, there is a gap in the literature when it comes to evaluating the effects of sensory alterations during overground walking. This dissertation presents a collection of work that characterizes gait responses to different sensory alterations during overground walking. Using virtual reality, a robotic neck brace, and haptic vibration motors, this research investigates the gait responses of older adults and football players and extends research on vibrational vestibular perturbations during overground walking. The dissertation provides insights into age-related and sports-related changes in gait adaptations to sensory perturbations, as well as the effects of vibrational and visual perturbations during overground walking. Chapter One offers an overview of current technologies and methods in balance assessment, highlighting the need to examine how gait and balance are affected by different sensory manipulations. Chapter Two presents the design considerations and construction of the overground sensory manipulation setup while exploring the feasibility of using virtual reality (VR) for gait assessment. Chapter Three investigates and compares the responses to visual, vestibular, and combined perturbations between football athletes and young healthy participants, focusing on differences in spatiotemporal gait parameters. Chapter Four explores how elderly individuals adapt to vestibular and visual perturbations during overground walking, in comparison to young healthy adults. Chapter Five explores the effects of mastoid vibration on overground walking. It examines both continuous and gait-timed vibrations and their effects on temporal and spatial gait parameters and balance. Subjective measures of pain and discomfort due to the vibration are also measured. Chapter Six further investigates vibration as a method to stimulate the vestibular system by comparing its effects on gait with robotically controlled head turns. Chapter Seven investigates how visual perturbations, such as shifts in the visual field, and vibrational simulations of the vestibular system interact and affect gait and balance. The final chapter, Chapter Eight, presents a method of gait analysis that simplifies the process of gait analysis by reducing the number of variables. The study explores which key gait, balance, and subjective outcomes should be considered during sensory perturbation experiments. This dissertation presents a sensory manipulation setup for overground gait assessment, designed to investigate how gait and balance are influenced by visual and vestibular perturbations. By systematically applying sensory disturbances, this research measures gait and balance adaptations in different populations, including athletes, older adults, and young healthy individuals. The findings highlight how various sensory manipulations impact balance and gait strategies across these groups. By comparing our results with earlier treadmill and postural response studies, this thesis offers valuable insights into how overground gait adjustments compare to or differ from existing postural or treadmill assessments.

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: In developing countries the increasing number of the aged are often viewed as a problem. In particular, the indigent elderly residing in poor urban areas are at risk of becoming marginalised and underserved. The Western Cape has the third largest elderly population in proportion to the total population in the country. Social assistance in the form of a monthly pension is paid out to all elderly who pass a national means test carried out by South African Social Security Agency (SASSA). An assessment of the characteristics and health status of the elderly collecting old age pensions living in low-income urban poor communities in the City of Cape Town was carried out at pension pay points across four communities, i.e. Gugulethu, Khayelitsha, Mitchells Plain and Bonteheuwel. In community health surveys, choices regarding the methodology have to be made that can have profound effects on the study design and study outcomes. The milieu of the present study is one of urban poverty and specifically those urban elderly who qualify for non-contributory pensions (also called social cash transfers or government grants). The paucity of existing community-based studies on old-age pensioners in the City of Cape Town meant that a cross-sectional survey with wide-ranging coverage of demographic, social and health factors was the most logical design to employ in order to determine the extent of present needs and generate hypotheses for further controlled studies. A systematic random sample of 703 elderly was drawn