Socioeconomic correlates of quality of life for non-Māori in advanced age: Te Puāwaitanga o Nga Tapuwae Kia ora Tonu. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ)

AIM

To establish socioeconomic and cultural profiles and correlates of quality of life (QoL) in non-Māori of advanced age.

METHOD

A cross sectional analysis of the baseline data of a cohort study of 516 non-Māori aged 85 years living in the Bay of Plenty and Rotorua areas of New Zealand. Socioeconomic and cultural characteristics were established by face-to-face interviews in 2010. Health-related QoL (HRQoL) was assessed with the SF-12.

RESULTS

Of the 516 non-Māori participants enrolled in the study, 89% identified as New Zealand European, 10% other European, 1% were of Pacific, Asian or Middle Eastern ethnicity; 20% were born overseas and half of these identified as 'New Zealand European.' More men were married (59%) and more women lived alone (63%). While 89% owned their own home, 30% received only the New Zealand Superannuation as income and 22% reported that they had 'just enough to get along on'. More than 85% reported that they had sufficient practical and emotional support; 11% and 6% reported unmet need for practical and emotional support respectively. Multivariate analyses showed that those with unmet needs for practical and emotional support had lower mental HR QoL (p<0.005). Reporting that family were important to wellbeing was associated with higher mental HR QoL (p=0.038). Those that did not need practical help (p=0.047) and those that reported feeling comfortable with their money situation (0.0191) had higher physical HRQoL. High functional status was strongly associated with both high mental and high physical HR QoL (p<0.001).

CONCLUSION

Among our sample of non-Māori people of advanced age, those with unmet support needs reported low HRQoL. Functional status was most strongly associated with mental and physical HRQoL.

Care for place: the contributions older people make to their communities

Older people are often positioned as passive recipients of care and dependent on resources or as overly productive and active. In this paper, we seek a more nuanced, middle ground between such stereotypes, by exploring the question: what contributions do older people make to the places they live in? Drawing on qualitative research from Aotearoa New Zealand, involving focus groups and interviews, we examine the varied and active ways many older people are involved in and contribute to their neighbourhoods and communities, or what we term 'care for place'. In particular, we identify the different forms of older people's care for place, including volunteering, activism, advocacy, and nurturing, and consider how these efforts positively impact on older people and the communities in which they live. Whilst we caution against assumptions that all older people should be productively involved, we argue that greater understanding of older people's care for place is central to challenging stereotypes of older people as either passive and dependent, or highly active.

The meaning of "aging in place" to older people

PURPOSE

This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with older people themselves.

DESIGN AND METHODS

Older people (n = 121), ranging in age from 56 to 92 years, participated in focus groups and interviews in 2 case study communities of similar size in Aotearoa New Zealand, both with high ratings on deprivation indices. The question, "What is the ideal place to grow older?" was explored, including reflections on aging in place. Thematic and narrative analyses on the meaning of aging in place are presented in this paper.

RESULTS

Older people want choices about where and how they age in place. "Aging in place" was seen as an advantage in terms of a sense of attachment or connection and feelings of security and familiarity in relation to both homes and communities. Aging in place related to a sense of identity both through independence and autonomy and through caring relationships and roles in the places people live.

IMPLICATIONS

Aging in place operates in multiple interacting ways, which need to be taken into account in both policy and research. The meanings of aging in place for older people have pragmatic implications beyond internal "feel good" aspects and operate interactively far beyond the "home" or housing.

The meaning of "aging in place" to older people

PURPOSE

This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with older people themselves.

DESIGN AND METHODS

Older people (n = 121), ranging in age from 56 to 92 years, participated in focus groups and interviews in 2 case study communities of similar size in Aotearoa New Zealand, both with high ratings on deprivation indices. The question, "What is the ideal place to grow older?" was explored, including reflections on aging in place. Thematic and narrative analyses on the meaning of aging in place are presented in this paper.

