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Bakgrund: Fysisk aktivitet (FA) ger goda hälsoeffekter för äldre, de rekommenderas att vara fysiskt aktiva på minst måttlig ansträngningsgrad under 150–300 minuter i veckan. Träffpunkter 65+ i Uppsala kommun erbjuder FA genom gruppträning men andelen män som deltar är liten. Det är värdefullt att ta reda på vad som skulle motivera männen att delta, för att nå ut till inaktiva män. Syfte: Att undersöka äldre mäns önskemål och motivatorer till att delta i gruppträning på Träffpunkterna 65+ i Uppsala kommun samt om det finns skillnader mellan äldre män som uppnår respektive inte uppnår rekommendationer för FA.  Metod: En kvantitativ icke-experimentell tvärsnittsstudie i form av en enkätstudie som delades digitalt genom pensionärsföreningar till män över 65 år.  Resultat:  Åttiosex män deltog (medianålder 74,5 år, 50 stycken uppnår FA). Gruppträning med rörlighet, balans och kondition var mest önskat men inga skillnader sågs mellan män som uppnår respektive inte uppnår FA. Faktorer som motiverade; gruppträning “erbjuder större fysisk utmaning”, “din vårdkontakt lyfter nyttan med träning” och “du tränar med en vän eller anhörig”. Faktorerna “erbjuder större fysisk utmaning” och “jobbar mot ett gemensamt mål” var signifikant mer motiverande för män som uppnår FA. Konklusion:  Männen föredrog gruppträningsaktiviteter för bibehållen och förbättrad kroppsfunktion. Motivatorer till att delta handlade om hälsonytta, gemenskap med vänner samt fysisk utmaning. Männen som uppnår FA motiverades i högre grad av att gruppträningen utmanar fysisk kapacitet. Ytterligare studier på målgruppen krävs. / Background: Physical activity (PA) provides health benefits for elderly. They are recommended to be physically active to a moderate level of exertion for 150-300 minutes a week. Träffpunkter 65+ in Uppsala municipality offers PA through group training, where the percentage of men participating is low. Value lies in finding what would motivate the men to participate, in order to attract inactive men. Purpose: To investigate older men's requests for and motivators to participate in group training at Träffpunkter 65+ and if there are differences between men who achieve recommendations for PA and those who do not. Method: A quantitative non-experimental cross-sectional study in the form of a survey was conducted and shared digitally through pensioner associations to men over 65 years. Results: Eighty-six men participated (median age 74.5 years, 50 respondents achieve PA). Group training with mobility, balance and cardiovascular fitness was requested, no differences were seen between the men who achieve and do not achieve PA. Motivating factors were: "offers greater physical challenge", "healthcare contact highlights benefits of training" and "training with a friend or relative". "Offering greater physical challenge" and "working towards a common goal" were significantly more motivating for men who achieve PA. Conclusion: Men preferred group training targeting body function. Motivators to participate included health benefits, group fellowship and physical challenge. Men who achieved PA were to a greater extent motivated by group training challenging physical capacity. Further studies on the target group are required.

Syftet med denna studie är att undersöka olika salutogenetiska aspekter för friska äldre och undersöka om dessa kan implementeras i ett preventivt arbete i yngre åldrar. Material och metod: Sökning gjordes i databasen Pubmed. Alla artiklar som uppfyllde inklusionskriterierna och var relevanta för frågeställningen lästes i fulltext. Dessa blev kvalitetsgranskade och sammanfattades i en tabell. Kvalitetsbedömningen skedde med hjälp av en checklista som kan användas för bedömning av både randomiserade och icke-randomiserade kliniska studier.Resultat: Efter sökningen i Pubmed och läsning samt granskning av artiklar inkluderades 29 artiklar. Av de 29 artiklar som inkluderades var 10 review artiklar, 14 tvärsnittstudier, 3 prospektiva studier och 2 fall-kontroll studier. Totalt ingick 13 346 personer i tvärsnittsstudierna, 5 391 personer ingick i de prospektiva studierna och 285 personer i fall-kontroll studierna. Flera determinerande faktorer och orsaker till av patienten upplevd god hälsa och av professionen fastställd god hälsa kunde identifieras efter litteratursökningen. Dessa delades in i livsstil och individrelaterade-, biologiska-, vårdorganisatoriska- och socioekonomiska faktorer. Konklusion: Fler studier behöver göras för att undersöka hur dessa faktorer interagerar och hur man kan implementera dessa i hälsoförebyggande arbete. / Objective: The objective with this study was to explore different salutogenic aspects amongst healthy elderly and to find out whether it could be implemented in younger age to prevent illness.Material and methods: The search was done in the Pubmed database. All articles that met the inclusion criteria and were relevant for the question at issue were read in full text. The included articles were analyzed and quality assessed and were also summarized in a chart. Quality assessment was done using a check-list that can be used for assessment of both randomized and non-randomized clinical studies.Results: After the search and examination of articles, 29 articles were included out of which 10 were reviews, 14 cross sectional studies, 3 prospective studies and 2 case-control studies. Totally there was 13 346 participants in the cross sectional studies, 5 391 participants in the prospective studies and 285 participants in the case-control studies. Several determinants and causes which influenced the patients self-perceived good health and of the professional established good health could be identified after the literature search. These were divided into individual and lifestyle-, biologic-, health care organization- and socioeconomic determinants.Conclusion: Additional studies need to be carried out to investigate how these determinants interact and how they can be implemented in health promotion.

