Recently, research on community gardens and their benefits to health and community has become very popular. However, this influx of research has failed to investigate challenges to successful community gardening. Some articles examine issues between community gardeners and the land owners, but other than these conflicts community garden challenges, like lack of participation and quality leadership, have not been discussed in the literature (Draper and Freedman, 2010). To allow future gardens to be as successful as possible it is important to identify potential obstacles. Additionally, it is just as important to continue to examine possible benefits, for example, physical activity and health benefits of community gardening and the breadth of community issues possibly addressed by community gardeners. Continuing to research on community will allow for more successful gardens and encourage funding for these programs. This study examines how food insecurity, health and community cohesion issues can be affected by community gardens in Central Florida. It also investigates challenges community gardens often face. To do this I conducted structured interviews with community gardeners and semi-structured interviews with community garden leaders at several gardens throughout Orange County, Florida. The results show that community gardens have several benefits including increased consumption of fresh produce, improved physical activity, mental health and community cohesion. However, gardens are not without difficulties. About a third of the gardeners and the majority of the leaders said that lack of participation was a challenge they faced.

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Das subjektive Wohlbefinden (SWB) spiegelt die Gesamtbeurteilung des Lebens (globales SWB) und die Höhen und Tiefen des täglichen Lebens (erfahrungsbezogenes SWB) wider. Eine Fülle von Belegen deutet darauf hin, dass gesundheitliche Herausforderungen die langfristige Aufrechterhaltung des globalen SWB älterer Erwachsener sowie ihre Emotionsregulation vor Ort gefährden (Barger et al., 2009). Gleichzeitig behauptet die Lebensspannenpsychologie, dass sich das SWB als Ergebnis gesundheitlicher Anfälligkeiten entfaltet, die in ein System von Kontextebenen eingebettet sind, das vom Individuum bis zur Dyade reicht (Baltes & Smith, 2004). Allerdings haben nur wenige Studien mehr als eine Facette der Gesundheit oder des SWB untersucht, noch haben sie typischerweise individuelle Unterschiede (Persönlichkeit) oder sozial-kontextuelle Antezedenzien (z. B. die Gesundheit von signifikanten anderen Personen) untersucht. Um diese Lücken zu schließen, untersucht diese Dissertation: (i) die langfristigen Verläufe mehrerer Facetten des globalen SWB im Alter und ihre Vorhersage durch den objektiven Gesundheitszustand; sowie die kurzfristige Variabilität der Facetten des erfahrungsbezogenen SWB älterer Erwachsener als Ergebnis (ii) anlassbezogener Abweichungen des Gesundheitszustands und (iii) anlassbezogener Abweichungen des Gesundheitszustands des Ehepartners. In jeder Studie wird zusätzlich die Rolle des Neurotizismus untersucht. Zu diesem Zweck verwenden diese Studien fünf unabhängige Datensätze älterer Erwachsener, die objektive, leistungsbezogene und subjektive Maße der Gesundheit und des SWB über drei zunehmend feinere Zeitskalen erhoben haben. Die Ergebnisse dieser Dissertation zeigen, dass es älteren Erwachsenen gelingt, gesundheitliche Herausforderungen zu überwinden, um das SWB über kurze und lange Zeiträume aufrechtzuerhalten. Dabei werden die Kontexte hervorgehoben, in denen dieser Erfolg versagt (angesichts der gesundheitlichen Gefährdung des Ehepartners). / Subjective well-being (SWB) reflects our overall appraisals of life (global SWB) and the ups and downs of everyday living (experiential SWB). Lifespan developmental theory considers the maintenance of SWB in the face of age-related loss an indicator of successful aging (Baltes & Baltes, 1990). However, such loss limits the resources necessary to maintain SWB across old age, with a wealth of evidence that health challenges threaten the long-term maintenance of older adults’ global SWB as well as their in-situ regulation of emotions (Barger et al., 2009). At the same time, lifespan psychology maintains that SWB unfolds as a result of health vulnerabilities embedded into a system of contextual layers from the individual to the dyad (Baltes & Smith, 2004). However, few studies have examined more than one facet of health or SWB, nor have they typically examined individual differences (personality) or social-contextual antecedents (e.g., health of significant others). To address these gaps, this dissertation examines: (i) the long-term trajectories of multiple facets of global SWB across old age and their prediction by objective health; as well as the short-term variability in facets of older adults’ experiential SWB as a result of (ii) occasion-specific deviations in health; and (iii) occasion-specific deviations in one’s spouses’ health. Each study additionally examines the role of neuroticism. To do so, these studies utilize five independent datasets of older adults that sampled objective, performance-based, and subjective measures of health and SWB across three increasingly finer timescales. The findings of this dissertation showcase older adults’ success at overcoming health challenges to maintain SWB across short and long-time scales, and in doing so, highlights the contexts where such success falls short (in the face of spousal health vulnerabilities).