at nine pension pay-out points in Cape Town Metropole. No pensioners refused to participate in the study. Structured interviews were carried out covering demographics, number of dependents, living conditions, socioeconomic circumstances, health status and needs and utilisation of health services. A reported 43% of participants lived in shacks and 88% reported regularly eating less than 3 meals a day. Eighty-seven percent of respondents reported waiting 3 hours or longer for medication at a clinic while 90% reported being dissatisfied with the service at their clinic. Fifty-eight percent of pensioners reported not being able to see well while 83% did not know where to get their eyes tested. Almost 70% of pensioners said that they have been ill-treated by a family member and 64% scored as severely depressed on the geriatric depression scale. In this study, 266 pensioners solely supported 471 children of which 65 (14%) were disabled children. In 95% of cases the pensioner does not receive any support from the child's parents. The study found that the elderly on a state grant had considerable unmet health needs and required assistance with activities of daily living. The indigent pensioners in this study bore a huge duty of care for minor children as custodial grandparents while not receiving a high level of health support themselves. / AFRIKAANSE OPSOMMING: Die toenemende aantal bejaardes word dikwels in ontwikkelende lande as 'n probleem gesien. In die besonder loop die bejaardes wat in lae-inkomste stedelike gebiede woon die risiko om gemarginaliseer te word en swak dienslewering te ondervind. Die Wes-Kaap het die derde grootste populasie van bejaardes in verhouding tot die totale bevolking in die provinsie. Sosiale bystand in die vorm van 'n maandelikse pensioen word betaal aan alle bejaardes wat die inkomstetoets slaag wat deur die Suid-Afrikaanse Agentskap vir Maatskaplike Sekerheid (SAAMS) uitgevoer word. 'n Ondersoek na die eienskappe en gesondheidstatus van bejaardes wat hulle ouderdomspensioene in lae-inkomste stedelike gemeenskappe in die Stad Kaapstad kom afhaal is uitgevoer. Die studie is gedoen by pensioen-uitbetaalpunte in vier gemeenskappe, naamlik Gugulethu, Khayelitsha, Mitchells Plein and Bonteheuwel. In gemeenskapsgesondheid-opnames moet keuses gemaak word ten opsigte van die metodologie wat diepgaande gevolge vir die studieontwerp en -uitkomste kan inhou. Die milieu van die huidige studie in dié van stedelike armoede en spesifiek die leefruimte van stedelike bejaardes wat kwalifiseer vir nie-bydraende pensioene (ook genoem sosiale kontantoordragte of staatstoelaes). Die gebrek aan bestaande studies van ouderdomspensioenarisse in Kaapstad het beteken dat 'n dwarsdeursnit-opname van die demografie, sosiale en gesondheidsfaktore die mees logiese ontwerp was om uit te voer. Dit is gedoen om die omvang van huidige behoeftes te bepaal en verdere hipoteses te genereer wat deur vergelykende studies ondersoek behoort te word. 'n Stelselmatige ewekansige steekproef van 703 bejaardes is getrek by nege betaalpunte in die Kaapse stadsgebied. Geen proefpersone het geweier om deel te neem nie. Gestruktureerde onderhoude is gevoer wat die volgende aspekte gedek het: demografiese eienskappe, aantal afhanklikes, gesondheidstatus en benutting van gesondheidsdienste. Van die deelnemers het 43% in informele behuising ("shacks") gewoon en 88% het gerapporteer dat hulle gereeld minder as 3 daaglikse maaltye eet. Daar het 87% gerapporteer dat hulle 3 uur of langer gewag het om medikasie by hulle plaaslike kliniek te ontvang terwyl 90% ontevrede was met die diens wat hulle by die kliniek ontvang het. Daar het 58% van die bejaardes gerapporteer dat hulle nie goed kan sien nie terwyl 83% van hulle nie geweet het waar hulle hulle oë kan laat toets nie. Omtrent 70% van bejaardes het gesê dat hulle deur 'n familielid mishandel word en 64% kon as ernstig depressief geklassifiseer word op die geriatriese depressieskaal. In hierdie studie was 266 pensioenarisse die enigste sorg en voog van 471 kinders van wie 65 (14%) gestremd was. In 95% van gevalle het die pensionaris geen geldelike of ander bydraes van die kind(ers) se ouers ontvang nie. Die studie het bevind dat bejaardes wat 'n staatstoelaag ontvang aansienlike onvervulde gesondheidsbehoeftes het en hulp benodig met aktiwiteite van daaglikse bestaan. Die behoeftige pensioenarisse in hierdie studie het 'n groot las gedra aan die versorging van minderjarige kinders as toesighoudende grootouers ("custodial grandparents") terwyl hulleself nie 'n hoë vlak van ondersteuning geniet nie.

published_or_final_version / abstract / Community Medicine / Master / Master of Philosophy