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Background: There is a burgeoning population of older adults globally and there is an increasing urgency in the policy literature to understand the health issues facing this population. A social exclusion lens provides an opportunity to understand health inequity and disadvantage among vulnerable populations. There is limited research examining how social exclusion plays out for older women, particularly in the rural context. This study examines the social exclusion experiences of Canadian, rural, older women and highlights policy implications for global health practitioners. Methods: Guided by the principles of interpretive description, this qualitative study included eight participants who identified as women, 65 years or older, spoke English, and who lived alone in private households in rural communities of Durham Region, Ontario. Concurrent data collection and analysis was conducted using an inductive approach. One-to-one, semi-structured interviews were completed. Findings: Six themes illuminate the exclusion experiences of rural, older women and they include: “Expectations of ageing in rural communities”; “Navigating the tensions of belonging within the social fabric”; “Singlehood isolation”; “Driving independence”; “Health infrastructure and changing personal health”; “Affording ageing”. Implications & Contributions: The study adds a Canadian, rural perspective to the global conceptual literature on social exclusion. It illuminates the unique ways in which female gender and rural context influence social exclusion experiences. Implications for global health policy include: recognizing health as a key category of exclusion and the need to address health equity, adopt a gender-specific and life-course approach to address social exclusion, foster a sense of belonging and peer connection, utilize unconventional channels for engagement, implement social support schemes and health programming which considers non-traditional families or single status as norm for family composition, and support affordable access to health-promoting programs and services. / Thesis / Master of Science (MSc) / This study examines how older (senior) women, living in rural communities in Durham Region, Ontario experience social exclusion, and aims to help inform global health policies for older adults. Social exclusion is a way of understanding how processes interact to impact on someone’s ability to participate fully in their life Six themes were identified and add to the global evidence on social exclusion. This Canadian study shows the unique ways in which female gender and the rural context influence on social exclusion experiences. Global health policy implications include: health is a key category of exclusion and addressing health equity is important, adopt a gender-specific approach that considers what happens over a lifetime that contributes to women’s exclusion, foster a sense of belonging and peer connection, use unconventional channels of engagement, and implement social support schemes and health programming which considers non-traditional families or single status as norm for family composition.