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Bakgrund: En stomi är en kirurgisk åtgärd där tarmen läggs upp och bildar en öppning på magen. Denna åtgärd resulterar i att elimination sker via denna öppning, och ändrar därför kroppsfunktionen. Det finns många orsaker till varför en stomi anläggs och det är inom sjuksköterskans arbetsområde att stödja patienten. Syfte: Syftet var att beskriva vuxnas upplevelse av att leva med stomi. Metod: En litteraturöversikt genomfördes där både kvalitativa och kvantitativa artiklar från två olika databaser, PubMed och CINAHL Complete användes. En granskning och analys av artiklarna utfördes utifrån Friberg. Resultat: Efter tematiseringen identifierades två huvudteman en förändrad vardag och psykisk hälsa med två underteman i varje. I resultatet framkom det att en stomi påverkade vardagen både fysiskt och psykiskt samt att personer med stomi upplevde ökat behov av stöd från vården efter stomioperationen. Slutsats: En stomi kan innebära både fysiska och psykiska konsekvenser. Avsaknad av stöd och information kan upplevas, vilket i sin tur kan påverka vardagen negativt. / Background: An ostomy is an intestinal opening placed on the abdomen through a surgical procedure. This procedure results in elimination passing through the opening and changes bodily functions. There are many reasons why a stoma is placed and it is within the field of nursing to support the patient. Aim: To describe adults’ experiences of living with a stoma Method: A literature review was performed using both qualitative and quantitative articles found on PubMed and CINAHL Complete. The articles were examined and analyzed to then form a base for the result. The control was performed with the support of Friberg. Results: When the thematization was completed, two main headings were formed; a changed everyday life and mental health. Each theme had two subheadings. In the results it appeared that the ostomy has both physical and psychological effects and that people with a stoma are in need of support from the healthcare, after the surgery.​ Conclusions: An ostomy can result in both physical and psychological consequences. An absence of support and information can be experienced and this can have a negative influence in daily life.

<p>This thesis presents the results of a study exploring the health status and health determinants in two farming groups in Waterloo, Ontario, Canada: Old Order Mennonites (OOMs) and non-OOM farmers. Physical health and mental health are examined, and Canada’s 12 health determinants (excluding genetics) are included in the analysis. A survey was distributed to both groups in 2010 to obtain information on health status and determinants. Comparing the two groups reduces the likely impact of contextual features impacting both, such as local economic conditions. The mental component summary (MCS) and physical component summary (PCS) of the SF-12 were used to measure mental and physical health. The study compares health in the two populations, and uses ordinary least squares (multiple) regression to determine the relative importance of the determinants in shaping health. The study found that mental health is better in OOMs, mainly due to OOM women’s strong mental health. Physical health was worse in OOMs, and while true for both genders, OOM women appear to be particularly disadvantaged. There is overlap between the groups in the determinants shaping physical and mental health. In both groups, mental health is shaped by social interaction, stress and coping; and physical health by age, childhood disease history, coping and body mass index. This suggests these factors may be important across many populations facing different life circumstances, thus representing priorities for policy action. Interestingly, the key determinants shaping physical health in both groups do not include social factors such as social capital, although social factors do shape mental health (especially in OOMs). This may be due to the rural or farming status of the two groups, or differences between physical and mental health. Determining which is more likely requires reconciling the results of this study with others, an effort hampered by differences in models, methods and health outcomes employed.</p> / Doctor of Philosophy (PhD)

Background: Cheap and effective tools for measuring patients’ physical activity (PA) level are needed. The first aim in this thesis was therefore to assess the validity of two PA -questions, and their three associated answer modes, that are used within the Swedish health care system. Sitting, light intensity PA (LIPA), and moderate and vigorous intensity PA (MVPA), are associated with health and longevity, but detailed population data assessed with objective methods is needed. The second aim was thus to assess the above with motion sensor technology, in a middle-aged Swedish sample. Low self-perceived health is a strong predictor of morbidity and mortality, but this association may vary over time with changes in the society and our lifestyle. The third aim was to assess secular trends in the interrelations between self-perceived health, physical fitness, and selected covariates. The effects of PA on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear, thus the fourth aim was to explore this. Methods: All data was collected in the Swedish population. Data from the PA -questions and accelerometers, aerobic fitness, counter movement jump, and balance tests, blood samples, and self-rated general health were collected in 365 participants, 21–66 yrs. The PA pattern was assessed in 948 individuals, 50‒64 yrs, from the SCAPIS pilot study. Self-perceived physical health, and measured aerobic fitness, counter movement jump height, and balance, and demographic and lifestyle data, was assessed in three independent samples from 1990, 2000 and 2013, including 3564 adults, 20‒65 yrs. The effects of Swedish PAP on HRQoL was assessed in a randomized controlled trial including 101 men and women, 67‒68 yrs, that were inactive, overweight (BMI&gt;25 kg/m2), and had a waist circumference ≥102 cm (men) or ≥88 cm (women), who were randomized to an intervention group or a control group. The 36-item Short Form Health Survey (SF-36) was used to assess HRQoL. Results: The multiple choice answer mode of the two PA -questions was found to have the strongest validity, compared with the two other (an open mode, and one where PA minutes is specified per weekday). The validity is in line with many other established PA-questionnaires, but the open mode has limitations. The assessment of PA pattern showed that 61% of motion sensor wear time represented sitting, 35% LIPA, and 4% MVPA. Only 7% of the sample met the PA recommendations. The odds for describing perceived health as good was found to increase by 5% per each increment of 1 ml/kg/min in VO2max. This was stable across genders and all three LIV-samples (i.e. over time). Waist circumference, chronic disease, sleep problems, and level of satisfaction with one’s life, were also important correlates. The Swedish PAP group improved significantly more, and more participants displayed clinically relevant improvements (OR 2.43), in mental aspects of HRQoL, compared to the controls. Physical aspects of HRQoL improved in the PAP group, but not in the control group. Conclusions: The multiple choice answer mode has the strongest validity and Open mode the weakest. The PA -questions may be used in populations, or in individuals to determine appropriateness for treatment. The questions’ advantages and limitations must be considered and further reliability and validity studies are needed. The results regarding sitting, LIPA, MVPA and fulfillment of PA recommendations, are of high clinical relevance. A great challenge remains to further implement methods to increase the level of PA in the Swedish population. Physical fitness is related to self-perceived health independently of changes in society and lifestyle over time, and simple questions may be useful for the clinical assessment of physical fitness. Swedish PAP has a positive effect on mental aspects of HRQoL, measured by the SF-36. This finding supports the clinical use of the Swedish PAP model. / LIV 2013

