To explore the influence that variations in projective stimuli might have on the respondent's ability to identify with pictorial representations of hands derived from the Hand Test (Wagner, 1961, 1983), 61 young adults (M age = 23) and 60 older adults (M age = 73) were presented with four alternate versions of hand stimuli (young male, young female, old male, and old female) in addition to the original Hand Test. Results indicated main effects for age and gender of respondent, which were primarily consistent with previous Hand Test research. Main effects for gender and age of hand stimuli (p < .05) were also found. Significant interaction effects were revealed for age of respondent by age of hand stimuli and for age of respondent by gender of hand stimuli (p < .05). These interactions resulted in the elicitation of a variety of responses to a differentiated manner than a standard set of Hand Test stimuli. A gender of respondent by gender of hand stimuli interaction effect was also found (p &lt; .05), suggesting that gender alterations of the card may also be beneficial for increasing respondent identification for some individuals. Overall, the results of variations in Hand Test stimuli, as they interact with respondent personal characteristics, indicate the utility of alternate versions of the Hand Test. This is based on the assumption that the respondent will identify with the hand that best resembles his/her hands, resulting in the stimulus performing its projective function to a greater extent.

The present study examined age cohort differences in older and younger adults as they relate to perceptions of helpful counselor characteristics. The present study also assessed whether previous help-seeking behavior influences perceptions of what counselor characteristics would be helpful. The social influence model is used as basis for predictions. The first research hypothesis for the present study was that there would be an age by cohort interaction in perceptions of helpful counselor characteristics at both Time 1 (1991) and Time 2 (2001). The second research hypothesis was that there would be a main effect for cohort, with more recently born cohorts preferring more interpersonal counselor characteristics. The third research hypothesis was that there would be a main effect for age in endorsement of the social influence model. The fourth research hypothesis was that there would be a significant difference between the perceptions of those individuals who had previously sought help from a mental health professional and those individuals who had not sought help, regardless of age and cohort. A revised Adjective Check List (Gough, 1965; Gough & Heilbrum, 1983) was used to assess perceptions of helpful counselor characteristics. Chi-square analyses, MANOVA/supplementary ANOVAs, and exploratory factor analyses were used to test the research hypotheses. The first and second research hypotheses were supported. The third research hypothesis was not supported. The fourth research hypothesis was supported for Time 1, but not for Time 2. Limitations of the present study and implications of this research are discussed.

Chronic pain is a widespread problem, especially in the older population, and can affect various aspects of daily living. At a time when it has been acknowledged that the population is increasingly ageing, research regarding the effects of chronic pain on the daily living of older adults is essential. Furthermore, the development of innovative technology is changing the way that much research is being conducted, and can lead to the retrieval of novel information, using a fresh approach. The adoption of this technology in the field of chronic pain research has the potential to examine various aspects of the daily living of older adults living with chronic pain using a different approach to previous research. This study is underpinned by a Critical Realist ontology and Hermeneutic epistemology and follows a Generic Qualitative Research methodology (Caelli, et al., 2003). The aim of the study was not to generalise the findings but to gather a deep theoretical description of the outcomes and offer an explanation of these findings based on an analysis of the multiple research methods used within the study. This study had two main aims and was split into two sections according to the aims. Firstly, Part A of this study aimed to explore a range of day-to-day patterns and experiences of functioning in older adults suffering from chronic pain. Part B aimed to explore the usability, acceptance and experience of the technology used to measure functioning as part of the first aim of this study. Part B also aimed to look at the practicalities the participants were faced with when using the technology. A mixed methods design was used for Part A in which 15 older adults (65+) living with chronic pain (pain >3 months) took part in an in-depth study lasting seven days. As well as the 15 core participants that took part in the study, two older adults (65+) without chronic pain and two younger adults (<65) with chronic pain took part in the study in order to provide some insight into the effects of either pain, or age, on functioning. Part A used four data collection techniques to gather data upon the daily functioning of older adults with chronic pain; the Daily Reconstruction Method diary (Kahneman, Krueger, Schkade, Schwarz, Stone, 2004), the Sensecam (also known as the Vicon Revue, Vicon©), the LifeShirt (Vivometrics Inc) and a semi-structured interview. However, although the LifeShirt was validated, as part of this PhD, and used throughout the study, the gathered data was not analysed due to multiple problems with the data. The Daily Reconstruction Method, Sensecam and the semi-structured interview were each analysed separately before the results of the Daily Reconstruction Method and Sensecam were integrated into the themes derived from the semi-structured interviews. The integrated results led to the development of two themes, each with sub-themes; ‘effect on daily living’ and ‘managing pain and functioning’. The themes from Part A highlighted the way in which pain affected functioning and the modifications to daily functioning as a result of chronic pain. The way in which individuals perceived the management of their own pain and functioning, as well as strategies and assistive devices to manage pain and functioning were also discussed. This study has furthered current knowledge due to the idiographic nature of the study, as well as multiple, novel, data collection tools used, adding additional details to how tasks have been modified, reduced, or terminated. Part B of this study used the Unified Theory of Acceptance and Use of Technology (UTAUT, Venkatesh, et al., 2003), the Flow-State Scale (Jackson & Marsh, 1996) and semi-structured interviews to explore participants’ use of both the Sensecam and LifeShirt. The questionnaires and interviews were carried out with all of the individuals that carried out Part A of this research. From the semi-structured interviews two main themes were reported, each with sub-themes; ‘expectations and experiences’ and ‘awareness of equipment’. Two concepts developed from the themes within Part B that were specific to the participants’ experiences of wearing wearable technology in this study, as opposed to ‘typical’ non-wearable technology; specifically, the importance of design and the importance of others. Both of these overarching concepts affected the expectations of the technology, the experiences of using the technology, as well as the awareness of the technology during use. Furthermore, both concepts will remain and are long-lasting, despite the development of the technology in this field, but there are specific details that are contemporary and are specific to either the Sensecam or the LifeShirt as used in this study.