Introduction: Alternate Level of Care (ALC) patients are those who are kept hospitalized although they are medically well enough to be discharged. Those patients wait in acute care because they cannot access an appropriate alternative level of care outside the hospital. ALC leads to the improper consumption of valuable resources that are needed for patients waiting in other departments such as emergency rooms. This reflects poor quality outcomes of the healthcare system and represents a significant economic burden. Moreover, particularly when it concerns older adults, longer stay in hospital results in worsening their health outcomes, declining their functional status and increasing their needs for long-term care. Therefore, ALC is costly from both patient and health care system perspective. Objectives: The main objective of this study was to assess the impact of the Home First strategy on the incidence of ALC. Moreover, the study addressed both the specialized clinical needs (such as dialysis, chemotherapy and mechanical ventilation) and socioeconomic status of ALC patients in order to unveil their association with the ALC length of stay. Methods: This study involved a secondary analysis of data from the Institute for Clinical Evaluation (ICES). The analyzed dataset included a cohort of 6,059,033 hospitalization records of Ontario citizens, aged 65 years and older, who were admitted to an acute care facility between April 2004 and March 2017. The study involved descriptive analytics grouping the dataset into ALC and non-ALC subsets and examined the percentage of ALC hospitalizations, ALC days and reported odds ratios across several patients' characteristics. Results: From 2004 until 2016, ALC patients waited to access an appropriate destination for 10.7 million days. Those numbers represented 19.7% of all hospitalization days across Ontario. ALC was more likely among seniors aged 75-84 (OR 1.36, 95% CI 1.35-1.36), aged 85-94 (OR 2.16, 95% CI 2.15-2.17), aged 95+ (OR 2.46, 95% CI 2.40-2.50), females (OR 1.37, 95% CI 1.35-1.36), those who were hospitalized 90 days prior to their current admission (OR 1.22, 95% CI 1.21-1.22), and those who were admitted to hospital through Emergency Department (OR 2.64, 95% CI 2.62-2.67). Moreover, ALC was 10 times more likely in the subgroup of patients who were discharged to long-term care (LTC) (OR 9.71, 95% CI 9.66-9.77). For the socioeconomic characteristics, this study showed that patients were more likely to have ALC days when they lived in urban areas, had a lower income, and were highly unstable and dependent. Furthermore, patients with special clinical needs spent from 10% to 25% of their total hospitalization length of stay waiting to be discharged to an appropriated alternative level of care. Finally, the study revealed that although the implementation of a Home First strategy resulted in a 26% reduction of ALC hospitalizations and a 13% decrease in ALC days, the percent of patients discharged to LTC did not change. For the subgroup having the highest percentage of ALC hospitalizations (53.4%) and ALC days (40.3%), this reflects a partial failure of the Home First strategy in achieving its main objective of facilitating the discharge of patients to their homes. Conclusions: Policy makers and health care practitioners may benefit from the findings of this study by considering the needs of the ALC patients while planning, allocating resources, and developing polices for discharge, LTC and community care. However, more work is required to quantify the impact of the ALC determinants suggested in this study and assess the efficiency of the current policies and procedures. Introduction: Alternate Level of Care (ALC) patients are those who are kept hospitalized although they are medically well enough to be discharged. Those patients wait in acute care because they cannot access an appropriate alternative level of care outside the hospital. ALC leads to the improper consumption of valuable resources that are needed for patients waiting in other departments such as emergency rooms. This reflects poor quality outcomes of the healthcare system and represents a significant economic burden. Moreover, particularly when it concerns older adults, longer stay in hospital results in worsening their health outcomes, declining their functional status and increasing their needs for long-term care. Therefore, ALC is costly from both patient and health care system perspective. Objectives: The main objective of this study was to assess the impact of the Home First strategy on the incidence of ALC. Moreover, the study addressed both the specialized clinical needs (such as dialysis, chemotherapy and mechanical ventilation) and socioeconomic status of ALC patients in order to unveil their association with the ALC length of stay. Methods: This study involved a secondary analysis of data from the Institute for Clinical Evaluation (ICES). The analyzed dataset included a cohort of 6,059,033 hospitalization records of Ontario citizens, aged 65 years and older, who were admitted to an acute care facility between April 2004 and March 2017. The study involved descriptive analytics grouping the dataset into ALC and non-ALC subsets and examined the percentage of ALC hospitalizations, ALC days and reported odds ratios across several patients' characteristics. Results: From 2004 until 2016, ALC patients waited to access an appropriate destination for 10.7 million days. Those numbers represented 19.7% of all hospitalization days across Ontario. ALC was more likely among seniors aged 75-84 (OR 1.36, 95% CI 1.35-1.36), aged 85-94 (OR 2.16, 95% CI 2.15-2.17), aged 95+ (OR 2.46, 95% CI 2.40-2.50), females (OR 1.37, 95% CI 1.35-1.36), those who were hospitalized 90 days prior to their current admission (OR 1.22, 95% CI 1.21-1.22), and those who were admitted to hospital through Emergency Department (OR 2.64, 95% CI 2.62-2.67). Moreover, ALC was 10 times more likely in the subgroup of patients who were discharged to long-term care (LTC) (OR 9.71, 95% CI 9.66-9.77). For the socioeconomic characteristics, this study showed that patients were more likely to have ALC days when they lived in urban areas, had a lower income, and were highly unstable and dependent. Furthermore, patients with special clinical needs spent from 10% to 25% of their total hospitalization length of stay waiting to be discharged to an appropriated alternative level of care. Finally, the study revealed that although the implementation of a Home First strategy resulted in a 26% reduction of ALC hospitalizations and a 13% decrease in ALC days, the percent of patients discharged to LTC did not change. For the subgroup having the highest percentage of ALC hospitalizations (53.4%) and ALC days (40.3%), this reflects a partial failure of the Home First strategy in achieving its main objective of facilitating the discharge of patients to their homes. Conclusions: Policy makers and health care practitioners may benefit from the findings of this study by considering the needs of the ALC patients while planning, allocating resources, and developing polices for discharge, LTC and community care. However, more work is required to quantify the impact of the ALC determinants suggested in this study and assess the efficiency of the current policies and procedures. / Thesis / Master of Science (MSc)

The objective of this study was to determine the association between the student’s general adjustment and his attitudes towards his parents and teachers and his school progress and the degree to which he was accepted by associates in social situations. Seventy high school senior girls and boys living in a small town and the surrounding area furnished the date for this study. The data on these students were secured from five sources. Information on attributes towards parents and teachers, social acceptability, and socio-economic factors was obtained by the questionnaire method. The questionnaires were completed by the students during their homeroom periods. Information on personality adjustments was obtained by the use of the bell adjustment inventory which was completed by the students during their home-room periods and was augmented by the combined ratings of three teachers. Rating of I. Q. was obtained by the Otis Quick-Scoring Gamma test. Information on school progress was obtained from the permanent school records. / Master of Science

