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Facing the challenge of adapting to a life alone' in old age: the influence of losses
Aim: The aim of this paper is to explore older people’s approaches to living a life characterized by losses and “aloneness” and how this relates to loneliness.
Background: Loneliness is closely related to social status and health condition. Older people are vulnerable to experiences of loneliness due to losses, which follow the ageing process.
Method: A qualitative interpretative design was used. Older people, aged 65 and above, living at home, in retirement villages or long-term care settings in Australia, Norway and United Kingdom, participated. 78 persons were included. Data were collected through open-ended interviews during autumn of 2006 and spring of 2007. The interviews were audio taped, transcribed and analyzed applying a hermeneutic, interpretative process.
Findings: Analyses revealed great differences in the way participants handled their life situation. Interviewees describing themselves as 'not lonely' viewed losses as normal, they participated in meaningful activities, connected to other people and thrived in their own company. Those describing themselves as 'lonely' on the other hand, strove to create meaning in their lives, were overwhelmed by losses, had problems finding meaningful activities and difficulty keeping up social relations.
Conclusion: Loneliness was associated with overwhelming losses, inactivity, meaninglessness and social isolation. The contrasting findings between ‘not lonely’ and ‘lonely’ older people have implications for nursing in that nurses must seek to identify those who need help in managing their loneliness and provide guidance and support. More research is needed to develop interventions that is effective in reducing loneliness
Advancing methods for research on household water insecurity: Studying entitlements and capabilities, socio-cultural dynamics, and political processes, institutions and governance
© 2017 Elsevier B.V. Household water insecurity has serious implications for the health, livelihoods and wellbeing of people around the world. Existing methods to assess the state of household water insecurity focus largely on water quality, quantity or adequacy, source or reliability, and affordability. These methods have significant advantages in terms of their simplicity and comparability, but are widely recognized to oversimplify and underestimate the global burden of household water insecurity. In contrast, a broader definition of household water insecurity should include entitlements and human capabilities, socio-cultural dynamics, and political institutions and processes. This paper proposes a mix of qualitative and quantitative methods that can be widely adopted across cultural, geographic, and demographic contexts to assess hard-to-measure dimensions of household water insecurity. In doing so, it critically evaluates existing methods for assessing household water insecurity and suggests ways in which methodological innovations advance a broader definition of household water insecurity
Co-infection by human immunodeficiency virus type 1 (HIV-1) and human T cell leukemia virus type 1 (HTLV-1): does immune activation lead to a faster progression to AIDS?
<p>Abstract</p> <p>Background</p> <p>Recent data have shown that HTLV-1 is prevalent among HIV positive patients in Mozambique, although the impact of HTLV-1 infection on HIV disease progression remains controversial. Our aim was to determine the phenotypic profile of T lymphocytes subsets among Mozambican patients co-infected by HIV and HTLV-1.</p> <p>Methods</p> <p>We enrolled 29 patients co-infected by HTLV-1 and HIV (co-infected), 59 patients mono-infected by HIV (HIV) and 16 healthy controls (HC), respectively.</p> <p>For phenotypic analysis, cells were stained with the following fluorochrome-labeled anti-human monoclonal antibodies CD4-APC, CD8-PerCP, CD25-PE, CD62L-FITC, CD45RA-FITC. CD45RO-PE, CD38-PE; being analysed by four-colour flow cytometry.</p> <p>Results</p> <p>We initially found that CD4<sup>+ </sup>T cell counts were significantly higher in co-infected, as compared to HIV groups. Moreover, CD4<sup>+ </sup>T Lymphocytes from co-infected patients presented significantly higher levels of CD45RO and CD25, but lower levels of CD45RA and CD62L, strongly indicating that CD4<sup>+ </sup>T cells are more activated under HTLV-1 plus HIV co-infection.</p> <p>Conclusion</p> <p>Our data indicate that HTLV-1/HIV co-infected patients progress with higher CD4<sup>+ </sup>T cell counts and higher levels of activation markers. In this context, it is conceivable that in co-infected individuals, these higher levels of activation may account for a faster progression to AIDS.</p
A profile of social isolation and the influence of demographics in older persons living in residential care, Durban, South Africa
Introduction: Residential care settings have shown high social isolation rates with incumbent risks necessitating
measurement to formulate health promotion policies.
Objective: To measure social isolation levels in older persons living in a lower socio-economic residential care
setting in South Africa.
Method: A cross sectional survey with older persons from four inner city residential care facilities. A researcher administered questionnaire was developed based on the Working Paper No.66, Oxford Poverty and Human
Development Initiative. Data were analysed to describe social isolation and assess the influence of demographics.
Results: The response rate was 72.14% (n = 277) and representative of the residential care population for age and
gender. Nearly half of the respondents (47.3%) met criteria for social isolation in terms of social network support
and density and almost 20% for perceived isolation through decreased levels of friendship.
Conclusion: Although residential care does not prevent social isolation, the residents in the setting may provide a
buffering in the provision of some social suppor
Interventions targeting social isolation in older people: a systematic review
This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. METHODS: Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL) were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. RESULTS: Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting. CONCLUSIONS: More, well-conducted studies of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. However, it appeared that common characteristics of effective interventions were those developed within the context of a theoretical basis, and those offering social activity and/or support within a group format. Interventions in which older people are active participants also appeared more likely to be effective. Future interventions incorporating all of these characteristics may therefore be more successful in targeting social isolation in older people.National Institute for Health Researc
Of prayer, and meditation : Wherein are conteined fouvertien devovte meditations for the seven daies of the weeke, both of the morninges, and eveninges : and in them is treyed of the consideration of the principal holie mysteries of our faithe ([Reprod.]) / written in the spanische tongue by the famous religious father, F. Luis de Granada,...
Collection : French books before 1601 ; 210.2Collection : French books before 1601 ; 210.2Contient une table des matière
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