Prevalence, Risk Factors, and Primary Causes of Disability Among Canadian Seniors: An Analysis of the 1986 and 1991 Health and Activity Limitation Surveys

An aging Canadian population highlights the need to examine the prevalence and causes of disabilities in seniors in order to be able to meet their health care needs. This report represents a step in that direction by examining disabilities among Canadian seniors using the 1986 and 1991 Health and Activity Limitation Surveys (HALS), two nation-wide surveys assessing the prevalence and impact of disabilities in the Canadian population. From these two surveys, disabilities among noninstitutionalized seniors, 65 years of age and older, were examined. Findings revealed that over 40% of seniors had at least one disability that impacted on activities of daily living and that one-quarter of disabled seniors were severely disabled. Risk factors that were associated with having a disability included marital status, language spoken, total household income, tenure of dwelling, number of people living in the household, and region of the country. Mobility and agility disabilities were the most common types of disabilities among seniors, with approximately 80% of disabled seniors having at least one mobility or agility disability. Further, mobility and agility disabilities tended to coexist, with approximately 70% of all seniors who had a mobility disability also having an agility disability. Arthritis/rheumatism was the medical condition that most often caused mobility and agility disabilities, followed by cerebrovascular disease, other forms of heart disease, and fractures/bone breaks. Women were more likely than men to have mobility and agility disabilities, with other risk factors associated with having mobility and agility disabilities similar to those for having any disability. The findings of this report indicate that many Canadian seniors suffer from disabilities, particularly disabilities that affect their mobility and agility. Therefore, to have a substantial effect on reducing the impact of disabilities on Canadian seniors, efforts should be directed toward finding effective medical interventions that reduce or control the most common conditions which result in mobility and agility disabilities. Further, finding means to reduce the negative impact that mobility and agility type impairments have on everyday living would serve to help disabled seniors.disability; seniors; HALS

A Review of the Literature and An Analysis of Mortality and Hospitalization Data to Examine Patterns of Injuries Among Canadian Seniors

Injury is a major cause of morbidity and mortality among seniors in Canada, resulting in large personal and economic costs. However, despite the importance injuries play in the health of seniors, with the exception of falls, there has been relatively little research aimed at understanding risk factors associated with injuries among this age group. Therefore, the purpose of this report is two-fold: a) to review the existing literature on the epidemiology of injuries among seniors and b) to examine in detail the epidemiology of injuries among Canadian seniors using data provided by the Health Statistics Division of Statistics Canada.seniors; injury; mortality

Does Cognitive Status Modify the Relationship Between Education and Mortality? Evidence from the Canadian Study of Health and Aging

Background: There is compelling evidence of an inverse relationship between level of education and increased mortality. In contrast to this, one study showed that among subjects with Alzheimer's Disease, those with high education are more than twice as likely to die earlier; however, this result has proven difficult to replicate. We examine the relationship between education and mortality by cognitive status using a large, nationally representative sample of elderly. Methods: A representative sample of 10,263 people aged 65 or over from the 10 Canadian provinces participated in the Canadian Study of Health and Aging in 1991. Information about age, gender, education, and an initial screening for cognitive impairment were collected; those who screened positive for cognitive impairment were referred for a complete clinical and neuropsychological examination, from which cognitive status and clinical severity of dementia were assessed. Vital status and date of death were collected at follow-up in 1996. The analysis was conducted using survival analysis. Findings: Cognitive status modifies the relationship between education and mortality. For those with no cognitive impairment, an inverse relationship between education and mortality exists. Elderly with cognitive impairment but no dementia, or those with dementia, are more likely to die early than the cognitively normal at baseline, but no relationship exists between education and mortality. Interpretation: These findings do not support previous work that showed a higher risk of mortality among highly educated dementia subjects.Alzheimer disease; cognition; dementia; education; epidemiology; etiology; mortality

Occupational Cancer Mortality In A Ten Percent Sample Of Males In The Canadian Labour Force, 1965-1979: The Establishment Of A Monitoring System

This study involved the establishment of a system for monitoring occupational cancer mortality in a ten percent sample of males in the Canadian labour force. The system was designed to detect associations between occupations and industries, and specific cancer sites, which merit more detailed study.;Occupational histories of approximately a ten percent sample of the Canadian labour force from 1965 to 1971 were linked to the Canadian mortality data base maintained by Statistics Canada to determine the mortality experience of the cohort between 1965 and 1979, using computerized record linkage. Standardized mortality ratios (SMR) were calculated for each occupation and industry code, for 33 cancer categories, with the total cohort as the reference population. In addition, occupations were grouped into four social classes so that the mortality for individual occupations could be compared to all occupations in the same social class. This provided an indirect method of controlling for confounders, on the theory that people in similar economic circumstances have similar lifestyles. The mortality of the ten percent sample was also compared to that of the Canadian population as a whole.;The file for analysis consisted of 415,316 males, of whom 41,196 had died by the end of 1979. Statistically significant results (P {dollar}\u3c{dollar} 0.05, 1 sided) with at least five observed deaths in the ten percent sample were compared with four other analyses of occupational cancer mortality, and five reviews of occupation-cancer associations. The results of the 10 percent sample were assessed according to specific criteria e.g. strength, and consistency. The strongest findings included the associations of plumbers and pipefitters with lung cancer, truck drivers with lung cancer, waiters and bartenders with cancer of the buccal cavity and pharynx, and carpenters with stomach cancer.;It was concluded that the above findings, as well as several others merit more detailed study in order to quantify risks and recommend preventive measures. Further follow-up of the ten percent sample would be valuable because the cohort was still relatively young as of 1979, and longer latent periods may be necessary to detect some occupation-cancer associations