RESULTS

Older people want choices about where and how they age in place. "Aging in place" was seen as an advantage in terms of a sense of attachment or connection and feelings of security and familiarity in relation to both homes and communities. Aging in place related to a sense of identity both through independence and autonomy and through caring relationships and roles in the places people live.

IMPLICATIONS

Aging in place operates in multiple interacting ways, which need to be taken into account in both policy and research. The meanings of aging in place for older people have pragmatic implications beyond internal "feel good" aspects and operate interactively far beyond the "home" or housing.

Methodological consideration of story telling in qualitative research involving indigenous peoples

BACKGROUND

The use of storytelling in qualitative research involving Inuit compliments the oral tradition of Inuit culture. The objective of the research was to explore the use of qualitative methods to gain understanding of the experience of living with diabetes, with the ultimate goal of better formulating health care delivery and health promotion among Inuit.

METHODS

In-depth interviews were analyzed and interpreted using thematic analysis, open coding, and structured narrative analysis. Inuit community members acted as partners through all stages of the research.

RESULTS

''Because the more we understand, the more we're gonna do a prevention on it ... What I want is use my, use my diabetes, what I have ... so that it can be used by other people for prevention because they'll have understanding about it'' - an Inuk storyteller speaks to the value of education in health promotion. Key methodological issues found relevant to improving qualitative research with Indigenous Peoples include: (i) participatory research methods, grounded in principals of equity, through all phases of research; (ii) the presentation of narratives rather than only interpretations of narratives; (iii) understanding of culture, language, and place to frame the interpretation of the stories in the context within which storytellers experience living with their diabetes, and (iv) the value of multiple methods of analyses.

INTERPRETATION

This article comments on the challenges of conducting rigorous research in a cross-cultural setting and outlines methodologies that can improve qualitative narrative analyses research. The research highlighted experiences of living with diabetes and the ways in which storytellers coped and negotiated social support.

Living with diabetes on Baffin Island: Inuit storytellers share their experiences

BACKGROUND

The prevention and management of Type 2 diabetes mellitus has become a concern in Inuit communities across Canada. Although Inuit living with diabetes in remote Canadian Arctic communities could help guide the development of health services, their voices have not been heard. The experiences and perceptions of Inuit themselves are often overlooked in research. In this study, Inuit living in a small rural Arctic community on Baffin Island were invited to share their experiences of living with diabetes.

METHODS

A qualitative multi-case study approach was taken. In-depth interviews (n=4), field observations, and informal interviews over one month in the community were used to build and contextualize the cases. In-depth interviews were transcribed, and analyzed using holistic thematic analysis and open coding.

RESULTS

Accessibility was a concern with respect to foods, health knowledge, language interpretation and health services. In all methods of analysis, the importance of language and effective cross-cultural communication figured prominently. It was also evident that trust and rapport is crucial when discussing diabetes. There was strong interest in promoting diabetes education and prevention within the community.

INTERPRETATION

These findings suggest that current health education and services may not be adequate for this setting. The voices of Inuit should be integral in steering the direction of their future diabetes education and health service delivery. Focusing on language barriers may help to improve the accessibility of knowledge about diabetes and nutrition, and enhance relationships between non-Inuit health service providers and Inuit.

Enzymatic hydrolysis, grease permeation, and water barrier properties of zein isolate coated paper

An inexpensive zein-lipid mixture was isolated from yellow dent, dry-milled corn. Grease permeation through zein isolate applied to brown Kraft paper was found to be independent of loading levels at zein isolate levels above 30 mg/16 in.(2). The data shows that water vapor transmission rates depended on the amount of coating applied. Triacylglycerols were the most abundant lipid in milled corn but were absent in the zein isolate (perhaps due to hydrolysis by lipases). Zein from the paper was hydrolyzed enzymatically and the hydrolysis monitored by SDS-capillary electrophoresis. At an E:S ratio of 1:100 no further increase in the hydrolysate peak occurred after 10 and 30 min for alpha-chymotrypsin and pancreatin 8 x; however, zein and lipid were still present 1 h after hydrolysis by pancreatin 1 x.