Class of 2017 Abstract / Objectives: The aim of this project was to assess community-dwelling older adults’ knowledge of prescription and Over-the-Counter (OTC) medications associated with fall risk, then provide an online educational intervention tailored to older adults on the topics they answer incorrectly. The knowledge assessment of the missed questions will be repeated after the online education to detect the effectiveness of the online intervention in increasing the knowledge of community-dwelling older adults. Methods: This study used an interventional design with pre-test, post-test survey method to quantitatively analyze community-dwelling older adults’ knowledge on medication-related fall risk. The persons taking the survey were community dwelling older adults, 65 years of age and older, living in the greater Tucson and Phoenix areas. Data was obtained through an online Qualtrics questionnaire between February 1, 2016 and February 1, 2017. The survey respondents answered questions regarding prescription and OTC medications associated with fall risk. For the questions they answered incorrectly, an online educational intervention tailored to older adults was provided immediately. The knowledge assessment of the missed questions was repeated after the online education to detect the effectiveness of the intervention. Results: Questionnaires were completed by 302 community-dwelling older adults. The mean age of the participants was 79 (range 65 to > 96), and majority were women (61.2%). A majority of respondents (53.87%) reported falling once in the last 5 years. Of the total participants, 50% were taking between 5 and 9 prescribed medications and 56% taking 0 to 4 OTC medications. The primary outcome of this study is that online education was effective in educating community dwelling older adults on medication-related fall risk. Patients whose pharmacist had previously educated them did not directly correlate with better performance on the pretest than those who did not receive counseling. Participants that received online education during the survey improved their score from 69% before education to 84% post education. Conclusions: The online educational intervention on medication-related fall among older adults was effective and informative. Such educational strategy may be used by pharmacists to educate older patients using medications that may increase fall risks.

Within the next 20 years, mental health problems are projected to be the leading cause of disability in Canada. Given that one in four Canadians is expected to be over the age of 65 by 2036, older adults’ mental health problems are a growing public health concern, especially because the rate of mental health service use is particularly low among this age group. Although there have been several decades of mental health research, it is still not well understood why older adults are not accessing treatment. A possible explanation for this is that identifying reasons for poor access alone does not capture the multifaceted, complex nature of individuals’ experiences with mental health problems and their paths into treatment. To address this gap in the literature, this study explored older adults’ experiences seeking psychological care and the factors that influence this dynamic process using the Network Episode Model-II (NEM-II; Pescosolido & Boyer, 2010; Pescosolido et al., 2013). To achieve this objective I conducted 15 individual semi-structured interviews with adults 60 years of age and older, who were receiving outpatient psychological services from a hospital in Winnipeg, Manitoba. Findings from this study suggest that participants’ background (social content), social support network, and the treatment system influence, and are influenced by, participants’ illness careers. Factors that delayed participants’ help-seeking included: a lack of support, “inappropriate” referrals or advice from treatment professionals, and a lack of knowledge among older adults about mental health and treatment options. This research has implications for researchers, clinicians, and public policy initiatives aimed at enhancing older adults’ access to psychological care. / October 2016

