Good places for ageing in place : development of objective built environment measures for investigating links with older people's wellbeing

Background: There is renewed interest in the role of the built environment in public health. Relatively little research to date investigates its impact on healthy ageing. Ageing in place has been adopted as a key strategy for coping with the challenges of longevity. What is needed is a better understanding of how individual characteristics of older people’s residential environments (from front door to wider neighbourhood) contribute to their wellbeing, in order to provide the basis for evidence-based housing/urban design and development of interventions. This research aimed to develop a tool to objectively measure a large range of built environment characteristics, as the basis for a preliminary study of potential relationships with a number of ‘place-related’ functional, emotional and social wellbeing constructs. Methods: Through a review of urban design literature, design documents, and existing measures, a new tool, the NeDeCC (Neighbourhood Design Characteristics Checklist) was developed. It was piloted, refined, and its reliability validated through inter-rater tests. A range of place-related wellbeing constructs were identified and measured through interviews with 200 older people living in a wide variety of rural-urban environments and different types of housing in England. The NeDeCC was used to measure the residential environment of each participant, and significant bivariate relationships with wellbeing variables were identified. Results: The NeDeCC was found to have convincing face and construct validity and good inter-rater and test/ retest reliability, though it would benefit from use of digital data sources such as Google Earth to eliminate the need for on-site survey. The significant relationships found in the study suggest that there may be characteristics of residential environments of potential relevance for older people’s lives that have been overlooked in research to date, and that it may be worthwhile to question some of the assumptions about where and how older people want to live (e.g. villages seem to be positive). They also point to the importance of considering non-linear relationships. Conclusions: The NeDeCC provides the basis for generation of evidence-based design guidance if it is used in prospective controlled studies or ‘natural experiments’ in the future. Ultimately, this will facilitate the creation of better places for ageing in place

Does Your Provider Care: A Mixed Methods Study of Empathy in Medical and Graduate Counseling Students

Undergraduate Applie

Community Music Therapy and Participatory Performance: Case Study of a Coffee House

This case study research explores the impact of a musical performance event—the Coffee House—held bi-annually at an adolescent mental health treatment facility in Southwestern Ontario, Canada. Any client or staff member is welcomed to perform at this event, which is organized by the facility’s music therapist and framed here as an example of community music therapy. Drawing upon Turino’s (2008) ethnomusicological perspective on performance, I will argue that the Coffee House’s success within this context is due to its participatory ethos, wherein success is primarily defined by the act of participation. Here, performance takes place within an inclusive and supportive atmosphere in which participants can overcome anxiety, engage in the risktaking of performance, and experience increased self-efficacy and confidence. This ethos also naturally affords a “levelling” of institutional relationship dynamics. Resonant with Aigen’s (2004) vision that “performances as community music therapy can forge a new type of art, one that creates meaning and invites participation” (p. 211), the Coffee House exemplifies the ways in which the values within participatory settings are indeed different and new in comparison to presentational settings that are the norm in Western society

Neighbourhood deprivation and biomarkers of health in Britain: the mediating role of the physical environment

Background: Neighborhood deprivation has been consistently linked to poor individual health outcomes; however, studies exploring the mechanisms involved in this association are scarce. The objective of this study was to investigate whether objective measures of the physical environment mediate the association between neighborhood socioeconomic deprivation and biomarkers of health in Britain. Methods: We linked individual-level biomarker data from Understanding Society: The UK Household Longitudinal Survey (2010–2012) to neighborhood-level data from different governmental sources. Our outcome variables were forced expiratory volume in 1 s (FEV1%; n=16,347), systolic blood pressure (SBP; n=16,846), body mass index (BMI; n=19,417), and levels of C-reactive protein (CRP; n=11,825). Our measure of neighborhood socioeconomic deprivation was the Carstairs index, and the neighborhood-level mediators were levels of air pollutants (sulphur dioxide [SO2], particulate matter [PM10], nitrogen dioxide [NO2], and carbon monoxide [CO]), green space, and proximity to waste and industrial facilities. We fitted a multilevel mediation model following a multilevel structural equation framework in MPlus v7.4, adjusting for age, gender, and income. Results: Residents of poor neighborhoods and those exposed to higher pollution and less green space had worse health outcomes. However, only SO2 exposure significantly and partially mediated the association between neighborhood socioeconomic deprivation and SBP, BMI, and CRP. Conclusion: Reducing air pollution exposure and increasing access to green space may improve population health but may not decrease health inequalities in Britain

Community Music Therapy and Participatory Performance: Case Study of a Coffee House

