Promoting and maintaining health of people with sight loss: A scoping study

This study was undertaken in response to a request by the Thomas Pocklington Trust to identify and explore the following issues: • The needs and concerns regarding immediate risks to health and safety related to sight loss; • Additional risks arising from sight loss for those who are also managing a long term disease; • The difficulties in maintaining and promoting health; • Whether or not health promotion activities and policies sufficiently address perceived needs. Findings pertaining to these objectives have been generated from data collected in Leeds, UK, a city where innovative programming for sight loss has either been planned or is being incorporated into health planning and a review of the literature. Findings related to the last two issues indicate that gaps exist in service provision for maintaining health and emphasise the need for more explicitly targeted health promotion initiatives that could address current weaknesses. - A review of the literature; - Focus group discussions with a range of people who had experienced sight loss; - Interviews with professional practitioners engaged in service provision to this population; - An expert hearing with four professional practitioners, one of whom had sight loss, and two service users with sight loss. Most participants were from the West Yorkshire region and the services described in the study are largely located in Leeds. Evidence from the literature review suggests that people with visual impairment have increased risk of accidents within the home and that ensuing consequences include injuries incurred and decreased confidence. Rates of depression among people who are blind or partially sighted are far higher than in the wider population and the likelihood of depression increases with age, although psycho-social interventions and technological assistance can be successfully implemented to improve quality of life. Sight loss together with other long term health conditions exacerbates the impact of other health conditions and has particularly severe impact on the wellbeing of older people insofar as it may affect their mobility, which in turn increases their risk of falls and depression. The nature and level of support available to people is variable but it is clear that access both to the right information at the right time and to appropriate services is a critical issue. Focus group discussions, interviews and the expert hearing corroborated and extended the themes noted in the literature and discuss the differential impact of different risks to health and the difficulties of coping with these at different times in a person’s life. A simple typology was defined using two dimensions of experience (‘stage of life’ and ‘early/late onset of sight loss’) as a means of organizing findings and providing a means of making further distinctions in interpreting the data. Potentially, this scheme can allow health promotion initiatives to be targeted more effectively to stages at which people with sight loss are more likely to encounter specific difficulties in managing and maintaining their health. There was a clear consensus throughout the study that interventions to meet the needs of people with sight loss must be tailored to meet the specific needs of individuals: people with sight loss are not a homogeneous group and the way in which each person experiences the challenges of sight loss and of managing their health will inevitably vary from person to person. Recommendations generated by this study include: • The scope for more pro-active services and need for closer collaboration between service providers; • The need for provision and promotion of targeted information; • The need for greater awareness of the needs of people with visual impairments among generic service providers; and • Further research that explores the usefulness of the typology with a larger sample more representative of population demographics such as BME communities that are more likely to slip through the cracks of service provision

Older adults, falls and technologies for independent living: a life space approach

This paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls

Understanding walking and cycling:summary of key findings and recommendations

It is widely recognized that there is a need to increase levels of active and sustainable travel in British urban areas. The Understanding Walking and Cycling (UWAC) project, funded by the EPSRC, has examined the factors influencing everyday travel decisions and proposes a series of policy measures to increase levels of walking and cycling for short trips in urban areas. A wide range of both quantitative and qualitative data were collected in four English towns (Lancaster, Leeds, Leicester and Worcester), including a questionnaire survey, spatial analysis of the built environment, interviews (static and whilst mobile) and detailed ethnographies. Key findings of the research are that whilst attitudes to walking and cycling are mostly positive or neutral, many people who would like to engage in more active travel fail to do so due to a combination of factors. These can be summarised as: Concerns about the physical environment, especially with regard to safety when walking or cycling; The difficulty of fitting walking and cycling into complex household routines (especially with young children); The perception that walking and cycling are in some ways abnormal things to do. It is suggested that policies to increase levels of walking and cycling should focus not only on improving infrastructure (for instance through fully segregated cycle routes along main roads and restriction on vehicle speeds), but also must tackle broader social, economic, cultural and legal factors that currently inhibit walking and cycling. Together, such changes can create an environment in which driving for short trips in urban areas is seen as abnormal and walking or cycling seem the obvious choices. A joint project by by Lancaster University, Oxford Brookes University and the University of Leeds

