Thesis (D. Min.)--Concordia Seminary, 1997. / Abstract. Includes bibliographical references (leaves [282]-291).

This study explores the relationship between Adult Protective Service (APS) referrals and the link between dementia type behaviors. The question is does self-neglect, due to dementia precipitate multiple APS referrals? A quantitative-study was conducted based upon a random selection of fifty client files from the years 2014 and 2015. The information collected was based upon data provided to the APS hotline and what was determined by the APS investigators. SPSS software was used to determine the values of the data. Table 1 displays the results of demographics with 37% males and 63% females. Results of this study are inconsistent with the existing literature.

No description available.

Importance – The homeless face higher rates of morbidity and mortality than the general population, and have lower rates of end-of-life care planning. An effective and sustainable intervention, to provide living wills and durable power of attorney, is required to protect the autonomy of a vulnerable population. Objective – To determine if medical student-led 1:1 counseling is as effective as social worker-led counseling as reported in the literature, determined by rate of advanced directive completion. Design – A focus groups and educational sessions on EOL care and ADs were conducted at 2 shelters, after which participants were offered the opportunity to sign up for a 1:1 counseling session with a medical student volunteer. Rates of sign-ups and completion were recorded. Setting – 2 North Philadelphia homeless shelters, requiring either an Axis I or current substance abuse diagnosis for residence. Participants – A convenience sample of 20 homeless men were approached; 10 enrolled in the study. Interventions – Educational sessions, focus groups, and 1:1 AD completion counseling sessions Main Outcomes – Interest in and completion of an advanced directive. Results – 9 participants signed up to complete ADs after an informational session. At the conclusion of the study, 8 of them (88.8%) completed ADs. 40% of the total participants completed an AD. Conclusions – Similar rates of advanced directive completion were achieved with the student-led intervention compared to a previous intervention in the literature. Further study with a larger sample including homeless women should be conducted to provide a generalized conclusion. / Urban Bioethics

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Health literacy is the degree to which individuals have the capacity to understand basic health information and services needed to make appropriate health decisions. Women seen at Maricopa Integrated Health System (MIHS) Refugee Women’s Health Clinic (RWHC) are routinely offered education on developing a Reproductive Life Plan (RLP). In order to influence women’s reproductive health and medical decision‐making, there is a need to tailor RLP counseling to engage their male partners in the refugee community. We aimed to assess increased knowledge on preconception care related to the importance of developing a RLP, perspectives on birth spacing, and the influence of men as well as religion in medical decision‐making. We aimed to identify the refugee community’s receptivity to culturally and linguistically appropriate audiovisual modalities. Study participants comprised 120 refugees (39 men and 81 women) including couples, across the respective target languages with pre‐ and post‐Likert scale surveys assessing perspectives on RLP, birth spacing, the role of religion, and readiness for behavior change. Summary statistics examined changes in pre‐ and post‐Likert scale survey responses with responses dichotomized as Strongly agree/Agree compared against all other responses. A higher frequency of male respondents agreed about knowing what RLP means in the posttest relative to pretest (71.8% to 89.7%, P = 0.016) as well as 'Not having children…' (41% to 64.1%, P=0.035). Female respondents were more likely to agree to 'Know what RLP means' (76.5% to 86.4%, P =0.039) and 'Having a baby soon after…' (65.4% to 76.5%, P =0.035) after the training. They also were less likely to agree that 'RLP is about birth control' (71.6% to 59.3%, P =0.021). Amongst Muslim participants, we found improvement in knowing what RLP means (65.5% to 87.9%) and that it is important for men to have a RLP (67.2% to 84.5%). Cronbach’s alpha was used to measure internal inconsistency, with most values less than 0.5 and deemed unacceptable. Only one value, birth spacing, was > 0.6 and deemed questionable. There was the same degree of concordance, yet there also was discordance in the direction of opinions between women and men pre vs post‐test answers. When comparing couples pre and posttest, there was no significant differences observed across genders. This is the first reported U.S. initiative to provide a culturally and linguistically appropriate preconception health education. Project had demonstrated ability to mobilize several ethnic communities around the RLP. Respondents among both genders were more likely to agree about knowing what RLP means. The most challenging aspect of our community mobilization efforts was recruiting a larger sample size. Another limitation was the use of the Likert scale in a population with low literacy as there were some discrepancies in responses to negatively‐worded questions. Future studies could use a visual analog scale of smiley faces to assist those with limited literacy and incorporate a more global feel.