The population of seniors is growing and will continue to increase in the next decade. Computer technology holds the promise of enhancing the quality of life and independence of older people as it may increase their ability to perform a variety of tasks. This is true for elderly. By the year 2030, people age 65 or older will comprise 22% of the population in the United States. As the population shifts so that a greater percentage are middle-aged and older adults, and as dependence on computer technology increases, it becomes more crucial to understand how to design computer displays for these older age groups. The research has compared various display representation formats to try to find out which is the best way to represent information to seniors in any form of display and the reason for the preferences. The formats compared include high and low density screens for abstract icon representation, concrete icon representation, tabular representation and graphical representation.This research also endeavored to study the effectiveness of remote usability testing as compared to inlab testing for seniors. Results indicated that density of screen is a very important factor affecting the performance of older adults. Density effect showed statistical significance F (1,112)=8.934, p< .05 from further post-hoc analysis that was conducted. Although significant results were not obtained, different formats of display representations may still be an area worth pursuing. Also it was noted that remote usability testing is not as effective as inlab testing for seniors in terms of time taken to conduct the study and the number of user comments collected. Implications, as well as recommendations and conclusions, of the study are presented. / Master of Science

Region Gotland är unik i Sverige eftersom den har både kommunala och regionala ansvar. På Gotland bor den största kommunala andelen seniorer, men andelen seniorresenärer i kollektivtrafiken är endast 5%. Ön trafikeras av bussar i stads- och regionbusstrafik och det finns närtrafik som kompletterar kollektivtrafiken. Uppsatsen syftar till att undersöka Region Gotlands planer för social rättvisa inom mobilitet, genom att utföra dokumentanalys på två av Regionens planeringsdokument. Det analytiska verktyget för dokumentanalysen är tematisk analys och en semistrukturerad intervju med en tjänsteman på Regionen ingår i den tematiska analysen. Resultat och resultatanalys har visat att Region Gotland till viss del planerar rättvist för senior mobilitet utifrån det som rättvis planeringsteori pekar ut som rättvist. Analysen har också påvisat hur Regionens planering kan skapa både inkludering och exkludering genom de riktlinjer som översiktsplanen, tillgänglighetsstrategin och intervjun med tjänstemannen presenterat. Slutsatsen är att Region Gotland till viss del planerar för social, rumslig och rural rättvisa för seniorer på Gotlands landsbygd, men att social rättvisa är mångfasetterad och komplicerad att uppnå då det finns mycket Regionen behöver beakta under planering.

The problem with which this investigation is concerned is discovering if there are any differences in knowledge and sources of knowledge about illegal drugs between rural and metropolitan high school seniors. The term "drugs" in this project includes those defined by law as illegal and also those drugs subject to abuse through misuse. The report concludes that both correct drug knowledge and attitudes toward drugs seem to depend upon the degree to which drugs have entered into the community and their availability. Since no actual differences in knowledge were discovered, the indication is that possibly rural and metropolitan areas can no longer be separated as to the reasons for, or the extent of, certain social problems.

Made available in DSpace on 2016-08-19T17:47:09Z (GMT). No. of bitstreams: 1 Priscila Monteiro de Almeida.pdf: 112979 bytes, checksum: 241de1d651d1b18323c115d2bdd504ed (MD5) Previous issue date: 2006-04-20 / The improvement of the life quality of the senior considering a higher expectation of life aimed to know the meaning of being a senior and having quality of life for the seniors of the Grupo Metamorfose de Terapia Ocupacional through a semi-structured interview applied to ten seniors from both sexes, with ages between 60 and 82 years. The analysis of the material collected in the interviews followed the Speech of Collective Subject Method. The results indicate that the interviewees own, in general, a positive vision about the old age. About life quality, ideas emerged related to the psychological dimensions and transcendency, health, social, citizenship, economic, autonomy and family, confirming that the studied phenomena has a multidimensional character. Through the results of this study, it is suggested that, the implementation of actions turned to the quality of life of the senior, it is considered the magnitudes and differences of each specific group, not being advisable the application of standardized measures, because life aging and life quality aren't homogeneous phenomena for all of the seniors. / A melhoria da qualidade de vida dos idosos diante da expectativa de vida cada vez mais alta. Objetivou conhecer os significados de ser pessoa idosa e de ter qualidade de vida a partir de depoimentos de idosos do Grupo Metamorfose de Terapia Ocupacional através de entrevista semi-estruturada aplicada a dez idosos de ambos os sexos, com idade entre 60 e 82 anos. A análise do material coletado nas entrevistas seguiu o Método do Discurso do Sujeito Coletivo. Os resultados indicam que os entrevistados possuem, em geral, uma visão positiva sobre a velhice. Sobre qualidade de vida emergiram idéias relacionadas à dimensão psicológica, saúde, convívio social, cidadania, economia, autonomia e família, confirmando que a questão estudada possui caráter multidimensional. Pelos resultados obtidos, este estudo sugere que, na implementação de ações voltadas para a qualidade de vida dos idosos, levem-se em conta as magnitudes e diferenças de cada grupo específico, não sendo aconselhável a aplicação de medidas padronizadas, pois envelhecimento e qualidade de vida não são questões que se apresentam de forma homogênea para todos os idosos.