Complexity Thinking and Methodology: The Potential of ‘Complex Case Study’ for Educational Research

publication-status: Acceptedtypes: ArticleComplexity theories have in common perspectives that challenge linear methodologies and views of causality, but in educational research, relatively little has been written explicitly exploring the implications of complexity theoretical perspectives for educational research methodology in general and case study in particular. In this paper, I offer a rationale for case study as a research approach that embodies complexity, and explore the implications of a ‘complexity thinking’ stance for the conduct of case study research that distinguish it from other approaches to case study. A complexity theoretical framework rooted in the key concepts of emergence and complexity reduction, blended using a both/and logic, is used to develop the argument that case study enables the researcher to balance the open-ended, non-linear sensitivities of complexity thinking with the reduction in complexity inherent in making methodological choices. The potential of this approach is illustrated using examples drawn from a complexity theoretical research study into curriculum change

"Walking the Line Between Structure and Freedom": A Case Study of Teachers' Responses to Curriculum Change using Complexity Theory

This thesis uses complexity theory to explore education in the context of a changing curriculum called ‘Opening Minds’. This new curriculum was introduced in the case study school in response to a wider curriculum change which emphasised ‘learning to learn’ and the development of ‘skills for the 21st Century’. In this study, a ‘complexity thinking’ theoretical framework was adopted, drawing especially on the work of Osberg and Biesta (Osberg et al., 2008, Osberg and Biesta, 2007, Biesta and Osberg, 2007) and Davis and Sumara (2006; 2007), paying particular attention to concepts of emergence and complexity reduction. Complexity theory, through the ‘logic of emergence’ offers a challenge to mechanistic approaches to understanding the world which, despite the work of postmodern and poststructural scholars in education, remains dominant in educational practice. The Opening Minds curriculum that is the focus of this case study demonstrated the potential to challenge this mechanistic approach, as the teachers expressed a desire to work in different, flexible and creative ways: this thesis therefore explores complexity theory’s challenge to a mechanistic approach in this particular case. It also addresses the relationship between Opening Minds and science education using complexity thinking. To facilitate exploration and analysis of the case, concepts of temporal and relational emergence and complexity reduction to develop a ‘complexity thinking’ understanding of concepts of agency/structure, power, identity and reflexivity. This entailed reconceptualisation of these ideas in a temporal-relational sense that explicitly incorporates a sensitivity to emergence. Specifically, an additional dimension to Emirbayer and Mische’s (1998) construction of multidimensional agency was added: that of creative agency. The research was conducted as a case study in which a ‘bricolage’ approach to data collection and analysis was used as part of an explicitly ‘complex’ methodology, addressing questions of the challenge of complexity reduction and ethics in research drawing on complexity theory. The findings indicated a challenge for teachers in negotiating tensions as they attempted to adopt approaches that could be considered ‘emergent’ alongside other ‘mechanistic’ practices. These tensions were explored in detail in relation to the concept of ‘reflection’, and in the interaction between science and Opening Minds. Bringing together the empirical and theoretical work in this study, it is suggested that mechanistic and emergent aspects may helpfully be viewed as a ‘vital simultaneity’ within the educational relationship (Davis, 2008) with the interaction between them facilitated by creative agency within a ‘pedagogy of interruption’ (Biesta, 2006). It was further argued that reflection could be used in responsive and flexible ways to support both learning and assessment as a crucial aspect of a pedagogy of interruption. Such a ‘contingently responsive and creative pedagogy’ may support the interaction between science and Opening Minds productively. It is suggested that complex approach to a pedagogy of interruption could support teachers in engaging with the creative and diverse elements of science or learning to learn curricula whilst maintaining the mechanistic aspects of teaching that support students in learning key concepts and skills

Sensory Impairments among Canadians 55 years and Older: An Analysis of 1986 and 1991 Health and Activity Limitation Survey

It has been well established that increasing age is associated with worsening health and decreasing functional ability among seniors, including conditions that lead to hearing and seeing impairments. The development of such sensory impairments can lead to a reduced quality of life by interfering with the ability to carry out activities of daily living and engaging in social activities. The review, which precedes the findings of this report, highlights the impact of sensory impairments on seniors (65 years and older) by first describing the prevalence of hearing and seeing impairments in this population and then examining the association between sensory impairment and physical, cognitive, and social functioning.HALS; aging

The Educational Attainment of Looked After Children - Local Authority Pilot Projects : Final Research Report

The aim of the research was to identify interventions that appeared to make the most difference in terms of both the educational experience and outcomes of the looked after children and young people participating in the local authority pilot projects. Data on attendance, exclusions and attainment were collected for a population of more than 600 children and young people. The research also analysed qualitative data, based on interviews with project co-ordinators, professionals, children and young people, and their parents and carers

Prevalence, Risk Factors, and Health Care Utilization for Injuries Among Canadian Seniors: An Analysis of 1994 National Population Health Survey

Despite the impact injuries have on hospitalization and mortality, relatively little research has been conducted examining injuries among seniors that do not require hospitalizations. Additionally, there is a paucity of research on the utilization of health care resources, other than hospitals, by injured older adults. The objective of this study is to examine the prevalence and characteristics of injuries not captured by the hospitalization and mortality data, risk factors associated with such injuries, and health care utilization among Canadian seniors using Statistics Canada's National Population Health Survey (1994). Specifically, this report has the following objectives: 1.To examine the prevalence of injuries among 55-64 year olds and seniors (65+). 2.To identify the causes, types, and locations of injuries. 3.To identify risk factors of injuries. 4.To compare health care use between injured and noninjured people.injuries; seniors; NPHS