För att möta en framtid där medelåldern bland Europas befolkning blir allt högre har Europeiska unionen riktat fokus på frågan om hur förvärvsfrekvensen i de högre åldersgrupperna kan höjas. Genom att anta en policy avseende det livslånga lärandet uppmanar EU sina medlemsländer att skapa nya förutsättningar för att förverkliga detta mål. Utifrån detta fokus på möjligheten att studera även i hög ålder har föreliggande studie utgått från seniora studenter i åldern 50+. Studiens syfte har varit att studera behov av och krav på anpassad pedagogik som den yrkes- och livserfarna seniora studenten har för att kunna tillgodogöra sig undervisning vid högskola och universitet. Studiens teoretiska perspektiv har utgått från sociokulturell teori och andragogik. Studien är byggd på vad den seniora studenten som individ upplevt samt hur omgivningen och dess krav ser på seniora studenter som grupp. Insamlandet av data har utgjorts av semistrukturerande intervjuer med sju individer som är 50+ och varit aktivt studerande på svensk högskola eller universitet under vårterminen 2016. Intervjuerna genomfördes utifrån frågeställningar om behov, krav och anpassad pedagogik. Svaren har analyserats utifrån interpretativ fenomenologisk analys, i relation till teorier och tidigare forskning. Studiens resultat visar att den seniora studenten inte ser att det egna lärandet har förändrats över tid men att förutsättningarna har förändrats. Den seniora studenten har behov av att bli bemött som vuxen ansvarstagande individ och att den erfarenhet som följer med ska ses som ett positivt komplement genom att bidra till förening av teori och praktik i lärsituationen. Den seniora studenten har krav på kvalitetssäkrad undervisning och vill lyfta frågan om validering av tidigare erfarenheter samt bidra med sin erfarenhet för en anpassad pedagogik. Studien visar att den seniora studenten vill ha insyn och vara medbestämmande, men att de seniora studenterna i föreliggande studie inte är kravställande varken individuellt eller som grupp.

Variability in neural activity has historically been treated as noise, in favour of deriving estimates based on central tendency (e.g., mean). Recently, researchers have shown that variability and mean confer different sources of information and that increased variability in neural activity is associated with superior behavioural performance and that it decreases during late-life. Although mounting evidence suggests that neural variability is beneficial, it is less clear whether these findings are driven by within- or between-person factors and whether they are apparent during higher-order cognitive tasks. Further, variability can be derived in several different ways, drawing into question its congruence across operationalizations. The present investigation sought to separate within- and between-person sources of variance in order to ascertain what was driving any observable effects in three operationalizations of cerebral oxygenation, computed based on central tendency (mean), variability (standard deviation) and signal complexity (multivariate multiscale entropy). 25 older adults (71-81 years of age) completed two tasks of executive functions while undergoing assessment using functional near infrared spectroscopy. Time-varying covariation models were employed to estimate the effects of cerebral oxygenation on behavioural performance, as well as the moderating effects of age and fall status. Findings suggest that mean and variability are differentially associated with behavioural performance and are increased in older adults at greater fall risk. Whereas mean based computations were positively associated with more accurate and faster responding, variability based computations were primarily associated with faster responding only and occurred in non-overlapping regions of prefrontal cortex. Future studies of neural variability may consider examining within- and between-person factors and operationalizing signal complexity in cerebral oxygenation over longer time periods to examine its effects over multiple time scales. / Graduate / drewh@uvic.ca

A growing body of research has emphasized the prevalent mental health problems faced by the fastest-growing demographic segment of Canada’s population, older adults, in addition to their particularly low rates of mental health service use. Research has also begun to demonstrate that although older adults express a desire to be involved in their health care decision-making, they are often not given sufficient information to participate in this process. In light of low rates of service use and generally poor mental health literacy, defined as knowledge and beliefs about the recognition, prevention, and management of mental health problems, several researchers posit that older adults experience a gap in the knowledge translation of mental health information. The present research explores older adults’ pathways to mental health information and treatment. In Study 1, individual interviews were conducted with older adults who came to seek psychological treatment for mental health problems (n = 15), and analyzed according to narrative analysis. The main storylines across participants’ narratives of treatment seeking included resistance to being labeled with mental health problems, muddling through the treatment seeking process, and interpretations of psychological treatment. Findings are discussed within the context of increasing efforts to enhance clarity in the complex process of seeking treatment for mental health problems. In Study 2, older adults’ mental health information preferences and predictors of information preferences were examined in a sample of community-dwelling older adults (n = 229). Results demonstrated that despite being unfamiliar with mental health treatment options, older adults reported a strong interest in receiving detailed information concerning a variety of mental health treatment options. Family, friends, and health care providers were highly rated informational sources; and written formats and discussions with health care providers were highly rated informational formats. The most consistent predictors of mental health information preferences included attitudes toward seeking psychological treatment and social support. Findings are contextualized within the importance of increasing the mental health literacy of older adults through knowledge translation efforts. Overall, findings of this research provide clear directions for decreasing the gap in mental health knowledge translation among older adults. / October 2016