Embora a juventude possua papel fundamental no processo de desenvolvimento rural, sua posição é subalterna, deixando de receber o devido reconhecimento. Neste sentido, estudar as percepções e os projetos dos jovens, filhos de produtores rurais, é pertinente, em especial aqueles inseridos no cultivo de tabaco, uma vez que esta produção agrícola está presente em diversos municípios do estado do Rio Grande do Sul e em muitos destes, com significativa relevância econômica. Neste sentido, o presente estudo busca responder a seguinte questão: Como os jovens percebem o cultivo de tabaco e de que forma eles tem projetado suas vidas no meio rural? O recorte empírico limita-se ao município de Arroio do Tigre, no Vale do Rio Pardo, estado do Rio Grande do Sul, em função da importância que o cultivo de tabaco representa para economia local. O objetivo principal do estudo é investigar as percepções dos jovens acerca do cultivo de tabaco, buscando analisar a relação desta atividade com os seus projetos de vida no meio rural, e os objetivos específicos são: a) identificar quem são os atores, na arena de Arroio do Tigre, que participam do debate em relação à juventude rural, produção de tabaco e à diversificação produtiva; b) caracterizar os jovens, a partir do perfil social e econômico; c) analisar as percepções dos jovens acerca do cultivo de tabaco; d) desvelar os principais projetos dos jovens e verificar a influência das relações sociais locais na sua constituição; e, e) identificar as principais políticas públicas dirigidas aos jovens e averiguar a contribuição delas às percepções e projetos. Tendo em vista a heterogeneidade do meio rural e a capacidade de agência dos jovens, o aporte teórico-analítico utilizado no estudo foi à perspectiva orientada ao ator (POA), que surgiu na década de 1970, criticando as perspectivas estruturalistas e a falta de reconhecimento do papel dos atores sociais A pesquisa utilizou metodologia qualitativa, a partir de algumas técnicas etnográficas. As técnicas escolhidas para a coleta e obtenção de dados foram: estudo documental, bibliográfico e coleta de dados primários e secundários. Realizou-se uma dinâmica grupal com 14 jovens rurais e 18 entrevistas com jovens, filhos de produtores de tabaco que estão projetando as suas vidas no meio rural. Também se realizou 14 entrevistas e conversas informais com agentes de desenvolvimento e líderes locais. Fez-se ainda o uso da observação participantes sendo as informações anotadas num caderno de campo. Como principais resultados visualizaram-se que as problemáticas do universo jovens são pouco discutidas na arena local, o cultivo de tabaco não é predominante nos projetos de vida dos jovens e percebe-se a falta de ações e políticas específicas para os jovens rurais seja na esfera municipal, estadual e federal. / Beside that the youth has vital role in shaping the rural development, their importance is neglected and lacks due recognition. Consequently, studying the perceptions and projects related to youth, rural farmer’s children, particularly those who are tobacco producers. This agricultural activity is present in several municipalities in the state of Rio Grande do Sul and has a key important in rural economic. In this background, this study focus to address the following questions; how youth relies on the tobacco cultivation and how it had shaped their life style in rural areas? The study was carried out in the municipality of Arroio doTigre, in the Vale do Rio Pardo, Rio Grande do Sul. Keeping in view the importance of the tobacco cultivation to the local economy, the main objective of the study was to investigate the youth perceptions about tobacco farming and to monitor the relationship of this farming activity to frame their life standards in rural areas. The specific objectives include: a) to investigate who are the key stakeholder in the arena Arroio do Tigre, participating in debate focusing on rural youth and tobacco production and it’s production diversification; b) to characterize the youth from the social and economic point of view; c) to analyze the perceptions of youth about tobacco farming; d) to explore the principal projects of the youth and verify the influence of local social relations on its formation and e) to analyze the major public policies addressing the youth issues and to monitor its importance to fulfill their expectations and goals. Keeping in view the heterogeneity of rural areas and the capacity of the youth agency, the theoretical-analytical approach was used in the study and was oriented to the actor (POA), which emerged in the 1970s perspective, criticizing the structuralism perspective and neglecting the role of social stakeholders. The research used qualitative methodology beside from some ethnographic techniques. To acquire and collect data the techniques include, documentary study, bibliography, and collection of primary and secondary data. We made a dynamic group by choosing 14 young rural representatives, 18 interviews with rural youth and children of tobacco growers who are sustaining their lives in rural areas. We also conducted 14 interviews and informal discussions with development agents and local leadership, yet we also used the information which was recorded from public participation during field visits. The results suggested that the youth problems are seldom discussed at the local scale, the tobacco cultivation did not uplifted the rural life standards and do not fulfill the rural youth ambitions. Our findings further highlighted that there were no specific actions plans and policies are set for improvement of rural youth on the municipality, state and national scale.