Syfte Syftet med denna studie var att undersöka samband mellan utbildning, civilstånd och inkomst gentemot upplevd fysisk och psykisk hälsa. Metod Undersökningen är en kvantitativ enkätstudie där totalt 525 individer ingick framförallt från Lidingö, Täby, Haninge, Östermalm och Solna. Åldern på individerna varierade mellan 37 och 89 år och medelåldern var 70,3 år (± 6,6), där cirka en tredjedel var män och två tredjedelar kvinnor. Samtliga har fått besvara frågor med fasta svarsalternativ kring deras upplevda fysiska (kroppslig) samt psykiska (själslig) hälsa och faktorerna inkomst, civilstånd samt utbildningsnivå. Därefter analyserades resultaten för att finna eventuella samvariationer mellan den upplevda hälsan och de specifika faktorerna. Samtliga deltagare har själva ansökt om att få vara med i ett projekt kring hälsa i Gymnastik- och idrottshögskolans regi. Resultat Signifikanta samvariationer fanns mellan upplevd fysisk och psykisk hälsa samt civilstånd där hög hälsa korrelerade med att leva i ett förhållande. I förhållande till inkomstnivå fanns tendenser till samband (dock utan signifikans) där en viss ökning av den upplevda fysiska samt psykiska hälsan noterades för varje inkomstintervall (låg, medel och hög), i synnerhet gentemot den psykiska hälsan. Utbildningsfaktorn visade inga signifikanta samband med grad av upplevd hälsa bland deltagarna. Slutsats Studiens hypotes om en positiv samvariation mellan den upplevda hälsan och samtliga tre livsfaktorer visade sig inte stämma fullt ut för denna grupp med företrädesvis äldre. Den faktor som signifikant korrelerade med upplevd hälsa var civilstånd. Även inkomst visade sig ha tendensen (dock ej signifikant) till ett visst samband med de skattade hälsoparametrarna för den undersökta gruppen. Det är möjligt, med använda arbetsmetoder, att starkare samband skulle fås fram på ett mer slumpmässigt urval av befolkningen. Studien ställer jämväl nya frågor om huruvida sambandet för undersökta faktorer i förhållande till upplevd hälsa eventuellt skiljer sig för olika åldersgrupper.

This study investigates social connectedness and social support in a military and civilian college population, and their associations with psychological, physical and stress-related health. There were 301 total participants, 51 of which were military personnel. The participant’s ages ranged from 18-59 (M = 23.48, SD = 7.24), with majority of the participants being female (71.8%), Caucasian (66.1%) and in a relationship (50.8%). The study was administered online via SONA. The following measures were administered in this study: the Social Connectedness Scale, the Multidimensional Scale of Perceived Social Support, the Physical Health Questionnaire, MOS Short Form Survey Instrument, UCLA Loneliness Scale, the Depression Patient Health Questionnaire, Hopkins Symptom Checklist Anxiety Scale, and the PTSD Checklist- Civilian Version. Veteran students indicated several issues while transitioning to higher education, as well as, several factors that they feel make them unique from their peers. Social connectedness significantly predicted all measures of health, especially PTSD (β = -.43, p < .001), depression (β = -.47, p < .001) and general health (β = -.30, p < .001), with higher rates of social connectedness denoting less symptoms. The social support’s association with health via the main effect model was supported by the results, whereas, the buffering hypothesis model was not supported. Social support was most predictive of anxiety (β = -.28, p < .001), PTSD (β = -.37, p < .001) and general health (β = .36, p < .001). Military status was not associated with social connectedness, rendering the serial multiple mediation model untestable. This study provides empirical evidence that social connectedness is a powerful and pervasive human need, with important health implications.