This case study research explores the impact of a musical performance event—the Coffee House—held bi-annually at an adolescent mental health treatment facility in Southwestern Ontario, Canada. Any client or staff member is welcomed to perform at this event, which is organized by the facility’s music therapist and framed here as an example of community music therapy. Drawing upon Turino’s (2008) ethnomusicological perspective on performance, I will argue that the Coffee House’s success within this context is due to its participatory ethos, wherein success is primarily defined by the act of participation. Here, performance takes place within an inclusive and supportive atmosphere in which participants can overcome anxiety, engage in the risktaking of performance, and experience increased self-efficacy and confidence. This ethos also naturally affords a “levelling” of institutional relationship dynamics. Resonant with Aigen’s (2004) vision that “performances as community music therapy can forge a new type of art, one that creates meaning and invites participation” (p. 211), the Coffee House exemplifies the ways in which the values within participatory settings are indeed different and new in comparison to presentational settings that are the norm in Western society

Performing Identities, Performing Possibilities: A Music-Centered and Relational Perspective on Performance in Community Music Therapy and Music Education

All humans are born with musical capacity, yet many individuals have minimal access to active music-making and its affordances. This integrated-article dissertation explores the impact of participation in musical performance as it pertains to self-identity and relationship for participants who face barriers in accessing artistic engagement. Drawing upon music-centered theory from music therapy, this research celebrates the fundamentally performed and relational nature of musicking and the self and explores implications for music therapy and music education. The first two articles explore the “Coffee House”, a community music therapy event at an adolescent mental health facility, through the voices of youth and staff performers. In the first article, a case study, I suggest that the Coffee House’s participatory ethos affords an inclusive and supportive atmosphere in which performers experience accomplishment and self-efficacy. As all members of this community are welcomed to perform, a levelling of hierarchical relationship dynamics occurs. In the following article, I examine the impact of performing at this event upon participants’ identities and relationships. I argue that expansions in youths’ identities were connected to staff members’ expanded perspectives on these youths; these expanded perspectives in turn afforded new relational possibilities. The narrative research presented in the third article explores the impact of performing at an inclusive creative-arts day camp. Participating campers and their families described performance as allowing children with disabilities to experience themselves as artistically capable and contributing to their communities. Transformations in children’s self-perceptions were interwoven with audience members’ transformed perceptions of them. These participants identify many affordances of music-making while affirming the value of musicking itself. That this music-centered perspective can serve as an impetus for transdisciplinary dialogue between music therapists and music educators, while providing a unifying vision for the role of music in therapy and education, is the final article’s focus. These articles illuminate that musical performance’s impact upon individuals and their communities, in music therapy and beyond, cannot be achieved in any other way. More broadly, this research exemplifies the vast potential for transdisciplinary work between all practitioners whose work celebrates music-making and human relationship

Preparing Music Educators to Work with Students with Diverse Abilities: An Introduction to Music Therapy

Music education programs are uniquely situated within Canadian universities as most disciplines do not offer honours education programs at the undergraduate level. Within faculties of music, honours music education students engage in both practical and philosophical preparation for their teaching careers prior to acceptance and enrolment at a Faculty of Education. These students often return to departments of music education to pursue graduate work after having taught music within public or private school systems. Music teachers regularly teach children with special needs within self-contained as well as integrated or inclusive classrooms. Research indicates that music educators are enthusiastic about the prospect of teaching children with diverse needs but feel underprepared as to how to teach them effectively. Music therapists have specific training in using music with individuals who have diverse needs so as to help these specific individuals accomplish goals in both musical and non-musical domains. This introductory workshop, led by a music therapist, will develop graduate students’ understanding of music therapy and introduce them to techniques based on music therapy literature. Relevant also for undergraduate music education students, as well as for pre-service and practicing teachers, this workshop addresses ways to further cultivate practical skills that are useful for any music educator. Although the content is specific to working with children in self-contained special-needs classes, applications to inclusive classrooms will be acknowledged throughout this workshop as well

Hypothesis testing near singularities and boundaries

The likelihood ratio statistic, with its asymptotic $\chi^2$ distribution at regular model points, is often used for hypothesis testing. At model singularities and boundaries, however, the asymptotic distribution may not be $\chi^2$, as highlighted by recent work of Drton. Indeed, poor behavior of a $\chi^2$ for testing near singularities and boundaries is apparent in simulations, and can lead to conservative or anti-conservative tests. Here we develop a new distribution designed for use in hypothesis testing near singularities and boundaries, which asymptotically agrees with that of the likelihood ratio statistic. For two example trinomial models, arising in the context of inference of evolutionary trees, we show the new distributions outperform a $\chi^2$.Comment: 32 pages, 12 figure