Embora a juventude possua papel fundamental no processo de desenvolvimento rural, sua posição é subalterna, deixando de receber o devido reconhecimento. Neste sentido, estudar as percepções e os projetos dos jovens, filhos de produtores rurais, é pertinente, em especial aqueles inseridos no cultivo de tabaco, uma vez que esta produção agrícola está presente em diversos municípios do estado do Rio Grande do Sul e em muitos destes, com significativa relevância econômica. Neste sentido, o presente estudo busca responder a seguinte questão: Como os jovens percebem o cultivo de tabaco e de que forma eles tem projetado suas vidas no meio rural? O recorte empírico limita-se ao município de Arroio do Tigre, no Vale do Rio Pardo, estado do Rio Grande do Sul, em função da importância que o cultivo de tabaco representa para economia local. O objetivo principal do estudo é investigar as percepções dos jovens acerca do cultivo de tabaco, buscando analisar a relação desta atividade com os seus projetos de vida no meio rural, e os objetivos específicos são: a) identificar quem são os atores, na arena de Arroio do Tigre, que participam do debate em relação à juventude rural, produção de tabaco e à diversificação produtiva; b) caracterizar os jovens, a partir do perfil social e econômico; c) analisar as percepções dos jovens acerca do cultivo de tabaco; d) desvelar os principais projetos dos jovens e verificar a influência das relações sociais locais na sua constituição; e, e) identificar as principais políticas públicas dirigidas aos jovens e averiguar a contribuição delas às percepções e projetos. Tendo em vista a heterogeneidade do meio rural e a capacidade de agência dos jovens, o aporte teórico-analítico utilizado no estudo foi à perspectiva orientada ao ator (POA), que surgiu na década de 1970, criticando as perspectivas estruturalistas e a falta de reconhecimento do papel dos atores sociais A pesquisa utilizou metodologia qualitativa, a partir de algumas técnicas etnográficas. As técnicas escolhidas para a coleta e obtenção de dados foram: estudo documental, bibliográfico e coleta de dados primários e secundários. Realizou-se uma dinâmica grupal com 14 jovens rurais e 18 entrevistas com jovens, filhos de produtores de tabaco que estão projetando as suas vidas no meio rural. Também se realizou 14 entrevistas e conversas informais com agentes de desenvolvimento e líderes locais. Fez-se ainda o uso da observação participantes sendo as informações anotadas num caderno de campo. Como principais resultados visualizaram-se que as problemáticas do universo jovens são pouco discutidas na arena local, o cultivo de tabaco não é predominante nos projetos de vida dos jovens e percebe-se a falta de ações e políticas específicas para os jovens rurais seja na esfera municipal, estadual e federal. / Beside that the youth has vital role in shaping the rural development, their importance is neglected and lacks due recognition. Consequently, studying the perceptions and projects related to youth, rural farmer’s children, particularly those who are tobacco producers. This agricultural activity is present in several municipalities in the state of Rio Grande do Sul and has a key important in rural economic. In this background, this study focus to address the following questions; how youth relies on the tobacco cultivation and how it had shaped their life style in rural areas? The study was carried out in the municipality of Arroio doTigre, in the Vale do Rio Pardo, Rio Grande do Sul. Keeping in view the importance of the tobacco cultivation to the local economy, the main objective of the study was to investigate the youth perceptions about tobacco farming and to monitor the relationship of this farming activity to frame their life standards in rural areas. The specific objectives include: a) to investigate who are the key stakeholder in the arena Arroio do Tigre, participating in debate focusing on rural youth and tobacco production and it’s production diversification; b) to characterize the youth from the social and economic point of view; c) to analyze the perceptions of youth about tobacco farming; d) to explore the principal projects of the youth and verify the influence of local social relations on its formation and e) to analyze the major public policies addressing the youth issues and to monitor its importance to fulfill their expectations and goals. Keeping in view the heterogeneity of rural areas and the capacity of the youth agency, the theoretical-analytical approach was used in the study and was oriented to the actor (POA), which emerged in the 1970s perspective, criticizing the structuralism perspective and neglecting the role of social stakeholders. The research used qualitative methodology beside from some ethnographic techniques. To acquire and collect data the techniques include, documentary study, bibliography, and collection of primary and secondary data. We made a dynamic group by choosing 14 young rural representatives, 18 interviews with rural youth and children of tobacco growers who are sustaining their lives in rural areas. We also conducted 14 interviews and informal discussions with development agents and local leadership, yet we also used the information which was recorded from public participation during field visits. The results suggested that the youth problems are seldom discussed at the local scale, the tobacco cultivation did not uplifted the rural life standards and do not fulfill the rural youth ambitions. Our findings further highlighted that there were no specific actions plans and policies are set for improvement of rural youth on the municipality, state and national scale.