This study design was to identify and examine how disaster experience, self-efficacy, and demographic factors influence disaster preparedness in community-dwelling older adults. Current data indicates the United States is rapidly aging. Parallel to this significant increase among the elderly population, natural disasters are more prevalent. Consequently, older adults are affected adversely by these disasters and exposure to social vulnerabilities during the disaster cycle. For the purpose of this study, non-identifiable secondary data were analyzed. Sources of the data were the 2007 and 2008 National Center for Disaster Preparedness surveys. The sample focus of this study was adults 50 and older. Regression analyses identified important predictors of disaster preparedness in the survey respondents. Sample adults with previous disaster experience are two times more likely to be in a higher category for having an emergency plan than those respondents with no observable effects of self-efficacy and no previous disaster experience. The frequency of natural disasters in the United States has generated a renewed interest in disaster management, in particular, disaster preparedness. Nevertheless, the focal point of disaster preparedness is no longer the rudimentary stockpile of water, a first aid kit, and a battery operated radio. To advance the field of disaster management it is vital for gerontologist to approach disaster preparedness by differentiating between stockpiling supplies and social cognitive interventions that fundamentally alters preparedness behavior.

Dementia incidence is rising as our population is ageing. There is growing evidence for the protective effect of physical activity against cognitive decline. However, there are inconsistent results across studies despite the large number of high quality trials. The role of psychosocial factors on cognitive outcomes was investigated in the present thesis due to the evidence of their relationship with physical activity and for their effect on cognitive ability in other contexts. The psychosocial factors investigated were attitudes towards ageing, perceived control, mental health, and self-efficacy using cross-sectional studies and pilot randomised controlled exercise trials to test proof of concept. Study 1a found that more positive attitudes towards ageing were associated with better self-reported subjective and functional health. Perceived control mediated the effect of attitudes related to psychosocial loss with ageing and physical activity level mediated the effect of attitudes related to psychological growth with ageing on subjective health. Attitudes towards ageing mediated the effect of perceived control on functional health. Study 1b and 1c explored attitudes towards ageing in more detail and found that older adults attitudes towards ageing were similarly negative to those held by young adults in the UK. A substantial proportion of attitudes reported by older adults related to physical functioning and cognitive ability. Attitudes towards ageing in China were more positive than those in the UK which suggested a potential relationship with socio-cultural and environmental factors and possible scope for attitude change from an intervention. A higher proportion of attitudes towards ageing reported in the UK were related to physical functioning and cognitive ability compared to China. These findings highlighted the potential for attitudes towards ageing and perceived control to play a role in the context of physical activity, cognitive ability and subjective health. Study 2a found that physical, social, and mental activities were independently associated with cognitive ability which informed the study design of exercises to include a pseudo control group that controlled for social interaction and mental stimulation. Study 2b found that mental health partially mediated the association between walking and cognitive ability. In older adults with better mental health, walking was not associated with cognitive ability. In older adults with poorer mental health walking was associated with better cognitive ability. Study 3 utilised available data from a pilot resistance training randomised controlled trial with middle-aged adults to test proof of concept for the role of psychosocial factors in this context. Preliminary evidence was provided for a potential association between improvements on some psychosocial factors and cognitive performance improvements. The associations of cognitive gains with psychosocial factors were independent to those of physical fitness improvements, which may indicate a potentially additive effect. Study 4 assessed the feasibility of the pilot randomised controlled trial of resistance training with older adults. Recruitment was successful but high drop-out rates lead to between group differences in age and baseline cognitive ability. Adaption of exercise to suit individual capabilities increased participation and adherence of those who completed the programmes was high. The limited usefulness of analysis by group was highlighted due to the large variation in response to exercise within groups on psychosocial and cognitive measures. Older participants were more likely to report a negative effect of resistance training on psychosocial measures, which indicated a potential confound on outcomes of exercise interventions with older adult populations. Preliminary analysis indicated that improvements on some psychosocial factors were associated with domain specific cognitive gains. This association could be due to a variety of mechanisms, such as meta-cognitive motivational processes, for example sustained effort and attention and the use of memory strategies. However, these findings need to be interpreted with caution due to the parallel change of variables, small sample size and feasibility and pilot nature of the interventions. There is a potential implication for the design of exercise programmes if they facilitate improvements in psychosocial factors as well as physical fitness, then this could enhance the effect of exercise on cognitive outcomes. Future research should replicate these studies with larger sample sizes to further understand the role of psychosocial factors in cognitive gains during exercise interventions in older adults.