Rapid demographic aging in countries around the world has prompted an interest in understanding the mobility patterns of seniors. While much research has been conducted in terms of motorized modes, the promotion of healthy aging argues for new research to investigate the multi-modal travel behavior of seniors including active travel. It is generally agreed that walking is a convenient, safe, and adequate activity for all ages and particularly for seniors, because it places the right amount of stress on their joints. It also is an inexpensive mode of transportation under a wide range of circumstances and can help achieve physical activity guidelines without imposing additional time demands. The objectives of this dissertation are fourfold. The first two objectives investigate the factors that influence use, length, frequency of two motorized (transit and car) and one active mode of transportation (walking) of seniors. The third objective is to introduce a concept of Compliance Potential Mapping (CPM) that produces maps to show spatial variation in percentage of physical activity requirements seniors obtain from their regular walking for transport. Finally, the dissertation implements a street segment sampling approach and investigates the attributes of walkable environments from the perspective of seniors. A joint discrete-continuous modeling framework was used to model mode use and trip length simultaneously and, on the other hand, a trivariate ordered probit model was used for estimating the multi-modal trip generation of seniors. CPM concept used simple map algebra operations on maps of spatial variations in trip length and frequency in order to produce potential maps of physical activity compliance. Lastly, the street sampling approach used multinomial spatial scan statistic to detect cluster of street segments where walkability audits can be conducted. Data were drawn from Montreal’s Household Travel Survey of 2008. A broad array of covariates related to personal, mobility tools (possession of driver’s licence and automobile), neighborhood, and accessibility variables were considered in the models of mode use, trip length, and trip frequency for the Montreal Island. The results of the analyses reveal a significant degree of geographical variability in the travel behavior of seniors in the Island. In particular, estimates for seniors with different socio- demographic profiles show substantial intra-urban variability in walking behavior, and the role of neighborhood design attributes and accessibility in influencing the mobility of seniors. Demonstration of CPM indicates that seniors in the central parts of Montreal Island obtain higher percentage of physical activity guidelines from walking, but with variations according to gender, income, possession of driver’s licence and vehicle. The results of the walkability analysis suggest that, other factors being equal, walking is more prevalent in street segments with marked cross–walks, horizontal and vertical mixtures in land uses, and low traffic volume. Other factors being equal, walking was less prevalent in segments with unmarked cross–walks, single residential and/or vacant land use, and high traffic volume. / Thesis / Doctor of Philosophy (PhD) / Number of seniors across Canada is increasing. Regular physical activity among these growing seniors can help them to maintain a healthy lifestyle. However, seniors are not active in their leisure time. This study shows how much seniors are active in travel behavior. In other way, how much walking seniors are undertaking as part of their travel needs and how much it contributes towards their recommended physical activity guidelines. In addition, this study also examines the street-scale built environment that encourages seniors to walk more and drive less.

Advancements in medical care are helping people to live longer lives. However, this longevity brings other challenges and health issues. As baby boomers age, the needs of an increasing number of individuals are growing as a consequence. Dementia is an issue in this aging population, and is associated with cognitive and other types of losses. Persons with dementia need emotional support, and these needs increase as the dementia progresses. It is important that these individuals with dementia receive medical and therapeutic care to maintain their quality of life for as long as possible. Music therapy is one treatment option that has been shown to provide cognitive, physical, emotional, social and behavioral benefits for this population. However, music therapy-specific assessments are needed to document the clinical and research outcomes of music therapy interventions. The purpose of this study was to examine the reliability of the Music Therapy Assessment for People with Dementia (MTAPD), a researcher-developed measure designed to assess behaviors or responses of persons with dementia during singing or vocalization, instrumental improvisation and in non-musical domains. In order to develop assessment items, the researcher, using videotapes, extracted and identified essential elements of clients' behaviors and responses. Those items were categorized into three domains (i.e., behaviors or responses during singing or vocalization (n=7), behaviors/responses during instrumental improvisation (n=16), and non-musical response or behaviors (n=6). Scoring was based on a five-point scale for items. After developing the assessment tool, the researcher asked eight music therapists with expertise in dementia to review the assessment. Nordoff-Robbins (NR) music therapists (n=9) and non-NR music therapists (n=14) participated in the reliability testing of the assessment. Therapists rated the musical behaviors and responses of clients in these three domains while viewing 15 video excerpts of clients with dementia in music therapy sessions. Results showed that the MTAPD was a reliable instrument for assessing musical and non-musical behaviors of individuals with dementia. An inter-rater reliability analysis generated particularly strong findings with all intraclass correlation coefficients above r = 0.85 with the exception of the analysis of agreement among the NR trained music therapists with more than 10 years of clinical experience. With further reliability and validity testing, the MTAPD may serve a variety of purposes in music therapy clinical practice and research. / Music Therapy