Embora a juventude possua papel fundamental no processo de desenvolvimento rural, sua posição é subalterna, deixando de receber o devido reconhecimento. Neste sentido, estudar as percepções e os projetos dos jovens, filhos de produtores rurais, é pertinente, em especial aqueles inseridos no cultivo de tabaco, uma vez que esta produção agrícola está presente em diversos municípios do estado do Rio Grande do Sul e em muitos destes, com significativa relevância econômica. Neste sentido, o presente estudo busca responder a seguinte questão: Como os jovens percebem o cultivo de tabaco e de que forma eles tem projetado suas vidas no meio rural? O recorte empírico limita-se ao município de Arroio do Tigre, no Vale do Rio Pardo, estado do Rio Grande do Sul, em função da importância que o cultivo de tabaco representa para economia local. O objetivo principal do estudo é investigar as percepções dos jovens acerca do cultivo de tabaco, buscando analisar a relação desta atividade com os seus projetos de vida no meio rural, e os objetivos específicos são: a) identificar quem são os atores, na arena de Arroio do Tigre, que participam do debate em relação à juventude rural, produção de tabaco e à diversificação produtiva; b) caracterizar os jovens, a partir do perfil social e econômico; c) analisar as percepções dos jovens acerca do cultivo de tabaco; d) desvelar os principais projetos dos jovens e verificar a influência das relações sociais locais na sua constituição; e, e) identificar as principais políticas públicas dirigidas aos jovens e averiguar a contribuição delas às percepções e projetos. Tendo em vista a heterogeneidade do meio rural e a capacidade de agência dos jovens, o aporte teórico-analítico utilizado no estudo foi à perspectiva orientada ao ator (POA), que surgiu na década de 1970, criticando as perspectivas estruturalistas e a falta de reconhecimento do papel dos atores sociais A pesquisa utilizou metodologia qualitativa, a partir de algumas técnicas etnográficas. As técnicas escolhidas para a coleta e obtenção de dados foram: estudo documental, bibliográfico e coleta de dados primários e secundários. Realizou-se uma dinâmica grupal com 14 jovens rurais e 18 entrevistas com jovens, filhos de produtores de tabaco que estão projetando as suas vidas no meio rural. Também se realizou 14 entrevistas e conversas informais com agentes de desenvolvimento e líderes locais. Fez-se ainda o uso da observação participantes sendo as informações anotadas num caderno de campo. Como principais resultados visualizaram-se que as problemáticas do universo jovens são pouco discutidas na arena local, o cultivo de tabaco não é predominante nos projetos de vida dos jovens e percebe-se a falta de ações e políticas específicas para os jovens rurais seja na esfera municipal, estadual e federal. / Beside that the youth has vital role in shaping the rural development, their importance is neglected and lacks due recognition. Consequently, studying the perceptions and projects related to youth, rural farmer’s children, particularly those who are tobacco producers. This agricultural activity is present in several municipalities in the state of Rio Grande do Sul and has a key important in rural economic. In this background, this study focus to address the following questions; how youth relies on the tobacco cultivation and how it had shaped their life style in rural areas? The study was carried out in the municipality of Arroio doTigre, in the Vale do Rio Pardo, Rio Grande do Sul. Keeping in view the importance of the tobacco cultivation to the local economy, the main objective of the study was to investigate the youth perceptions about tobacco farming and to monitor the relationship of this farming activity to frame their life standards in rural areas. The specific objectives include: a) to investigate who are the key stakeholder in the arena Arroio do Tigre, participating in debate focusing on rural youth and tobacco production and it’s production diversification; b) to characterize the youth from the social and economic point of view; c) to analyze the perceptions of youth about tobacco farming; d) to explore the principal projects of the youth and verify the influence of local social relations on its formation and e) to analyze the major public policies addressing the youth issues and to monitor its importance to fulfill their expectations and goals. Keeping in view the heterogeneity of rural areas and the capacity of the youth agency, the theoretical-analytical approach was used in the study and was oriented to the actor (POA), which emerged in the 1970s perspective, criticizing the structuralism perspective and neglecting the role of social stakeholders. The research used qualitative methodology beside from some ethnographic techniques. To acquire and collect data the techniques include, documentary study, bibliography, and collection of primary and secondary data. We made a dynamic group by choosing 14 young rural representatives, 18 interviews with rural youth and children of tobacco growers who are sustaining their lives in rural areas. We also conducted 14 interviews and informal discussions with development agents and local leadership, yet we also used the information which was recorded from public participation during field visits. The results suggested that the youth problems are seldom discussed at the local scale, the tobacco cultivation did not uplifted the rural life standards and do not fulfill the rural youth ambitions. Our findings further highlighted that there were no specific actions plans and policies are set for improvement of rural youth on the municipality, state and national scale.