Giving voice to equitable collaboration in participatory design

An AHRC funded research project titled Experimenting with the Co-experience Environment (June 2005 – June 2006) culminated in a physical environment designed in resonance with a small group of participants. The participants emerged from different disciplines coming together as a group to share their expertise and contribute their knowledge to design. They engaged in storytelling, individual and co-thinking, creating and co-creating, sharing ideas that did not require justification, proposed designs even though most were not designers …and played. The research questioned how a physical environment designed specifically for co-experiencing might contribute to new knowledge in design? Through play and by working in action together the participants demonstrated the potential of a physical co-experience environment to function as a scaffold for inter-disciplinary design thinking,saying, doing and making (Ivey & Sanders 2006). Ultimately the research questioned how this outcome might influence our approach to engaging participants in design research and experimentation

Convergent invention in space and place: a rhetorical and empirical analysis of Colorado State University's Morgan Library

2014 Summer.Includes bibliographical references.This thesis seeks to describe the ways in which contemporary academic library spaces facilitate rhetorical invention. To observe rhetorical invention in a real space, this thesis analyzes spatial practices in Colorado State University's Morgan Library. This thesis argues that Morgan Library is a representative space of convergent invention. The neologism convergent invention is defined as the cross-platform and multi-modal creation of a rhetorical text which accounts for external factors on the creator(s). To describe the functions of the contemporary library, this thesis uses Michel de Certeau's theories of strategies and tactics to articulate usage patterns. Strategies are analyzed through a rhetorical criticism of Morgan Library to show how the library materially articulates its vision of convergent invention. Users' tactics to accept or reject Morgan Library's messages about convergent invention are explicated through the results of survey data and behavior observations. In the conclusion this thesis provides some implications for convergent invention and the future of libraries, both academic and otherwise

Experience of furniture in homes: Creating conditions for the design with consideration to people in the third age

This licentiate thesis in industrial design concerns the challenge and opportunity to meet the demographic changes and the future senior market. The aim is to explore how various user-centered design methods can be combined, modified and practiced to create conditions for the design of totally new or improved products. Design is understood as a process to develop solutions with the starting point in users’ needs. A user-centered design process, instead of a technology and market driven one, is believed to lead to products that are more desirable, useful, in line with users’ needs and contribute to long-term use. The product category in focus is furniture and other interior products and the context of use is the home. Two studies were carried out, one with focus group interviews about changes when moving to and living in a newly built apart¬ment particularly developed to fit the needs of seniors and one with situated interviews in homes. Both had the intention to identify various end-user needs. In total, 26 people aged 53-93 participated in the two studies. The focus group interviews emphasized views and attitudes towards, changes needs and aspirations. The situated interviews offered deeper insights and understanding of the interplay between user, products and the context where the products were used. The finding demonstrate that products perceived as comfortable, flexible and pleasurable lead to attachment and desirable emotional experiences such as dignity, meaningfulness and freedom. The findings about needs that the end-users themselves express differ from the existing recommendations for the design of furniture and other interior products for old people. The latter are mainly based on individual physiological changes that aging may bring. New findings point to demands on products that also support the psychological and social changes, and that correspond to an identity of an active, independent and self-determinant individual. The thesis concludes that designers may benefit from being closely involved in the creation of end-user knowledge to ensure that the findings are adequate for the present challenges’ specific needs and that the findings embrace a holistic perspective on humans’ needs. A future recommendation is to respond to the findings of the studies with design solutions as physical representations, and to involve users in iterative design processes

Low-income families : experiences and responses to consumer exclusion

The purpose of this paper is to focus on low-income families who are excluded from consumer culture. It explores their experiences and responses to material deprivation, social deprivation and stigmatization. Given the need for identification and calculation of exclusion thresholds to be supplemented by the voice of the excluded themselves, the study is based on qualitative analysis of 30 in-depth interviews with low-income families who encounter consumption constraints in the marketplace. While the harsh realities of consumer exclusion cannot be denied, findings also present a more positive outlook as excluded consumers can achieve empowerment through employment of stigma management strategies, creative consumer coping and rejection of the stigmatizing regime. Research is based only on families with children under the age of 18; future research on older people and exclusion would prove a useful comparison. The research raises a number of important policy issues in relation to social barriers to inclusion and the role of marketing in contributing to consumer exclusion. Social policy studies surrounding social exclusion in terms of separation from mainstream society tend to focus on employment. This paper highlights that a social exclusion discourse can also provide a useful perspective to investigate exclusion in relation to consumerism