How do people anticipate the future and plan their lives when little is certain? How can we take account of the significance of demographic ‘vital events’ (such as marriage, childbirth or migration) when the horizon of a possible future within which these events acquire meaning becomes pluralized, fluid or contested? How do changing life-course patterns relate to social transformations on larger spatial and temporal scales? Which social and economic institutions construct and normalize life-stages and, vice versa, how do life-course patterns affect and transform institutions? Finally, how do these processes relate to the construction and practice of gender orders? These were the central questions debated during the workshop on ‘Vital Conjunctures — Gender in Times of Uncertainty’1, where the papers by Jennifer Johnson-Hanks and Erdmute Alber compiled in this SPP 1448 Working Paper were presented, the first as keynote and the second as critical comment.

Death is an inevitable part of life, yet many Americans fail to plan for this final part of life. Only about 1/3 of our country has an advance directive (Off White Papers, 2014). This underutilization of advance directives is reflected in our health care spending. It is estimated that 30% of all Medicare spending occurs during the last six months of a patient’s life. The numbers are even lower when broken down into sub-categories. Only 24% of older Black Americans possess an advance directive versus 44% of their older White counterparts (Huang, Neuhaus, & Chiong, 2016). Some studies found that African Americans were more likely to “express discomfort discussing death, want aggressive care at the end of life, have spiritual beliefs which conflict with the goals of palliative care, and distrust the healthcare system” (Johnson, Kuchibhatla, & Tulsky, 2008). Other studies have even concluded that Black race is an independent predictor of lack of advance directive possession (Huang et al., 2016). This paper further explores the possibility that race and ethnicity may simply be proxies for cultural values that impact advance directive possession. We’ll discuss the barriers, for both Black patients and health care providers, to advance directive possession as well as investigate culturally mindful interventions to combat the barriers. / Urban Bioethics